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PART 2
Preventive aspects
DR SANDEEP KUMAR
PG STUDENT
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INTRODUCTION
Dental environment is associated with a significant risk forexposure to various microorganisms.
Dental patient and dental health care workers may beexposed to variety of microorganisms via blood or oral or
respiratory secretions. For an infection to occur all three factors should be
present host, agent, environment
Effective infection control strategies are intended to breakone or more of these links in the chain thereby preventing
infections. A set of infection control strategies are needed to reduce the
risk of transmission of infectious diseases caused by bloodborn pathogens such as HBV and HIV.
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CATEGORIES OF TASK IN RELATION TO
RISK
CATEGORY 1
Task that involve exposure to blood, body
fluid, or tissues. Most tasks performed by the
dentist, dental hygienist, dental assistant and
lab technician falls in this category.
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CATEGORY 2
Tasks that does not involve routine exposure
to blood, body fluid or tissues.
Clerical or non professional workers who may
help clean up the office ,handle instruments
or impression materials or send dental
materials to the lab fits into this category.
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CATEGORY 3
Tasks that involve no exposure to blood, body
fluid or tissues. A front office receptionist ,book keeper or
insurance clerk who does not handle dental
instruments or materials belongs to a category
3 worker.
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OSHA REGULATIONS
(occupational safety and health act)
The American dental association and
occupational safety and health act
(OSHA)guidelines advice that all dental office
staff in category 1 and 2 and dentist be trained
in infection control to protect themselves and
their patients.
TEXTBOOK OF PREVENTIVE AND COMMUNITY DENTISTRY SOBEN PETER 6
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SUMMARY OF OSHA REGULATIONS
Provide Hepatitis B immunization toemployees without charge within 10 days ofemployment.
Require that universal precaution be observedto prevent contact with blood and otherpotentially infectious material .
Implement engineering control to reduceproduction of contaminated spatter, mists andaerosols.
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Implement work practice control precautions
to minimize splashing, spatter or contact of
bare hands with contaminated surfaces.
Provide facilities and instructions for washing
hands after removing gloves and for washing
skin immediately or as soon as possible after
contact with blood or other potentiallyinfectious material.
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Prescribe safe handling of needles and other sharpitems.
Prescribe disposable or single use needles, wires,carpules, and sharps as close to the place of use as
possible, as soon as feasible, in leak proof containersthat are closable. Containers must be red or bear abiohazard label. Teeth must be discarded into sharpscontainers.
Contaminated reusable sharp instruments must not be
stored or processed in a manner that requiresemployees to reach hands into containers to retrievethem.
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Prohibit eating, drinking, handling contact
lenses etc in contaminated environments. Ban
storage of foods and drinks in refrigeration or
other spaces where blood or infectious
materials are stored.
Place blood and contaminated specimen to be
shipped, transported or stored into suitableclose containers that prevent leakage.
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At no cost to employees, provide them with personal
protective protective instruments and clear directions
for use of appropriate universal barrier protection in
treating all patients.(PPE includes gloves, gowns)
Ensure that employees correctly use and discard PPEor properly prepare it for reuse.
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As soon as possible after treatment attend to
housekeeping requirements including floor
,sinks etc that are subject to contamination.
Provide a written schedule for cleaning.
Contaminated sharps are regulated waste:
Discard in hard walled containers
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Contaminated equipment that requires servicemust first be decontaminated or a biohazard labelmust be used to indicate contaminated parts.
Place reusable contaminated sharp instrumentsinto a basket in a hard walled container fortransportation to clean up area. Personnel mustnot reach hands into containers of contaminated
sharpsProvide laundering of protective garments used
for universal precautions at no cost to employees
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VACCINES FOR DENTAL HEALTH CARE
WORKERS The OSHA blood borne pathogens final rule requires that
employers make hepatitis B vaccinations available withoutcost to their employees who may be exposed to blood orother infectious materials.
In addition CDC recommends that all workers includingDHCW who might be exposed to blood or bloodcontaminated substances in an occupational setting bevaccinated for HBV
DHCW also are at risk for exposure to and possibletransmission other vaccine preventable disease.Accordingly, vaccination against influenza, measles,mumps, rubella and tetanus may be appropriate forDHCWS.
The book of hospital waste management Dr.D.B Acharya and Dr Meeta Singh 14
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PROTECTIVE ATTIRE AND BARRIER
TECHNIQUES
Gloves should always be worn by DHCW whenthere is potential for contacting blood, bloodcontaminated saliva, or mucous membranes.
Sterile gloves should be used: non sterile glovesare inappropriate for surgical procedures.
Before treatment of each patient DHCW shouldwash their hand and put on new gloves .
After treatment of each patient or before leavingthe dental operatory, DHCW should remove anddiscard gloves :and then wash hands.
TEXTBOOK OF PREVENTIVE AND COMMUNITY DENTISTRY SOBEN PETER 15
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DHCW should always wash hands and re-glovebetween patients
Surgical or examination gloves should not be
washed before use nor should they be washed,sterilized or disinfected for reuse.
Washing of gloves may cause wicking(penetrationof liquid through small holes) and is not
recommended. Disinfecting agents, oils, oil based solutions
,autoclaving cause detoriation of gloves.
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Surgical mask and protective eyewear should
be worn while performing dental procedures.
When a mask is used it should be changed
between patients or during patient treatment
if it becomes wet or moist.
Face shields or protective eyewear should be
washed with an appropriate cleaning agent.
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Reusable protective coating should be washedusing normal laundry cycle, according to theinstruction of the detergent and machine
manufacturers. Protective coating should be changed daily or as
soon as it becomes visibly soiled.
Protective garments and devices should be
removed before personnel exit areas of thedental office used for laboratory or patient careactivities.
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Aluminium foil or plastic covers should be used toprotect items and surfaces that may becomecontaminated by blood or saliva during use.
Between patients, the coverings should beremoved ,discarded and replaced with cleanmaterial.
Appropriate use of rubber dam ,high velocity airevacuation and proper patient positioning should
minimize the formation of droplets and aerosolsduring patient treatment.
Splash shield must be used in dental lab.
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HANDWASHING AND CARE OF HANDS
DHCW should wash their hands before and after treatingeach patient and after barehanded touching of inanimateobjects likely to be contaminated with saliva or blood.
Hands should be washed after removal of gloves becausegloves may become perforated during use and maycontaminate the hands of DHCW.
nonsurgical procedures soap
surgical antimicrobial hand scrub
When gloves punctured or torn replace immediately
Dhcw who have exudative lesions or weeping dermatitisshould refrain from all direct patient care and handling theinstruments
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For procedure involving multiple injections
with a single needle, the unsheathed needle
should be placed in a location where it will not
become contaminated .
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Cleaning and disinfection of dental
unit and environmental surfaces
Dental unit surfaces should be cleaned withdisposable toweling, using an appropriatecleaning agent and water as necessary.
Surfaces then should be disinfected using asuitable germicide.
A chemical germicide registered with EPA as ahospital disinfectant and labeled fortuberculocidal activity is recommended for
disinfecting surfaces that has been soiled withpatient material.(eg iodophors, phenoliccompounds)
TEXTBOOK OF PREVENTIVE AND COMMUNITY DENTISTRY SOBEN PETER 23
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A fresh solution of sodium hypochlorite prepared
daily is an inexpensive and effective intermediate
level germicide.
Concentrations ranging from 500 to 800 ppm ofchlorine are effective on environmental surfaces
that have been cleaned of visible contamination.
Intermediate or low level disinfectants are notrecommended for reprocessing critical or semi
critical dental instruments.
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Dental Unit Waterlines, Bio film, and
Water Quality
Water that meets EPA regulatory standards for drinkingwater (i.e.,
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Disinfection and dental laboratory
Lab materials and other items that have been
used in mouth should be cleaned and
disinfected before and after being
manipulated in laboratory.
A chemical germicide having at least an
intermediate level of activity is appropriate for
such disinfection.
TEXTBOOK OF PREVENTIVE AND COMMUNITY DENTISTRY SOBEN PETER 26
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Receiving area
It should be separate from production area. The worksurface should be cleaned and then disinfected dailywith appropriate surface disinfectant.
Incoming cases
All cases should be disinfected as they are received.
Containers should be sterilized or disinfected after each
use. Packing materials should be discarded to avoid cross
contamination.
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Production area Person working in production area should wear a clean
lab coat, face mask, protective eyewear, disposablegloves.
Work surfaces should be kept free of debris anddisinfected daily.
Brushes and other equipments should be disinfecteddaily.
Outgoing cases Each case should be disinfected before it is returned to
dental office.
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Use and care of hand pieces, anti retraction valves, and
other intraoral dental devices attached to air and water
lines of dental use
According to manufacturers, virtually all highspeed and low speed hand pieces in productiontoday are heat tolerant.
Manufacturers instruction for cleaning,lubrication and sterilization procedure should befollowed closely.
Internal surfaces of hand pieces may become
infected during treatment. Surface disinfection bywiping or soaking in liquid chemical germicides isnot an acceptable method.
GUIDELINES FOR INFECTION CONTROL IN DENTAL HEALTH-CARE SETTINGS --- 20032003 / 52(RR17);1-61WILLIAM G. KOHN ET AL
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Retraction valves may cause the aspiration of patient
material back into hand pieces and water lines.
Hence, antiretraction valves must be installed.
Water lines should be allowed to run and to
discharge water for several minutes at the beginning
of each day. Studies have shown that there is
reduction in microbial accumulation in water lines.
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All other reusable instruments which are
attached to but removable from dental unit air
or water lines should be cleaned and
sterilized.
Flushing at the beginning of each clinic day
also is recommended.
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Disposal of health care waste material
Waste produced in the course of health care
activities carries a higher potential for
infection and injury than any other type of
waste.
Whenever it is generated, safe and reliable
methods for its handling are therefore
essential.
TEXTBOOK OF PREVENTIVE AND COMMUNITY DENTISTRY SOBEN PETER 32
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Categories of health care waste
Infectious waste lab cultures, equipments in contactwith infected patients
Pathological waste human tissues, fluids
Sharps needles, blades
Pharmacutical waste drugs
Genotoxic waste contains genotoxic substanceswhich has carcinogenic properties eg: cytotoxic drugs
Chemical waste lab reagents, solventWaste with high content of heavy metal
Radioactive waste
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Handling storage and transportation of
health care wastes Health care waste should be segregated and waste material
should be sorted in different color coded plastic bags.
The other practices recommended are:
Sharps should be collected together regardless of whether
they are contaminated or not. Containers should bepuncture proof and tamper proof.
Where plastic or metal containers are unavailable, densecardboard containers with a plastic lining recommended.
Bags and containers for infectious wastes should be marked
with the international infectious substance symbol. Highly infectious waste should preferably be packed in red
bags and sterilized immediately by autoclaving.
TEXTBOOK OF PREVENTIVE AND COMMUNITY DENTISTRY SOBEN PETER 34
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Expired pharmaceutical should be returned to thepharmacy for disposal.
The identity of waste should be clearly marked oncontainer.
Waste with a high level of heavy metals like cadmium andmercury should be collected separately.
Aerosols containers if empty may be collected with generalhealth care wastes. They should not be incinerated.
Low level radioactive wastes may be collected in yellow
bags if destined for incineration. Non hazardous waste should be handled in same manner
as domestic refuse and collected in black bags
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Collection
The waste bags are tightly closed or sealed when theyare about three quarters full.
Waste should not be allowed to accumulate at point ofproduction.
Waste should be collected daily and transported tostorage site.
No bags should be removed until they are labeled.
The bags and containers should be replacedimmediately with new ones of same type.
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Storage
The waste should be stored in an appropriate area depending
upon quantity of waste produced and frequency of collection.
The storage area should have an impermeable hard standingfloor with good drainage. It should be easy to clean and
disinfect.
There should be water supply for cleaning purposes..
The storage area should allow easy access to staff.
Easy access for waste collection vehicle is essential.
There should be protection from sun.
It should be inaccessible for birds, insects.
It should have good lighting and ventilation.
It should not be located close to food sources.
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Transportation
Should be transported in wheeled trolleys or
carts not used for any other purpose.
Vehicle should be cleaned and disinfected
daily.
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Treatment and disposal technology for
health care waste
The treatment and disposal options are
incineration
chemical disinfection
wet thermal treatment
microwave irradiation
encapsulation
safe burying
inertization
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Handling of biopsy specimens
Biopsy instruments should be put in a
container with a secure lid to prevent
leakage.
Care should be taken when collecting
specimens to avoid contamination of the
specimen outside of the container.
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Precautions For Handling Extracted
Teeth
All persons who collect, transport or manipulateextracted teeth should handle them with sameprecaution as a specimen for biopsy.
Universal precautions should be adhered to
whenever extracted teeth are handled. All persons who handle extracted teeth in dental
educational settings should receive Hepatitis Bvaccines.
Teeth should first be cleaned of adherent patientmaterial by scrubbing with detergent and wateror by using ultrasonic cleaner.
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Person handling extracted teeth should wear
gloves.
Gloves should be disposed properly and hands
washed after completion of work activities.
Work surfaces and equipments should be
cleaned and decontaminated with an
appropriate liquid germicide after completionof work activities.
Disinfection Methods of Extracted human teeth Nikita V Lolayekar, Vidya Bhat S, Sham S Bhat 42
IN SOME STUDIES 10%
Formalin, 5.25% Sodium
Hypochlorite and autoclaving
were able to sterilize all the
teeth,but each method does
have its drawbacks.
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PREVENTION OF PSYCHOLOGICAL
HAZARD: STRESS
Stress is the most common psychological
condition that occurs in the dental profession.
Some studies indicate that dentists perceive
their profession as more stressful than other
occupations .
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PREVENTION
THE CAUSE OF STRESS SHOULD BE IDENTIFIEDAND EFFECTIVE MEASURES SHOULD BE TAKENTO ELIMINATE THE CAUSE.
SOME EFFECTIVE WAYS TO BREAK STRESS GOOD EXERCISE
INTAKE OF HEALTHY AND NUTRITIOUS DIET
GOOD INTERACTION WITH FAMILY AND COLLEAGUE
HEALTHY COWORKER RELATIONSHIP
DEVELOP A PATTERN OF HEALTHY LIVING CULTIVATE JOB SATISFACTION.
STRESS, BURNOUT, ANXIETY AND DEPRESSION AMONG DENTISTS
ROBERT E. R ET AL (2004) J AM DENT ASSOC, VOL 135, NO 6, 788-794. 44
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PREVENTION OF HAZARDS TO BODY
PARTS
Injury to eye may occur during operative procedures
which can be prevented by use of protective eye wear
or face shield
Noise has tendency to damage inner receptor cells ofcochlea. Noise of 120 db or more can damage hearingwithin a very short time. This can be prevented by use
of modern and well equipped low frequencyinstruments.
Infection prevention in dental practice
Dutch Working Party on Infection Prevention October 2007 45
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Regular oiling of handpieces recommended.
If noise produced by any other source whichhas tendency to damage the ear, the cause
should be identified and eliminated.Treatment rooms should be made acoustically
satisfactory.
Personal protection by using ear plugs andmuffs which reduce high intensity sounds by30 to 35 db should be used.
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Skin complaints make up about half of the
total number of occupational illness in health
care workers. Occupational skin disease
affects about 6 in 1000 workers.
This can be prevented by use of barrier cream
and gloves.
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The respiratory system can become a site of
infection or can be damaged by various dusts
or other materials.
Can be prevented by use of face mask and
regulation of aerosol production.
Infection prevention in dental practiceDutch Working Party on Infection Prevention October 2007 48
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PREVENTION OF PHYSICAL HAZARDS:
These include chemical dependency and
musculoskeletal problems that have a direct
relation to practising dentistry, such as
postural practices that may increase the risk oftwisting and contorting the body, varicose
veins,etc.
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PREVENTION OF
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PREVENTION OF
MUSCULOSKELETAL DEFORMITIES
Reduction of physical stress to the body by
adopting a correct posture is important in
everyday practice.
Low seated, closely supported dentistry with
certain physiotherapeutic exercises provide a
new ray of hope.
PREVENTING MUSCULOSKELETAL DISORDERS IN CLINICAL DENTISTRY AM DENT ASSOC, VOL 134, NO 12, 1604-1612. 2003 BETHANY VALACHI 50
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Prevention of Neck, Shoulder and Back DisordersErgonomic recommendations for minimizing therisks of back injuries focus on improving workingposture and equipment design. These include:
1) Change Posture - Alternate between sitting andstanding to reduce postural fatigue and maximize
postural variety, which helps to reduce staticmuscle fatigue.
PREVENTING MUSCULOSKELETAL DISORDERS IN CLINICAL DENTISTRY AM DENT ASSOC, VOL 134, NO 12, 1604-1612. 2003 BETHANY VALACHI 51
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2) Use Support - When sitting or standing, dont leanforwards or stoop in an unsupported posture forprolonged periods. If you are sitting, sit up straight orrecline slightly in a chair with good back support, anduse a good footrest if necessary. If you are standing forprolonged periods try to find something to help youlean against.
3) Safe reaching - Avoid having to reach awkwardly toequipment and work close to the patient. Keep the
items used most frequently within a distance of about20 inches (50 cm). Use assistants to help moveequipment into this zone.
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4) Normal arm posture - Keep elbows and upperarms close to the body and dont raise and tensethe shoulders when working. Also, ensure thathand postures are not deviated because this
could lead to wrist problems.5) Use Comfortable Equipment - Use equipment
that isnt too heavy, that can be used withoutawkward upper body posture, and that feels
comfortable to use. Ergonomically designedequipment helps to minimize stresses on theupper extremities and the back.
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6) Manage Time - Avoid long appointments
where possible, or intersperse these with
frequent short rest breaks in which you
change posture and relax the upperextremities.
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PREVENTION OF PERCUTANEOUS
EXPOSURE
Reducing Inoculation Injuries:
The majority of inoculation injuries sustained in thedental environment are avoidable.
For example:For re-sheathing local anestheticneedles manually
The barrel of the syringe is held in one hand and theneedle cap is scooped up from a flat, hard surface.
Only when the needle is covered by the cap shouldthe second hand be used to complete the re-sheathing and secure the needle cap.
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Cover existing wounds, skin lesions and all breaks inexposed skin with waterproof dressings
Remember that gloves cannot be relied upon to form
an intact barrier.
The longer that gloves are worn, the more likely that:
The number and size of holes in gloves will
increase as a consequence of physical trauma. Latex gloves become porous due to hydration of
latex.
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Avoid sharps usage where possible.
When sharps have to be used, exercise particularcare in handling and disposal.
Each member of the team should understand inadvance what tasks they are to perform.
Use approved sharps containers that conform tostandards for off-site disposal.
The book of hospital waste management
Dr.D.B Acharya and Dr Meeta Singh 57
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Out of the reach of children.
As close as is practical to the point of use.
Place all disposable sharps in sharpscontainers immediately after use.
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Discard disposable items as a single unitwhere possible, rather than dismantling theminto their components.
Do not overfill sharps containers.
Secure the lids of sharps containers prior to
transfer to a licensed authority for subsequentincineration.
The book of hospital waste management
Dr.D.B Acharya and Dr Meeta Singh 59
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Avoid wearing open footwear in situationswhere blood may be spilt or where sharpinstruments or needles are handled.
Clear up spillage of blood promptly anddisinfect surfaces.
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Wear gloves:
Where contact with blood or other body fluids (e.g. saliva) isanticipated.
To clean equipment prior to sterilization or disinfection.
When handling disinfection fluid
When cleaning up spillages.
The book of hospital waste management Dr.D.B Acharya and Dr Meeta Singh
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PREVENTION OF CHEMICAL HAZARDS
Mercury health hazard:
It is known that high exposure to mercury
vapour can cause biological and neurological
damage . The use of sealed amalgam capsuleswith reduced mercury level, water irrigation
and high suction, good ventilation and proper
collection and discarding of amalgam havegreatly reduced the mercury hazard .
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Prevention
Use of precapsulated alloys
Good ventilation
Excess and spilled mercury should be collected infixer containing break resistant bottles.
Do not touch mercury with bare hands becausemercury gets absorbed quickly through the skin.
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STANDARD OPERATIVE PROCEDURES TO
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STANDARD OPERATIVE PROCEDURES TO
PREVENT MERCURY HAZARDS
Clean the area around spill Wear heavy duty latex gloves or two layers of latex gloves.
A regular syringe can be used to suck the mercury. Smallspills can be managed by using stiff paper to scoop andgather the mercury . Large droplets of mercury may besucked up by a syringe.
The collected mercury should be poured into a plasticcontainer with 5 to 10 ml of water.
Seal the container that contains mercury by using scotch
tape Put the used syringe in a separate plastic container for
further use.
Dispose off the used gloves carefully after disinfection
The book of hospital waste management Dr.D.B Acharya and Dr Meeta Singh
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Anaesthetic gases in the dental office:
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Anaesthetic gases in the dental office:
This is a specific hazard for those who use
nitrous oxide gas regularly over an extended
period of time .
Adequate ventilation and proper
handling by a trained dental staff
helps to overcome this hazard.
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PREVENTION OF RADIATION HAZARDS
Ionizing radiation: The use of X-ray machinesin the dental office exposes dentists toionizing radiation
Non-ionizing radiation: introduction ofcomposites and other resins, in addition tothe introduction of lasers in dentistry, exposes
dentists to non ionizing radiations.
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Radiation Protection and Prevention
The goal is to minimize the radiation exposure
of office personnel and patients during
radiographic examination.
TEXTBOOK OF RADIOLOGY:WHITE AND PHAROAH 67
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Following are the recommendations for safety ofthe practitioner:
Buying of standard radiographic equipment,which rigidly follows the National Council onRadiation Protection and Measurements (NCRP)and ISI recommendations.
Well-collimated and filtered beam of at least 1.5mm of aluminium filtration should be available.
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Special conch shell designs are recommendedfor the X-ray departments.
During construction use a special bariumplaster, which absorbs the scattered radiation.
Lead aprons should be routinely used for allpatients, and for all children special thyroidshield should be used.
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Use of fast films, i.e. Ekta (E) speed to lower
exposure times.
Dental surgeons must use a film badge service
provided by the Bhabha Atomic Research
Centre (BARC), Mumbai for personnelmonitoring.
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Wear gloves when exposing radiographs and
handling contaminated film packets.
Use heat-tolerant or disposable intraoral deviceswhenever possible (e.g., film-holding andpositioning devices).
Transport and handle exposed radiographs in an
aseptic manner to prevent contamination ofdeveloping equipment
TEXT BOOK OF ORAL MED -ANIL GOVINDRAO GHOM(1ST EDITION) 71
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PREVENTION OF INFECTIOUS HAZARDS
Various types of infections like HIV, Hepatitis,
Tuberculosis etc are potential threat for
dentists.
They may be spread from one patient to otherif adequate sterilization protocols not
followed.
Every care should be taken to prevent thisfrom happening.
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The risk of nosocomial transmission of HIV, HBV,and other blood borne pathogens can beminimized if health-care workers use the followinggeneral guidelines:**
Take care to prevent injuries when using needles, scalpels,
and other sharp instruments or devices; when handlingsharp instruments after procedures; when cleaning usedinstruments; and when disposing of used needles.
Do not recap used needles by hand; do not remove usedneedles from disposable syringes by hand; and do not
bend, break, or otherwise manipulate used needles byhand.
GUIDELINES FOR INFECTION CONTROL IN DENTAL HEALTH-CARE SETTINGS --- 2003
2003 / 52(RR17);1-61WILLIAM G. KOHN ET AL 73
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Place used disposable syringes and needles,
scalpel blades, and other sharp items in
puncture-resistant containers for disposal.
Locate the puncture-resistant containers as
close to the use area as is practical.
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Use protective barriers to prevent exposure to
blood, body fluids containing visible blood,
and other fluids to which universal
precautions apply. The type of protective barrier(s) should be
appropriate for the procedure being
performed and the type of exposureanticipated.
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Immediately and thoroughly wash hands andother skin surfaces that are contaminated withblood, body fluids containing visible blood, orother body fluids to which universal precautions
apply.
USE OF GLOVES: Gloves should always beavailable to health-care workers who wish to use
them.
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The Center for Devices and Radiological Health, FDA,has responsibility for regulating the medical gloveindustry.
The following general guidelines are recommended:
Use sterile gloves for procedures involving contact withnormally sterile areas of the body.
Use examination gloves for procedures involvingcontact with mucous membranes, unless otherwiseindicated, and for other patient care or diagnostic
procedures that do not require the use of sterilegloves.
Change gloves between patient contacts.
GUIDELINES FOR INFECTION CONTROL IN DENTAL HEALTH-CARE SETTINGS --- 2003
2003 / 52(RR17);1-61WILLIAM G. KOHN ET AL 77
PREVENTION OF TB
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General Recommendations
A)Educate all DHCP regarding the recognition of signs,
symptoms, and transmission of TB .
B) Conduct a baseline TST, preferably by using a two-steptest, for all DHCP who might have contact with persons with
suspected or confirmed active TB, regardless of the risk
classification of the setting.
C) Assess each patient for a history of TB as well as symptoms
indicative of TB and document on the medical history form .
GUIDELINES FOR INFECTION CONTROL IN DENTAL HEALTH-CARE SETTINGS --- 20032003 52 RR17 1-61WILLIAM G. KOHN ET AL
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E)Evaluate the patient away from other patients and
DHCP. When not being evaluated, the patient shouldwear a surgical mask or be instructed to cover mouthand nose when coughing or sneezing .
F) Defer elective dental treatment until the patient isnon infectious .
G) Refer patients requiring urgent dental treatment toa previously identified facility with TB engineeringcontrols and a respiratory protection program .
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Immunization Against Blood-Borne Viruses and
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Immunization Against Blood Borne Viruses and
Prevention of Hepatitis B
All health care workers (HCWs) who have directcontact with patient's blood or other potentiallyinfectious body fluids or tissues, should be
immunized against Hepatitis B.
Successful immunization also provides protection
against Hepatitis D (delta agent) which can only
replicate in the presence of Hepatitis B infection.
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Immunization does not diminish the need tofollow rigorous cross-infection procedures.
To date, no effective vaccines have been
produced that prevent
HIV infection
Hepatitis C infection
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PREVENTION OF MEDICOLEGAL HAZARDS
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Medico legal hazards are of a quite different
nature from the risks already discussed.
Complications of dental practice
Professional negligence
Professional misconduct
Problems with employees or partnerships
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PREVENTION
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PREVENTION
The dental surgeon can minimize medicolegal risks in hispractice by
Maintaining correct dental records.
Obtaining informed consent from patient/parents in
case of children.
By attending conferences, workshops and continuingdental education programs to keep updated with thelatest technologies and knowledge.
Lastly the dental surgeon can cover himself usingProfessional Indemnity Insurance in event of amalpractice suit.
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CONCLUSION
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CONCLUSION
Occupational health risks are present in every
profession.
With advent of advanced technology, no matter howbeneficial it is, can exert a negative impact also on
some members of the population.
Dentists are one such professional group. In spite of
these hazards we cannot refrain from providing care
and serving community.
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Once identified and recognized as risk, newguidelines, precautions and protocols shouldbe rapidly instituted to reduce or eveneliminate the hazards.
Proper care and proper handling ofinstruments would play a significant role inelimination of hazards which exists in this
profession and would provide a betteropportunity to serve the people.
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REFERENCES
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REFERENCES
TEXTBOOK OF PREVENTIVE AND COMMUNITYDENTISTRY SOBEN PETER (1ST EDN)
PREVENTIVE DENTISTRY DR.SATISH
CHANDRA,DR.SHALEEN CHANDRA.
THE BOOK OF HOSPITAL WASTE MANAGEMENTDR.D.B ACHARYA AND DR MEETA SINGH
TEXT BOOK OF ORAL MED -ANIL GOVINDRAO
GHOM(1ST EDITION)
TEXT BOOK OF PREVENTIVE AND COMMUNITYDENTISTRYSS HIREMATH(1ST EDITION)
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STRESS, BURNOUT, ANXIETY AND DEPRESSION AMONG DENTISTS
ROBERT E. R ET AL (2004) J AM DENT ASSOC, VOL 135, NO 6, 788-794.
INFECTION PREVENTION IN DENTAL PRACTICE DUTCH WORKING
PARTY ON INFECTION PREVENTION OCTOBER 2007
PREVENTING MUSCULOSKELETAL DISORDERS IN CLINICAL
DENTISTRY AM DENT ASSOC, VOL 134, NO 12, 1604-1612. 2003BETHANY VALACHI
GUIDELINES FOR INFECTION CONTROL IN DENTAL HEALTH-CARE
SETTINGS --- 2003
2003 / 52(RR17);1-61WILLIAM G. KOHN ET AL DISINFECTION
METHODS OF EXTRACTED HUMAN TEETH NIKITA V LOLAYEKAR,
VIDYA BHAT S, SHAM S BHAT
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Thank you