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Question:
Discuss about the Infection Control Procedures.
 
 
Answer:
Introduction

This assignment aims to discuss all the aspects of infection control procedures in the dental clinic for preventing and avoiding contamination of patients as well as the dental clinic staff with microorganism that may cause diseases. The pathogens such as bacteria, viruses and prions cause infections and different forms of diseases that are deadly in nature such as typhoid, diphtheria and pneumonia. In a dental clinic, the most prevalent type of infections that may occur includes blood born infections and infections occurring from the saliva of the patient. A discussion regarding the procedures of controlling infection, room decontamination and the different will be discussed. In addition, it will also discuss the importance of cross infection of microorganisms in the dental office along with the procedures that are involved in the prevention of contamination procedures of sterilization between the patients and the dental professionals.

Infection control involves the procedures that are employed in the healthcare setting for controlling the spreading of infections. It is necessary for all the healthcare professionals to be alert regarding the area in which they work and the type of infections and diseases they may encounter on regular basis. The dental healthcare professionals should have an awareness regarding all the potential factors of risk in their working environment particularly when they have a contact with the patients. The aspects of prevention and control are important for the safety of the patients as well as the staff of the dental clinic. It deals with the procedures that can be employed for controlling the spread of blood-borne diseases and their process of emerging. The professionals of dental care have an obligation for maintaining the standards of practice and follow the procedures for controlling the spread of infections. In a dental clinic, the dentists should have knowledge for maintain the consistency of their profession and safeguard the health of their patients (Darby and Walsh 2014).

 
Infection Control Procedures in the Dental clinic
Hand Hygiene for dental staff

In a dental clinic, maintaining hand hygiene is the initial and most important step before beginning the work. It controls the spreading of pathogens and is mandatory in all the healthcare clinics. According to the Center for Disease Control and Infection, effective hand washing is a vital measure to prevent the spreading of pathogens (Wright et al. 2013). In addition, the drying of hands after washing is also an essential part of the procedure of hand washing. Dentists have an obligation to wash their hands before as well as after coming in contact with the tools, equipments and gloves while dealing with the patients. They must wash their hands properly in order to control the spreading of infections. For drying the hands paper towels can be used as it reduces the number of bacteria that are present on the hands and exhibit no significant spreading of microorganisms. According to khan et al. (2012), Jet air dryers can be used, which has the capability to blow the microorganisms from the hands up to two meters away. In addition, a warm air hand dryer can be used which can blow the microorganisms up to 0.5 meters away effectively (Mutters et al. 2014).

Sterilization in dental Clinic

Sterilization is a method for killing and destroying the microorganisms particularly the spores of bacteria that are most difficult to destroy as they are resistant in nature (Arrow 2015).  In dentistry, it is necessary to have an understanding regarding the concept of sterilization as well as disinfection. In the procedure of sterilization, the killing of almost all the microorganisms but in the method of disinfection the killing of microorganisms involves chemical and physical means. It is usually employed for killing the pathogens present on the inanimate objects or surfaces (Nejatidanesh et al. 2013). It does not ensure the level of safety, which is attained in the method of sterilization. Therefore, all the equipments and tools should be sterilized on a regular basis before starting the work. In addition the surfaces should be cleaned with disinfectants and all the materials that have been contaminated must be discarded. There are three most commonly used sterilization methods used namely, sterilization by dry heat, sterilization by steam under pressure, also known as autoclaving and sterilization by unsaturated chemical vapor (Khanghahi et al. 2013).

In the dental clinics, the instruments that are tolerant to heat should be sterilized by employing the above three methods but one thing should be kept in mind that the compatibility of the instruments should be checked against heat-tolerance. For instance, a few of the instruments may be tolerant with autoclaving but it may not have resistance against dry heat. Therefore, it is essential to know regarding the characteristics of the three discussed methods together with the capability of the instruments of the dental clinic that are meant to be sterilized (Ayatollahi et al. 2012). The instruments can be sterilized by the following:

Autoclaving or steam under pressure- Autoclaving is the most widely used method for sterling those types of instruments, which can tolerate heat as well as moisture. Sterilization by means of steam always needs the exposure of the instruments by keeping them with a direct contact with steam usually at a specific temperature and pressure for a required time for killing a d destroying the microorganisms. Autoclaves are available in different ranges from a small tableside model to a large sized (Laheij et al. 2012).

Unsaturated chemical vapor-It involves a similar operating principle like that of the autoclaves but with some significant differences. Like, instead of using the distilled water, the procedure involves heating with a pre-mixed solution. This mixture consists of water and a minimum percentage of formaldehyde, which is 0.23%. Besides that, the temperature and pressure for sterilizing are comparatively higher in comparison to sterilization by autoclaving (Khan et al.  2012).

Dry heat- One of the key advantages of this method is that it is cheap. It requires a high temperature and is an extended procedure. Before sterilizing the instruments by this method, it is necessary to dry the instruments. Several dentists have a preference to use dry heat sterilizers in the clinic rather than autoclaving due to the reason that numerous sharp cuttings edges are utilized. Before using, the dry heat sterilizers, the instruction manual should always be checked (Mustafa et al. 2015).

The concept of all the sterilization methods along with their procedures is necessary all staff of the dental clinic and in case if they are not familiar with these methods of sterilization, then training and guidance should be provided to them for preventing errors. In addition, the monitoring of sterilization should be carried out on a regular basis by using the biological, chemical and mechanical methods. The monitoring of sterilization can act as a best way for evaluating the conditions of sterilizations together with the effectiveness of the procedures that are carried out for sterilization (Nejatidanesh et al. 2013).

 
Personal Protective Equipment (PPE)

Personal protective equipment involves the physical barriers between the healthcare personnel and the potential infectious substance. It helps in preventing and protecting the health care personnel against the materials that are potentially infectious in nature (Haridi et al. 2016). For dental health professionals, the various components of PPE comprise facemasks, show covers, gowns, goggles and gloves. The procedure of using these components should always be determined by the protocols for controlling infection or according to the regulation of the countries. Generally, these equipments are discarded for avoiding the risk of transmitting infections from one patient to the other. PPE is concerned with the prevention of contact with the materials, which are potentially infectious. It creates a physical barrier between the healthcare personnel and the materials that are potentially infectious. According to the Occupational Safety and Health Administration (OSHA), the healthcare personnel for preventing blood-borne infections require PPE. Therefore, the dental staffs should oblige with PPE in their course of work (Oosthuysen, Potgieter and Fossey 2014).

Vaccination of the dental staff

For ensuring the measures of protection, the dentists need to have vaccination against diseases like hepatitis and diphtheria (Mutters et al. 2014). They dental staff may be exposed to infectious pathogens in the dental clinic. Therefore, they need to receive vaccinations against a number of infectious diseases such as diphtheria, influenza, hepatitis B, rubella and mumps. According to an epidemiological data, the dental staffs are exposed to a number of biological risks in the course of their work and this may result in infections and serious health damage. The practice of vaccination is one of the key tools to prevent the attack of infectious diseases (Bensel et al. 2013).

Room decontamination of dental clinic

Room decontamination involves the method of categorization of waste in the dental clinic as it helps in avoiding the spreading of microorganisms within as well as out of the dental clinic (Khanghahi et al. 2013). The key requirement of room decontamination is related with the separation of uncontaminated activities with the contaminated ones to minimize the risk of contamination of products, which are sterile. Wastes have been categorized into three types, namely clinical waste, surgical waste and general waste. Clinical wastes have microbes and should be stored in a bin. Surgical waste includes scalpels, needles, endodontic files, broken glass, dental burs and reamers that should be stored in the sharp waste container and should be discarded later on. The general waste can be stored in the general storage bin. It is essential to clean and disinfect the working area at the beginning of the say to the end of the day. All the dental equipments, trays, and the dental chair should be cleaned and disinfected on a daily basis. The dental staff can utilize antiseptic solutions as well as personal protective equipment for ensuring and effective procedure of room decontamination (Haridi et al. 2016).

 
Importance of Cross infection of microorganisms in the dental office

In cross contamination, the harmful microorganisms such as viruses and bacteria are transferred from one individual to the other. It can result in severe health complications of the dental staff as well as the patients (Khanghahi et al. 2013). Cross infections depend on the infection source and the body part, which gets affected. In a dental clinic, the transmitting of microorganisms may occur through physical contact, contaminated surgical equipments, sneezing and coughing. This risk of cross infection is more while carrying out medical procedures. It can occur within the body and can spread to the other parts of the body. The most common method for preventing cross infection can be done through aseptic techniques (Hedayati, Marjadi and Askarian 2014).

Prevention of contamination between patient and the dental professionals

In a dental clinic, the following steps are important in the prevention of contamination between patient and the dental professionals:

  • The dental staff should practice aseptic techniques carefully as it helps in minimizing the the spreading of infections associated with saliva and blood.
  • The instruments of the dental clinic should be organized properly.
  • The dental staff should perform sterilization and disinfection on a daily basis.
  • They should minimize the possible contamination resulting from the dental equipments
  • They should carefully discard the contaminated waste, so that the patients and the dental professionals should not be infected from the pathogens present in the contaminated waste materials.
  • The dental staff must remain healthy and they should be trained in a better to practice the methods for preventing contamination.
  • They must follow the National and local guidelines and must adhere to them for prevent contamination (Webb,Whittle and Schwarz 2015).
 
Conclusion

To sum up, all the discussed aspects of infection control procedures in the dental clinic are essential for preventing and avoiding the contamination of patients as well as the staff of the dental clinic with the microorganisms that can cause a number of diseases. The dental professionals must always try to carry out the procedures of infection control for preventing infections and improving the health of the patients who visits the dental clinics. They should always keep one thing in their mind that every patient may be carrier of an infectious pathogen and it can be transmitted to the dental professional and the other patients through contaminated materials and prosthesis. Hence, it is necessary to sterilize and disinfect them before using. On an overall basis, wearing personal protective equipment, room decontamination, sterilization, hand hygiene and vaccination are the most important priorities of the dental prosthetists for minimizing the transmission of microorganisms and protecting the patients as well as themselves effectively.

 
References

Arrow, P., 2015. Oral health of school children in Western Australia.Australian dental journal.

Ayatollahi, J., Ayatollahi, F., Mellat Ardekani, A., Bahrololoomi, R., Ayatollahi, J., Ayatollahi, A. and Owlia, M.B., 2012. Occupational hazards to dental staff. Dental research journal, 9(1).

Bensel, T., Pollak, R., Stimmelmayr, M. and Hey, J., 2013. Disinfection effect of dental impression tray adhesives. Clinical oral investigations, 17(2), pp.497-502.

Darby, M.L. and Walsh, M., 2014. Dental hygiene: theory and practice. Elsevier Health Sciences.

Haridi, H.K., Al-Ammar, A.S. and Al-Mansour, M.I., 2016. Compliance with infection control standard precautions guidelines: a survey among dental healthcare workers in Hail Region, Saudi Arabia. Journal of Infection Prevention, p.1757177416645344.

Hedayati, H., Marjadi, B. and Askarian, M., 2014. Barriers to standard precautions adherence in a dental school in Iran: A qualitative study.American journal of infection control, 42(7), pp.750-754.

Khan, A.A., Javed, O., Khan, M., Mehboob, B. and Baig, S., 2012. Cross infection control. Pakistan Oral & Dental Journal, 32(1).

Khanghahi, B.M., Jamali, Z., Azar, F.P., Behzad, M.N. and Azami-Aghdash, S., 2013. Knowledge, attitude, practice, and status of infection control among Iranian dentists and dental students: a systematic review. Journal of dental research, dental clinics, dental prospects, 7(2), p.55.

Laheij, A.M.G.A., Kistler, J.O., Belibasakis, G.N., Välimaa, H. and De Soet, J.J., 2012. Healthcare-associated viral and bacterial infections in dentistry.Journal of oral microbiology, 4.

Mustafa, E.A., Humam, A.K. and Al-Mosuli, T.A., 2015. Evaluation of Dental Assistant Awareness Concerning Infection Control Policy of Blood Borne Diseases. Journal of International Dental and Medical Research, 8(1), p.21.

Mutters, N.T., Hägele, U., Hagenfeld, D., Hellwig, E. and Frank, U., 2014. Compliance with infection control practices in an university hospital dental clinic. GMS Hygiene & Infection Control, 9(3).

Nejatidanesh, F., Khosravi, Z., Goroohi, H., Badrian, H. and Savabi, O., 2013. Risk of contamination of different areas of dentist's face during dental practices. International journal of preventive medicine, 4(5).

Oosthuysen, J., Potgieter, E. and Fossey, A., 2014. Compliance with infection prevention and control in oral health‐care facilities: a global perspective. International dental journal, 64(6), pp.297-311.

Webb, B.C., Whittle, T. and Schwarz, E., 2015. Oral health and dental care in aged care facilities in New South Wales, Australia. Part 3 concordance between residents' perceptions and a professional dental examination.Gerodontology.

Willis, E., Reynolds, L. and Keleher, H. eds., 2016. Understanding the Australian health care system. Elsevier Health Sciences.

Wright, J.T., Graham, F., Hayes, C., Ismail, A.I., Noraian, K.W., Weyant, R.J., Tracy, S.L., Hanson, N.B. and Frantsve-Hawley, J., 2013. A systematic review of oral health outcomes produced by dental teams incorporating midlevel providers. The Journal of the American Dental Association, 144(1), pp.75-91.

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