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42 Cards in this Set
- Front
- Back
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1. How is the number of organisms in the normal flora held in check?
Four mechanisms.. |
1. Rapid epithelial turnover w/ desquamation
2. Host immunologic factors 3. Dilution of salivary flow 4. Competition between oral organisms for available nutrients and attachment sites |
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2. Which hepatitis virus has the most serious risk of transmission for unvacinated dentists?
Why? |
Hep. B
Minute quantities of the virus have been found capable of transmitting the disease It's in high concentration in saliva |
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3. What is a mycobacterial infection?
How is Mycobacterium TB spread? |
Mycobacterium tuberculosis
Through exhaled aerosols from infected lungs to lungs of another individual **coughing, sneezing, speaking Also spread through inadequately sterilized instruments **highly resistant to desiccation and most chemical disinfectants |
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4. What is asepsis?
What is sepsis? What is sterility? What is sanitization? |
Refers to the avoidance of sepsis
The breakdown of living tissue by the action of microorganisms Freedom from viable forms of microorganisms Reduction of the numbers of viable microorganisms to levels judged safe by public health standards |
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5. What is an anti-septic?
What is a disinfectant? What is the main difference between the two? |
A substance applied to living tissue that prevents the multiplication of organisms capable of infection
A substance used on non-living surfaces that prevents the multiplication of organisms capable of causing infection Antiseptic --> used on living tissue Disinfectant --> inanimate objects |
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6. What are four pathways for potential cross-contamination and infection?
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1. Patient to dental team
2. Dental team to patient 3. Patient to patient 4. Dental facility to community |
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7. How can infection be spread from patient to dental team?
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1. Through breaks in the skin
2. Injury exposure 3. Through mucous membranes (eyes) |
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8. How can infection be spread from dental team to patient?
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1. Bleeding into patient's mouth
2. Bleeding onto items used in patient's mouth 3. Respiratory contamination |
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9. How can infection be spread from patient to patient?
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1. Improper hand washing & gloving
2. Improperly cleaned and sterilized instruments 3. Improperly cleaned & disinfected operatory surfaces |
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10. How can infection be spread from dental office to community?
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1. Improper waste management
2. Sending contaminated items to dental lab 3. Wearing contaminated clothing out of office/clinic |
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11. How is employee health safeguarded?
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Vaccine recommendations
-Hep. B -Polio -Tetanus -Rubella -Rubeola -Influenza -Varicella |
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12. If there is an occupational exposure what should be done?
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1. Make HBV vaccine available
2. Document route of exposure 3. Inform patient of accident & obtain consent for testing **test for HBV, HVC, HIV 4. Employee's blood is tested for baseline 5. Post-exposure prophylaxis if medically indicated |
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13. What is the goal of the aseptic technique?
What are some examples of the aseptic technique? (four things) |
Use procedures that break the circle of infection and reduce the potential for cross-contamination
1. Basic cleaning principles 2. Handwahsing 3. Single use disposables 4. Keep sterilized instruments wrapped until use |
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14. What is the single most important infection control precaution?
When is proper hand washing done? |
Hand asepsis
1. Before treatment 2. After glove removal 3. Between patients 4. After handling contaminated items 5. Before leaving treatment areas |
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15. What are the agents used in hand washing?
What are some antiseptic agents? |
Plain soap for non-surgical procedures
Antiseptic agents for surgical procedures 1. Chlorhexidine gluconate -affective against gram positive -builds up over day -> more effective 2. Iodophors -don't use on pregnant women -effective for gram pos. & neg. 3. Triclosan |
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16. What type of antiseptic hand wash agents should not be used?
What does universal precaution include? |
Ones that remove skin oils, dry skin and exacerbate dermatitis
1. Wear barrier devices (gloves, masks, eye protection) 2. Decontaminate or dispose of all surfaces that are exposed to patient blood, tissue or secretion 3. Avoidance of touching surfaces w/ contaminated gloves or instruments |
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17. What does a protective attire include?
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1. Face mask or chin length shield
-change when become wet -change after each patient -doesn't sub for surgical mask 2. Disposable gloves 3. Protective clothing 4. Protective eye wear 5. Side shields |
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18. What are characteristics of protective clothing?
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1. High neck and long sleeves
2. Fluid resistant 3. Material doesn't allow blood or infectious materials to pass through it |
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19. What is used in surgery?
What is worn for routine dental procedures? |
Disposable gowns
Cotton or polyester coats or clinic jackets **protective garments or covers must be removed before leaving workplace |
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20. Why would disposable environmental barriers be used?
What are some disposable barriers? |
1. Reduce the disinfectants that have to be used
2. Reduce time in preparing treatment area for next patient Plastic covers for chairs, counter tops, handpiece tubing, light handles |
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21. What is the instrument recirculation system divided into?
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1. Receiving
2. Cleaning 3. Packaging 4. Sterlization 5. Storage 6. Dispensing area |
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22. What is the classification of patient care instruments, items and surface as per CDC?
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1. Critical
-instruments that touch bone or penetrate tissue 2. Semi-critical -items that touch mucous membrane but do not touch bone or penetrate tissue 3. Non-critical -equipment and environmental surface that come into contact only w/ intact skin |
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23. Why is the steam autoclave more efficient than dry heat?
How is the steam created? How should the instruments be wrapped? |
Moist heat is more efficient b/c its effective at lower temperatures and requires less time
**faster than dry heat Steam is created under pressure Packaged to allow for free flow of steam **autoclave bags or wrapped in paper or cotton wraps |
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24. What biologic indicator provides the best challenge for monitoring the effectiveness of the sterilizer?
How often should biologic monitoring be done? What is the temperature and time needed for steam heat sterilization? |
Bacillus spores
**extremely resistant to heat so used to test the reliability of heat sterilization Once a week 125 to 132 degree C for 16 minutes |
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25. What is dry heat must commonly used to sterilize?
How much time is need for dry heat sterilization? |
Glassware and bullky items that can withstand heat but are susceptible to rust
Need warm up time and it take more time sterilize items than steam **6 to 12 hours at 121C (250F) |
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26. What are chemical disinfectants used on?
When is chemical disinfection used? |
Used on instruments that cannot withstand the temperatures for heat sterilization
Used when absolute sterility is not required and if gaseous sterilization is not available |
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27. How is a chemical disinfectants capabilities classified?
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High, intermediate or low based on ability to inactivate...
-vegetative bacteria -tubercle bacilli -bacterial spores -lipid & non-lipid viruses |
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28. What does classification of chemical disinfectants do?
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1. High
-biocidal activity for all microbes & spores 2. Intermediate -all microbes but not spores 3. Low -vegetative bacteria and lipid viruses |
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29. What are some acceptable chemical disinfectants?
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1. Gluteraldehyde
2. Iodophors 3. Chlorine compounds 4. Formaldehyde **Glutaraldehyde 2% compounds are the most commonly used |
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30. When using chemical disinfectants what should be done to ensure maximum disinfection?
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1. Wash blood and other materials off instruments
2. Proper formulation & proper time of instrument exposure 3. Rinse off instruments so they are free of chemicals |
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31. When selecting products for environmental surface and equipment asepsis what are the categories?
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1. EPA registered
2. Hospital level disinfectant 3. Tuberculocidal (CDC criterion) -requires 10 minutes or less 4. Virocidal to lipophilic viruses (HIV) polio, cocksackle and rhinovirus in 10 minutes |
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32. What does a hospital level disinfectant kill?
What is the most commonly technique for environmental surface disinfection and asepsis procedures? |
1. Staph aureus
2. Salmonella choleraesuis 3. Pseudomonas aeruginosa Spray, wipe, spray technique |
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33. What is the difference in dental waterline asepsis for surgical and non-surgical?
How long must high speed handpieces be run to discharge water and air at the beginning of each clinic session and between each patient? How must the quality of water used be? |
Surgical
-sterile water or physiologic saline used as an irrigant Non-surgical -anti retraction valves present to prevent back flow of water in lines to patient 30 seconds **use a barrier or container to catch the discharge At least equal to drinking water **no more than 1 coliform per 100ml |
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34. What is appropriate for dental laboratory asepsis?
What is the general procedure for disinfection of dental impression, casts and appliances? |
Chemical germicide having at least intermediate level of activity (tuberculodical hospital disinfectant)
1. Rise w/ tap water 2. Spray w/ intermediate disinfectant 3. Place in headrest cover for 20 min 4. Remove & rinse w/ water |
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35. How is a biopsy specimen handled?
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1. Place in rigid, puncture proof container w/ secure lid
2. Biohazard symbol on label 3. Avoid contamination of outside of container |
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36. How should extracted teeth be disposed?
How should extracted teeth be stored? |
As regular medical waste
**do not dispose in medical waste intended for incineration 1. Clean teeth of visible debris 2. Place in household bleach diluted 1:10 w/ water 3. Use universal precautions **In Pa patients can keep extracted teeth |
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37. What are the regulated waste categories for the dental office?
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1. Sharps contaminated w/ blood or saliva
2. Non-sharp solids saturated w/ blood/saliva (i.e. gauze) 3. Liquid body fluids 4. Tissues 5. Microbiological materials containing body fluids |
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38. Are blood and saliva stained items considered regulated waste?
What is considered regulated waste? |
No
Items saturated w/ blood and saliva |
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39. What is the clean technique?
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Generally used in office based surgery
Depends on proper dress, hand washing and gloving procedures Disinfection of surfaces and autoclaving of instruments |
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40. What is the sterile technique?
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Used in office based surgery when skin incisions are made or in hospital
Depends on proper hand washing techniques, use of sterile towels to dry hands, sterile gowns and gloves and sterile drapes on all mayos, tables and patient |
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41. What are the big do not's?
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1. Don't pick up instruments or suction tip or tubing that hits the floor
2. Don't use counter top for used instruments, syringe, or bloody gauze 3. Do not leave cubicle wearing bloody glooves 4. Do not remove blue sterilized towel from mayo stand to place instruments on non-sterile stainless steel mayo tray |
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42. What are the big do nots?
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5. Do not hold cap w/ fingers when replacing needle into cap
6. Do not place bag w/ forceps on opened sterilized instruments 7. Do not leave sharps on trays that are returned to the sterilization area |
