Principles And Techniques Of Disinfection

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Antiseptic

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Substance for killing microorganisms on the skin bi

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Bioburden

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Blood, saliva, and other bodily fluidsb

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Broad spectrum activity

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Capable of killing a wide range of microbes

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Chlorine dioxide

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Effective, rapid acting environmental surface disinfectant or chemical sterilant

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Clinical contact surface

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Surface touched by contaminated hands, instruments, or spatter during dental treatments

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Disinfectant

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Chemical used to reduce or lower numbers of microorganisms on inanimate objects

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Environmental surfaces

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Surface within a health care facility that is not directly involved in patient care but may be contaminated. (Floors/walls)

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Fungicidal

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A product that is capable of killing fungi

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Glutaraldehyde

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Environmental protection agency registered high level disinfectant

Can also be used as a liquid sterilant when the immersion time is greatly increased

Good for items that can’t withhold heat sterilization

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Greener infection control

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Minimizing the environmental impact of infection control products and procedures

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High level disinfectant

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Hospital disinfectant with tuberculocidal activity

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Hospital disinfectant

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Ability to kill staphylococcus aureus,salmonella choleraesuis, and pseudomonas aeruginosa

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Housekeeping surface

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Surface that is not contaminated during dental treatment

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Immersion disinfectant

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Used for immersion (soaking) of heat sensitive instruments

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Intermediate level disinfectant

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Liquid with EPA registered as a hospital disinfectant with tuberculocidal activity. Used for operating surfaces

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Lodophor

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EPA reg intermediate level hospital disinfection

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Liquid sterilant

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Chemical used at room temp for items that are heat sensitive

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Low level disinfectant

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Destroys certain viruses and fungi used for general housecleaning

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Precleaning

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Removal of bioburden before disinfection

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Residual activity

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Action that continues long after initial application

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Reuse life

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Time period that a disinfectant should remain effective during use and reuse

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Shelf life

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How long a product may be stored

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Single used items

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Throw away after one use

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Sodium hypochlorite

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Surface disinfectant commonly know as bleach

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Sporicidal

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Capable of killing bacterial spores

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Sterilization

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Process that kills microorganisms

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Surface barrier

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Fluid resistant material used to cover surfaces likely to become contaminated

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Synthetic phenol

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EPA reg intermediate level hospital disinfectant with broad spectrum disinfecting action

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Touch surface

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Surface directly touched and contaminated during procedures

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Transfer surfaces

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Surface not directly touched but often contacted by contaminated instruments

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Tuberculocidal

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Capable of inactivating tubercluosis causing microorganisms

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Virucidal

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Capable of killing some viruses

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Surface barrier advantages vs disadvantages

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Advantages: protects surfaces that are not easily cleaned and disinfected, prevents contamination when properly placed, less time consuming, reduces handle and shortages of chemicals, provides patient with visual assurance of cleanliness, no damage.

Disadvantages: adds plastics to the environment after disposal, may be more expensive then precleaning and disinfectant, requires different sizes and shapes, may become dislodged during treatment

Surfaces typically with barries: head rest, control bottoms on chair, light handles and switches, evaluator hoses and controls, xray control switches, airway stringe handles, etc

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Precleaning and disinfecting advantages vs disadvantages

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Advantages: may be less expensive then surface barriers, does not add plastic to environment, some dentists do not like the appearance of barriers.

Disadvantages: Requires more time and therefor may not be done properly, not all surfaces can adequately cleaned, overtime chemicals ruin equipment, no method to determine if the microbes have been removed or killed, some disinfectants must be prepared freshly, chemicals.

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Disposal/ reusable products

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Air way syringe tips, high volume evaculator tips, impression trays, mirrors, prophy angles, Burs/diamonds, vaccine line traps

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Categories of disinfecting/sterilizing chemicals

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Sterilant - destroys microorganisms, including high numbers of bacteria spores- glutaraldehyde, hydrogen proxide, peracetic acid - use for heat sensitive reusable items (immersion only)

High-level disinfectant - destroys all microorganisms but not necessarily high numbers of bacterial spores - glutaraldehyde, hydrogen proxide, peracetic acid, ortho phthalaldehyde- used for heat sensitive reusable items- immersion only

Intermediate level disinfectant- destroys vegetable bacteria, most fungi, viruses, inactives (tuberculocidal) - EPA reg hospital disinfectant with label claim tuberculocidal activity and normally contains chlorine based products - used for clinical surfaces, non clinical surfaces with visible blood

Low level disinfectant - destroys vegetable bacteria, some fungi, some viruses, does not inactive tuberculocidal- EPA reg hospital disinfectant mainly quaternary ammonium compounds - used for housekeeping surfaces

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Ideal surface disinfectant

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Would rapidly kill a broad range of bacteria, would exhibit residual activity and mini meal toxicity and no damages to surface. Odourless and not expensive. Unfortunately this is not the case as there is no ideal one.

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Ideal surface disinfectant

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Would rapidly kill a broad range of bacteria, would exhibit residual activity and mini meal toxicity and no damages to surface. Odourless and not expensive. Unfortunately this is not the case as there is no ideal one.

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Disinfectant precautions

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Follow manufactures recommendation for:

Mixing/diluting

Application technique

Shelf life

Activated life

All safer warnings

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Iodophors

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EPA reg intermediate level hospital disinfectant with tuberculocidal action. Ideal for disinfectant after an infectious patient

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Synthetic phenol compounds

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EPA reg intermediate disinfectant with broad spectrum activity. Meaning it can kill a wide range of microbes. When diluted its used for surface cleaning

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Sodium hypochlorite

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Intermediate level disinfectant that is NOT EPA REG and it’s mean ingredient is bleach. Used for house cleaning not recommended for dental setting disinfectant

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Chemical classification of disinfectants

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High level - relatively short contact time and sterilant when used with prolonged contact time- semi critical items that cannot be tolerate heat sterilization

Intermediate level - hospital disinfectant with tuberculocidal activity - noncritical items or surfaces that have been contaminated with blood is saliva

Low level - non tuberculocidal- surfaces not contaminated with blood

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OSAP surfaces disinfectant reference chart

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No Alcohol -

Lysol IC disinfectant wipes - 1838-174675-RTU 10min Sultan health care

Sani Cloth wipes - 9480-5 RTU 3 min - PDI

Sodium hypochlorite -

Clorox spray - 30 sec

Clorox wipes - 2 min

Sodium bromide and chlorine -

Micro stat 2 tables - 5 min

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Evacuator system

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High volume evacuation greatly reduces the escape of saliva and splatter from patients mouth which reduces contamination of the dental team and clinical surfaces

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Ortho phthalaldehyde

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High level disinfectant and is effective in achieving high level disinfection with 12 mins of room temp. More expensive then glutaraldehydes.

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Traps

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Periodically the traps in the evacuated system need to be cleaned

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FDA cleared instrument immersion disinfectants for dentistry

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Glutaraldehyde:

Sterilant time 6-10hours

High level disinfectant 20-90 mins

Hydrogen peroxide:

S- 6 hours

H- 30 mins

Ortho- phthalaldehyde

S - no indicated for sterilization

H- 12 mins