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     Infection Control
 
We at Dental Specialities are committed to Infection control; and sterilization and disinfection is a top priority for us. The most state of the art and modern techniques are followed to maintain a safe and hygenic environment. Dental patients and dental health care workers (DHCW) may be susceptible to many blood borne, water borne or air borne infections like HIV, Hepatitis etc. In today?s dental practice infection control procedures are standardized and rigidly followed so as to ensure a safe hygienic working environment for all.

Our Protocol

Techiniques Methods
Barrier techniques Use of gloves, masks, protective eye wear, protective clothing such as aprons, disposables such as needles, syringes, gloves, wipes, suction tips, scalpel blades, glasses etc. & employment of proper hand washing methods & high-vacuum evacuation.
Cleaning of instruments, equipment & surroundings Meticulous cleaning of equipment & instruments are carried out prior to subjecting them to disinfection / sterilization procedures.
Disinfection Use of chemical disinfectants such as: glutaraldehyde, ethyl alcohol, isopropyl alcohol, sodium hypochlorite, iodophores & iodines, phenolics, Pursue, formaldehyde.
Sterilization Using steam under pressure, hot air and boiling water& additional methods to sterilize hand-pieces.
Treatment techniques Treatment techniques are selected and employed giving prime importance to infection control.
Equipment & materials used Internationally certified Autoclave Hot Air Oven with microbial indicator. Vapoclave Disinfectants Glass bead sterilizer
Waste disposal Contaminated wastes are chemically treated prior to disposal. Proper and hygienic waste disposal is carried out. Bio 2000 is used to flush out the water lines and kills the bacteria.
Preventive measures adopted by staff Doctors & Staff are very much aware of the importance of proper infection control measures. They adhere to all norms in this respect. Doctors are all vaccinated against Hepatitis B.


Standard Precautions
  • Standard Precautions are utilized for all contact with a patient's blood, body fluids, secretions, and excretions (except sweat) and/or mucous membranes.
  • The use of appropriate barrier precautions like gloves and face masks will reduce transmission of infection from the DHCW to the patient and from the patient to the DHCW.
  • DHCWs working in Oral Health Services who are not previously immune to Hepatitis B are strongly encouraged to undergo vaccination with the Hepatitis B vaccine.
Barrier Precaution Guidelines
  • Hand hygiene is performed:

    • before and after each patient contact
    • after removing examination gloves
    • Immediately after contact with blood
    • body fluids or mucous membranes.
  • Gloves are worn for anticipated contact with:
    • blood
    • all body fluids, secretions and excretions regardless of whether they contain visible blood or not
    • mucous membranes
    • non-intact skin
    • Handling objects or surfaces soiled with blood or body fluids
  • Masks, fluid impervious or surgical (i.e., 3M 1800) are worn.

  • Masks are changed between patients or during patient treatment if it becomes wet or moist
  • Protective eye wear/face shield are worn

  • Needles and sharp instruments

  • Used needles, disposable syringes, scalpel blades, and other sharp items are disposed of in a designated puncture-resistant biohazard container.
  • Control of environmental contamination

    • Environmental surfaces, which are difficult to clean/decontaminate and may become contaminated by blood or saliva during use, are to be covered with a disposable fluid impervious sleeve/drape (e.g., light handles, hand operated controls, x-ray unit head, etc.)
    • environmental surface coverings are to be changed between patients, with a gloved hand, discarded and replaced (after ungloving and washing of hands) with clean material.
    • Rubber dams, high-speed/low-speed air evacuation, and proper patient positioning should minimize the formation of droplets, splatter and aerosols during patient treatment.
    • Countertops and surfaces that are contaminated with blood and body fluids are to be disinfected as soon as feasible with the hospital-approved germicide.
    • Work surfaces are to be disinfected at the end of each workday with the hospital-approved germicide.
    • General housekeeping is to occur on a routine schedule and when the area is visibly soiled.
Cleaning, Disinfecting, and Sterilization of Instruments and Equipment
Dental instruments are classified into three categories - critical, semi critical, or non-critical - depending on the instruments? risk of transmitting infection and the need to sterilize these instruments between uses.

Classification Method of Disinfection or Sterilization
Critical
Surgical and other instrument used to penetrate soft tissue or bone (e.g., forceps, scalpels, bone chisels, scalars, and burs).
Sterilization Required
Steam or Gas (ETO) sterilization
Semi-Critical
Instruments that are not intended to penetrate oral soft tissue or bone but contact oral tissues (e.g. amalgam condensers, air/water syringe tips mirrors, intraoral radiography accessories, digital radiography sensors, and other dental high-technology instruments).
Steam or Gas (ETO) sterilization is ideal
Non-Critical
Uncovered operatory surfaces, instruments and medical devices only having contact with intact skin (e.g. countertops, etc.)
We minimize the use of germicide on plastic as it erodes the surface
Hospital-approved germicide (i.e., Wexcide or Asepti-Wipe


Specific Standards/Procedures for the Dental Services Unit
  • Environmental surfaces that are heat sensitive or are permanently attached to dental unit water lines are to be covered with disposable fluid impervious sleeve/drape/cover and changed after each patient include:
    • handles for the overhead dental lamp
    • patient's head rest
    • high-speed air evacuation unit
    • low-speed air evacuation unit
    • metal instrument tray beside dentist
    • air/water syringes on both sides of chair
    • assistant's instrument tray
    • X-ray head
    • exposure button for x-ray unit
    • Handles or dental unit attachments of saliva ejectors
  • Air/water syringe tips/ultrasonic scalar tips and component parts are to be:
    • autoclaved after each patient
  • Disposables used per patient:
    • high speed evacuation tip
    • low speed evacuation tip
    • environmental barrier protection mentioned above
    • prophylaxis angles/cups/brushes
    • saliva ejector tipsv
    • air/water syringe tips
  • Staff barrier protection:
    • Gloves are to be removed if leaving the operatory or entering a drawer/cabinet; and a second pair of gloves donned upon returning to the procedure.
    • Fluid impervious masks
    • Chin length face shield (e.g., Opti-op) protective eye wear to be cleaned with the hospital-approved germicide after each use.
    • Disposable fluid impervious barrier gowns
    • Maintenance of air and water lines
    • Antiretraction valves (one-way flow check valves) are installed and maintained to reduce the risk of possible aspiration of patient material into the hand pieces and the water lines.
    • High-speed/low-speed hand pieces, syringes and ultrasonic scalars are run to discharge water and air for a minimum of 20-30 seconds after use on each patient.
    • At the beginning of each day, the hand pieces are removed and the water is allowed to run for several minutes to flush the water lines that connect to dental instruments.
    • Sterile water or sterile saline is used during a procedure which involves the cutting of bone.
 
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