Chapter. 20 Principles and Techniques of Disinfection Flashcards
During patient treatment, surfaces in equipment and treatment rooms are likely to become contaminated with saliva or by aerosol containing blood, saliva, or both
Introductions
During patient treatment, surfaces in
equipment and treatment rooms are likely
to become contaminated with saliva or by
aerosol containing blood, saliva, or both
Laboratory studies have shown that
microorganisms may survive on
environmental surfaces for varying periods
Assume that if a surface has had contact
with saliva, blood, or other potentially
infectious materials, it contains live
microorganisms
Environmental Infection Control
The Centers for Disease Control and
Prevention (CDC) Guidelines for Infection
Control in Dental Healthcare Settings—
2003 divide environmental surfaces into
clinical contact surfaces and housekeeping
surfaces
Housekeeping surfaces include floors,
walls, and sinks
Because they have a much lower risk of
disease transmission, cleaning and
decontamination are not as rigorous as that
for clinical areas and patient treatment items
Cleaning and Disinfecting
Considerations
Amount of direct patient contact
Type and frequency of hand contact
Potential amount of contamination by
aerosol and spray
Other sources of microorganisms (e.g.,
dust, soil, and water)
Clinical Contact Surfaces.1
Can be directly contaminated either by spray or
spatter generated during dental procedures or
by contact with dental professional’s gloved
hands
Current infection control guidelines of the Office
Safety and Asepsis Procedures Research
Foundation (OSAP) recommend that clinical
surfaces be classified and maintained under
three categories
Touch
Transfer
Splash, spatter, and droplet
Clinical Contact Surfaces.2
Touch surfaces are directly touched and
contaminated during treatment procedures
Include handles of dental lights, controls of dental units,
chair switches, chairside computers, pens, telephones,
containers of dental materials, and drawer handles
Transfer surfaces are not directly touched but
often are touched with contaminated
instruments
Include instrument trays and handpiece holders
Splash, spatter, and droplet surfaces do not
actually come into contact with the members of
the dental team or the contaminated
instruments or supplies
Countertops are a major example
Surface Contamination
There are two methods of dealing with
surface contamination
Surface barriers
Precleaning and disinfecting surfaces
between patients
Surface Barriers
Wide variety of surface barriers available today
Should be resistant to fluids to keep
microorganisms in saliva, blood, or other liquids
from soaking through to the surface underneath
Some plastic bags are designed in the shape of
items such as the dental chair, air-water syringe,
hoses, pens, and light handles
Plastic barrier tape is frequently used to protect
smooth surfaces (e.g., touch pads on equipment,
electrical switches on chairs, and x-ray equipment)
Aluminum foil can also be used because it is easily
formed around any shape
Single-Use (Disposable) Items.1
Used on only one patient and then
discarded, so they help reduce the
chance for patient-to-patient
contamination
Single-use items are often made of
plastic or less expensive metals, and
they are not intended to withstand
cleaning, disinfection, or sterilization
Never process (clean, disinfect/sterilize)
single-use items for use on another
patient
Single-Use (Disposable) Items.2
In most areas, contaminated disposable
items that are not sharps and are not
soaked or caked with blood may be
discarded with the regular office trash
There is no need to discard these items
in a medical waste or biohazard
container
State and local regulations may vary, so
always consult the regulatory agency
for your area
Precleaning and Disinfection
Although no cases of cross-infection
have been linked to dental treatment
room surfaces, cleaning and disinfection
of these surfaces are important
components of an effective infection
control program
In addition, the OSHA Blood-Borne
Pathogens Standard requires that
contaminated work surfaces be
disinfected between patient visits
Precleaning.1
Precleaning means to clean before
disinfecting
All contaminated surfaces must be
precleaned before they can be
disinfected
Even if there is no visible blood on a
surface, it must be precleaned because
even a thin layer of saliva on the surface
can decrease the effectiveness of the
disinfectant
Precleaning reduces the number of
microbes and removes blood and saliva
Precleaning.2
Most effective when used on contaminated
surfaces that are smooth and easily
accessible for cleaning
Always wear utility gloves, mask, protective
eyewear, and protective clothing when
precleaning and disinfecting
Surfaces that are irregular or textured are
difficult or impossible to clean or to disinfect
Regular soap and water may be used to
preclean, but it is more efficient to select a
disinfectant that can be used to clean as
well as disinfect
Disinfection
Intended to kill disease-producing
microorganisms that remain on the
surface after precleaning
Spores are not killed during disinfecting
procedures
Do not confuse disinfection with
sterilization
Sterilization is a process in which all
forms of life are destroyed
Disinfectants.1
Chemicals that are applied to inanimate
surfaces (e.g., countertops and dental
equipment)
Antiseptics are antimicrobial agents that
are applied to living tissue
Disinfectants and antiseptics should
never be used interchangeably because
tissue toxicity and damage to
equipment can result
Disinfectants.2
Disinfectants are chemicals that destroy or
inactivate most species of pathogenic
(disease-causing) microorganisms
In dentistry, only those products that are
EPA-registered hospital disinfectants with
tuberculocidal (kills the tuberculosis
bacteria) claims should be used to disinfect
dental treatment areas
Mycobacterium tuberculosis is highly
resistant to disinfectants, and if a
disinfectant will inactivate M. tuberculosis it
will inactivate the less resistant microbial
families (e.g., bacteria, viruses, and most
