EXAM 1 (dhyg104) Flashcards
Recommended surface management protocols for splash/spatter and aerosol surfaces
at the end of clinic session, before and between patients if gross debris present
What are the two types of instrument grasps?
Modified pen grasp, palm grasp
Exploratory stroke with curet: adaptation and angulation
- insert toe of blade using light touch
- angle to tooth greater than 45 but less than 90
What is the goal of surface management as it relates to patient treatment?
the goal is to use products and methods that allow pt tx without the risk of x- contamination
What are the points throughout the clinic session where surface management protocols will be performed?
at the beginning of clinic, between each patient, and after each clinic
Recommended surface management protocols for items that enter the oral cavity
either heat sterilize (autoclave) or use disposable items
Recommended surface management protocols for touch surfaces and transfer surfaces
wipe wipe method, using barrier covers
What are the properties of an ideal disinfectant?
broad spectrum, fast acting, not affected by physical factors, non-toxic, surface compatible, residual effect on treated surfaces, odorless, easy to use, economical
recommended chemical disinfectants for environmental surfaces
Glutaraldehyde, chlorine compounds, iodophors
What is the objective of infection control?
to protect patient and clinician from spreading infection and x-contaminating
When should gloves be worn during clinic?
all patient treatment, all cleanup before and after patients
What is the rule in conjunction with washing hands and glove wearing?
wash hands before putting on gloves and after taking them off
Clinical activities that require protective eyewear?
during pt. treatment, during sterilization and disinfection, and during cleaning the suction system
List fulcrum function
support, control, prevent tissue trauma, decrease fatigue to clinician
What is the standard location of the fulcrum of the instrument hand?
on the occlusal or incisal edge of a tooth in same arch you are working on, closest to tooth as possible
Explain four purposes of the mouth mirror
indirect vision - opening up the ability to see areas of the tooth that aren’t visible with direct vision
indirect illumination - reflecting light from dental light onto areas that need illumination
transillumination - reflection of light through the teeth
retraction - pull back tongue, cheeks, lip to prevent interference
Scaling
the process of removing calculus and heavy stain from tooth surfaces
Supra-marginal scaling
removal of calculus and heavy stain from above the margin of gingiva
Tactile sensitivity
the ability to distinguish characteristics of tooth anatomy, degrees of tooth roughness, and sulcus anatomy during instrumentation using the sense of touch
Barrier techniques
using paper, plastic, metal, etc. to prevent the transport of microorganisms
What is the procedure for using a chemical solution for disinfection by submersion
- preclean to remove debris
- rinse
- dry
- completely immerse items in solution
- follow manufacturers instructions for length of time
- drain
- remove from drain basket with sterile forceps
- dry with sterile towel
- rinse if solution is known to be irritating to tissue
different types of blade (2) and shank (2) shapes for sickle scalers
blade: straight or curved
shank: straight or modified (also called contra-angled)
What is the main use of a sickle scaler?
removal of supramarginal calculus and heavy stain
Reasons why not to use sickle scaler submarginally?
-causes tissue trauma because of size, thickness, or length of blade
-grooving and scratching of cemental surface because harder to adapt pointed tip
-reduces tactile sensitivity because of the large/heavy blade
What is the blade angle formed by the facial surface of instrument during sharpening?
110 degrees, or 11:00/1:00
Name/describe the two steps performed when disinfecting a surface
step one: wipe once to clean the surface/remove large debris and microorganisms from the surface
step two: wipe again to wet the surface for disinfection
What are the three classifications of operatory/equipment surfaces?
1) touch surfaces - surfaces that are touched and contaminated during dental procedures (dental light handles, chair controls)
2) transfer surfaces - surfaces that are not touched but come in contact with other surfaces that are contaminated (instrument tray, dental unit handpiece holders)
3) splash/splatter/aerosol surfaces - everything else besides the touch transfer surfaces (dental seat, light)
What is a barrier cover and what are the four rules for it?
barrier cover - liquid impervious cover that is placed over a surface to prevent contamination
1) single use!!
2) if they get contaminated, take them off in a way that allows no contamination of the surface below the barrier
3) if this surface below barrier does become infected, clean and disinfect before new barrier is put on
4) clean barrier covered surfaces after clinical session is over
What is the length of time that the surface needs to be wet in order for the disinfectant to work in the FSU clinic?
1 minute
What are the small items that need to be treated prior to patient treatment?
patient safety glasses, pens, patient mirror
What is the amount of times the water line should be flushed between patients and at the beginning of clinic?
between patients - 30 seconds, beginning of clinic - 2 mins
When do you rinse pt tx gloves?
going into the oral cavity after extraoral exam, after accidentally touching unsterilized/undisinfected objects
When must you put on new gloves?
after patient treatment, after discovering a tear/puncture, if gloves become sticky
Manifestations and management of latex hypersensitive patient
Manifestations are a rash near exposed areas and difficulty breathing, look at MDHx for their allergy info
What is the purpose of a face mask?
To protect pt and clinician from airborne particles
Three clinical activities when a face mask must be worn
during patient treatment, during sterilization and disinfection, during cleaning the suction system
When is a new mask donned?
after each patient
When is a new mask donned during pt tx?
if face mask becomes wet during pt treatment, after 1 hour of ultrasonic scaling
What is the purpose of wearing protective eyewear during pt tx?
To protect pt and clinician from contamination of the mucous membrane of the eyes by splashes and sprays
Design features that need to be present with safety goggles
side shields, easily disinfected, shatterproof
When should protective eyewear be cleaned?
At the end of a clinical session or if they are visibly contaminated with blood/debris
When should a face shield be worn ideally
in combination with mask
When should protective eyewear be cleaned?
At the end of a clinical session or if they are visibly contaminated with blood/debris
Name the parts of an instrument
Handle, shank, working end
What are the functions of the instrument grasp
increase tactile sense, increase control, prevent tissue trauma, less fatigue to the operator
What is the technique of use for the modified pen grasp?
thumb and index finger are opposite each other, middle finger rests on shank of instrument, contact between index, middle, and ring finger
Which finger is used as a fulcrum?
the ring finger
What is the technique of use for the palm grasp?
instrument lays across palm of hand, fingers close around instrument handle
Describe wrist rock and pivot
wrist rock - left to right motion
pivot - up and down motion (raise and lower wrist)
Define and describe the three A’s of instrumentation
Adaptation: relationship of instrument to tooth, refers to getting instrument on tooth (looks at two or more of the parts of instrument)
Angulation: angle formed by the working end of the instrument and the surface of tooth (only care about relationship of working end)
Activation: initiation of the stroke, single unbroken movement of instrument across tooth
Name and describe the two types of strokes and when they’re used
exploratory strokes - light feeling stroke used for examining tooth surface
working strokes - firm stroke used to remove a deposit from the tooth
Identify the stroke directions used during instrumentation
vertical, oblique, horizontal, circular
What are the parts of the mouth mirror?
handle, shank, working end (mirror head)
Describe the technique for use of the mouth mirror
modified pen grasp on opposite side of arch, retract lips or cheek without fulcrum
palm grasp when not in use
Sub-marginal scaling
removal of calculus and heavy stain from below the margin of the gingiva
Universal Curet
an instrument used to remove supra and sub marginal deposits of calculus and stain on all posterior and anterior teeth
Basic design of the working end of a curet
it has a half circle cross section, curved/spoon shaped, the parts of the working end include the: facial surface, lateral ends (2), cutting edges, back, toe
shank designs of anterior and posterior curets
anterior - straight shank
posterior - modified or contra-angled
Three main uses of curets
scaling - calculus and hard stain removal
root planing - residual calculus, portions of cementum and dentin are removed from root to create smooth/hard surface
soft tissue curettage - removal of diseased sulcular epithelium from pocket wall
Working stroke with curet: adaptation and angulation
- position blade apically (closer to root) to the deposit of calculus
- angulate the facial surface to tooth to form a degree greater than 45 but less than 90
Considerations with curet calculus removal
try to break deposit away from tooth
remove a corner of the deposit at a time
be conservative with working strokes
explore the surface with curet in between each working stroke
Three essential components in the infectious disease transmission process
1) causative (infectious) agent
2) susceptible host
3) mode of transmission
What are the two bloodborne pathogens of concern in dentistry?
Hep B Virus, HIV - acquired immune deficiency virus
What are the five factors that affect host susceptibility?
Nutritional status, use of meds, therapeutic procedures, underlying diseases, immunization status
________________ is the most important vehicle of transmission of HBV and HIV
Blood
Six measures that should be taken to aid in prevention of disease transmission
- medical history
- oral exam
- using disposable supplies
- proper sterilization and disinfection of non-disposables
- use of PPE
- application of proper asepsis principles
Infectious disease process
the way that infectious diseases are transmitted from one person to another person
Causative agent/pathogen
any microorganism that can cause disease
susceptible host
a person lacking effective resistance to a particular pathogenic host
Modes of transmission
ways by which an infectious agent is transferred to a susceptible host
Universal precautions
infection control guideline that focuses on the prevention of the spread of bloodborne disease
asepsis
the absence of living pathogenic organisms
What happens to the lateral surface of the curet through sharpening?
as you sharpen the lateral edge, the face of the blade gets narrower
supplies needed during instrument sharpening
-light
-stable surface to work on
-place to sit
-lubricant
-water
Advantages of using sharp instruments
increased tactile sensitivity, increased efficiency, increased effectiveness, reduced stress to operator and patient
Four factors that influence conservation of instrument blade when sharpening
-hardness of abrasive in sharpening stone
-particle size of abrasive in sharpening stone
-amount of pressure
-number of strokes
Three goals for instrument sharpening
produce a sharp cutting edge, conservation of instrument, preservation of blade’s original shape
How to use plastic testing stick
-adapt the blade to the stick at the same angle used for scaling, less than 90 degrees but more than 45
-press blade into stick, if you hear metallic ping and if instrument grabs the test stick, it is sharp
What will a dull cutting edge look like in comparison with a sharp cutting edge
dull will reflect light whereas the sharp will not reflect light since it has no surface
Three factors that dull the cutting edge of a scaler?
-autoclaving
-scaling procedures
-improper sharpening technique
What is the proper technique for activation of the sickle scaler?
pull stroke only, vertical or oblique, overlapping and very short
Adaptation and angulation for sickles
adaptation: adapt with tip end only, keep tip on tooth at all times, 1-2mm of blade on tooth
angulation: facial surface of blade form angle that is less than 90 degrees but more than 45
If one end of a posterior sickle adapts to the buccal, the _____________ end of the instrument will adapt to the ___________ tooth surfaces on the other quadrant of the same arch
same, lingual
If one end of a posterior sickle adapts to the buccal, the ___________________ end of the instrument will adapt to the ______________ tooth surfaces in the same quadrant.
opposite, lingual
What are the areas of use for anterior sickles?
all surfaces of anterior teeth, sometimes with occlusal pits and grooves with stain, possibly premolars
Blade and shank design of H5/33
blade - one end straight, other end curved
shank design - straight
When can we use the sickle scalers submarginally?
-if calculus is 1-2mm below margin and is continuous with supramarginal calculus
-when the tissue is spongy and flexible enough to allow easy insertion
What are the five parts of a sickle?
face of the blade - depending on type of sickle, may be curved or straight
lateral surfaces - flat and equal sizes
cutting edges - facial and lateral surfaces converge
back - sharp pointed edge of underside
tip - sharp and pointy
What two shapes can the cross section of a shank be?
triangular or trapezoidal
Regulations for sharps
placed into a puncture resistant, leak proof container with the BioHazard label on it
Regulations for blood, suction fluids, other liquid wastes
poured into a drain or collected in a suction system that is connected to a sanitary sewer system
Regulations for items that are contaminated with blood or body fluids (like gloves, masks, wipes, gauze, barriers)
must be placed in impervious plastic trash bags
List in order of preference and reliability these methods of sterilization and disinfection: steam under pressure, prolonged dry heat, ethylene oxide gas, boiling water/hot oil, chemical agents
- steam under pressure
-ethylene oxide gas
-dry heat
-chemical agents
-boiling water/hot oil
Autoclave tape is related only to the ____________ of the autoclave, not with living organism ______________
temperature, destruction
Cavicide: use, example, irritating or not, associated caution
-irritating to skin
Combination Phenolics: use, example, irritating or not, associated caution
-irritating to skin
-
Iodophores: use, example, irritating or not, associated caution
antiseptic, environmental surface disinfectant
-Providone-iodine, Promedyne
-not irritating to skin
-adding too much concentrate to solution makes it harmful/destructive to equipment, don’t presoak gauze with solution
Chlorine Compounds: use, example, irritating or not, associated caution
-water purification, surface disinfectant, soak to clean dentures
-chloroform, chlorine dioxide
-irritating to skin and eyes
-corrodes metals and damages clothing, degrades plastics and rubber, bad odor, activity diminished by organic matter
Glutaraldehyde: use, example, irritating or not, associated cautions
Chemical sterilization, disinfection by immersion
-cidex, sporacidin
-irritating to eyes and skin
-items must be rinsed after removal from a solution, use gloves when handling items
State the time, temperature and pressure needed to sterilize by dry heat
2 hours after temperature is reached, 320 degrees F
State the time, temperature and pressure needed to sterilize by moist heat
20 mins, 250 degrees F, 15 psi
What are three methods of disinfection?
Glutaraldehyde, chlorine compounds, iodophores
What are three methods of sterilization?
moist heat, dry heat, ethylene oxide
What is the f(x) of cleaning in instrument processing
It is to remove bioburden to facilitate sterilization
Spatter is greater than _______ microns, doesn’t remain in the air suspended
50
Bioburden
saliva, blood, exudate, oral debris that might coat dental instruments or operatory surfaces
Bacteriocidal/germicidal
capable of killing bacteria
Bacteriostatic
capable of inhibiting growth and multiplication of bacteria
Disinfection
the process (chemical or physical) where pathogenic microorganisms are destroyed on inanimate surfaces
Sterilization
the process where all forms of life are killed, including bacterial spores and viruses
aseptic technique
the techniques that aim to exclude all microorganisms from the field of operation
