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ABPD 2021 > Radiation/Infection Control > Flashcards

Radiation/Infection Control Flashcards

1
Q

Image Gently

A

The Alliance for Radiation Safety in Pediatric Imaging

National alliance with goal of decreasing radiation/being more aware of radiation in pediatrics

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2
Q

Millimeter-Wave Technology Unit

A

Airport security scanner

Uses non-ionizing radio-frequencies in millimeter wave spectrum to generate an image based on energy reflected from the body

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3
Q

Pregnancy and radiation

A

Some relationship between antepartum dental radiography and infant low birth weight

More radiation was associated with low birth weight of babies in one study

Many confounders (more periodontal disease, more infection, etc.)

Thought to be related to subclinical hypothyroidism (why ADA recommends thyroid collar for patients)

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4
Q

How are x-rays formed?

A

Electromagnetic radiation of penetrating power is produced by the bombardment of a substance (usually heavy metal) by a stream of high velocity electrons usually in a vacuum tube

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5
Q

Electromagnetic spectrum

A

X-rays have high frequency (less than gamma but above everything else)

High frequency = short wavelengths

Spectrum based on wavelength:
Radio > microwave > infrared > visible light > UV > x-ray > gamma

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6
Q

3 interactions of x-ray with matter

A

Coherent Scattering

Photoelectric absorption

Compton Effect

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7
Q

Compton effect

A

Some x-rays scatter off of the patient

Why staff should be 6 feet away from x-ray source when taking radiographs

X-rays that scatter lose energy

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8
Q

What percentage of the scattered photons formed during a dental x-ray exposure exit the patient’s head?

A

30%

Scattered photons travel in all directions

9% pass through without any interaction

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9
Q

Most radiosensitive cells

A

Those with high mitotic rate

Those that will undergo future mitosis

Cells with primitive differentiation

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10
Q

Deterministic effects

A

Response is proportional to the magnitude of the dose

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11
Q

Stochastic effect

A

The response is proportional with the frequency of the dose

Most related to dental radiography

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12
Q

Earth Radiation

A

Natural radiation is 3.6 mSv/year

83% of this is coming from natural sources (radon is the most, but also cosmic or terrestrial or food radiation)

17% is from artificial sources (medical radiation, of which dental is a very small proportion)

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13
Q

How much radiation is in a bitewing?

A

3.6mSv / 365 = 0.00986 mSv per day

One posterior bitewing is 0.005 mSv (with rectangular collimation) -> about 0.6 background radiation days

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14
Q

What is the best way to reduce radiation exposure?

A

Rectangular collimation

Reduces by 50%

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15
Q

Digital imaging versus film

A

Reduces dose of radiation compared to film

However, ease of retakes and increase in number makes this effect not as large

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16
Q

Dose reduction of digital versus F-speed film

A

0-50%

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17
Q

Handheld x-ray system

A

Designed to minimize user’s radiation dose

Doses for handheld system is less than wall-mounted system

Additional shielding efforts will not provide significant benefit nor reduce staff radiation dose

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18
Q

Justification for radiographs (overview)

A

Patient selection

Positive clinical signs/symptoms

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19
Q

Patient selection for radiographs

A

Patient selection is the most significant factor influencing per capita dose

Recommendations are subject to clinical judgment

Dentist should NOT prescribe routine radiographs at preset intervals for all patients

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20
Q

When should a dentist prescribe dental radiographs?

A

Only AFTER clinical evaluation

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21
Q

Radiograph prescription for a child with primary dentition - new patient

A

Individualized radiographic exam consisting of selected PA/occlusal views and/or posterior bitewings if proximal surfaces cannot be visualized or probed

Patients without evidence of disease and with open proximal contacts may not require a radiographic exam at this time

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22
Q

Radiograph prescription for a child with primary dentition - recall with high caries risk

A

Posterior bitewing exam at 6-12 months if proximal surfaces cannot be examined visually or with a probe

23
Q

Radiograph prescription for a child with primary dentition - recall with low caries risk

A

Posterior bitewing exam at 12-24 month intervals if proximal surfaces cannot be examined visually or with a probe

24
Q

Radiograph prescription for transitional dentition - new patient

A

Individualized radiographic exam consisting of posterior bitewings with panoramic exam or posterior bitewings and selected PAs

25
Q

Radiograph prescription for transitional dentition - recall with high caries risk

A

Posterior bitewing exam at 6-12 month intervals if proximal surfaces cannot be examined visually or with a probe

26
Q

Radiograph prescription for transitional dentition - recall with low caries risk

A

Posterior bitewing exam at 12-24 month intervals if proximal surfaces cannot be visualized or felt with a probe

27
Q

Radiograph prescription for adolescent in permanent dentition - new patient

A

Individualized radiographic exam consisting of posterior bitewings with panoramic exam or posterior bitewings and selected periapical images

Full mouth intraoral radiographic exam is preferred when patient has clinical evidence of generalized oral disease or history of extensive dental treatment

28
Q

Radiograph prescription for adolescent in permanent dentition - recall with high caries risk

A

Posterior bitewing exam every 6-12 months if proximal surfaces cannot be examined visually or with a probe

29
Q

Radiograph prescription for adolescent in permanent dentition - recall with low risk

A

Posterior bitewing exam at 18-36 month intervals

30
Q

Radiograph prescription for adult patient - new exam

A

Individualized radiographic exam consisting of posterior bitewings with panoramic exam or posterior bitewings and selected periapical images

Full mouth intraoral radiographic exam is preferred when patient has clinical evidence of generalized oral disease or history of extensive dental treatment

31
Q

Radiograph prescription for adult patient - recall with high risk

A

Posterior bitewing exam at 6-18 month intervals

32
Q

Radiograph prescription for adult patient - recall with low risk

A

Posterior bitewing exam at 24-36 month intervals

33
Q

Positive clinical signs and symptoms

A 
Clinical evidence of periodontal disease
Large or deep restorations
Deep carious lesions
Clinically impacted teeth
Swelling
Evidence of trauma
Mobility of teeth
Sinus tract
Clinical suspected sinus pathology
Growth abnormalities
Positive neurological symptoms in head and neck
Clinical tooth erosion
Unexplained bleeding
34
Q

Standard (universal) precautions

A 
Handwashing
Use of gloves/mask/eye protection
Patient care equipment 
Environmental surfaces
Injury prevention

Intended to prevent spread of organisms by blood and other sources

35
Q

Personnel health elements

A 
Education and training
Immunizations (strongly recommended)
Exposure prevention and management 
Medical condition management 
Health record maintenance
36
Q

Degrees of hand hygiene

A

Routine hand wash: 15 seconds with soap and water

Antiseptic hand wash: 15 seconds with antimicrobial soap

Antiseptic hand rub: until hands are dry

Surgical antisepsis: antimicrobial soap and water for 2-6 minutes (forearms) or plain soap and water followed by alcohol-based surgical scrub

37
Q

Mechanical monitor of sterilization

A

Cycle Time
Pressure
Temperature

38
Q

Biological Indicators of sterilization

A

Should be done at least weekly

Should be done with every load containing implantable material

Use control BI from same lot

39
Q

When should you use biological indicators?

A

A new type of packaging material or tray is used

After training new sterilization personnel

After repair

After change in loading procedures

40
Q

Chemical indicators of sterilization

A

Internal indicator should be placed in every package

External indicator if internal cannot be seen from outside packaging

41
Q

Medical waste

A

Not considered infection - discard with regular trash

42
Q

Regulated medical waste

A

Potential risk for infection during handling and disposal

Solid waste soaked with blood or saliva
Extracted teeth
Surgically removed hard or soft tissues
Contaminated sharps

43
Q

Guidelines for exposure determination and prevention

A

Discharge air and water for 20-30s after each patient

Anti-retraction valves in water lines

44
Q

Water lines

A

Regulatory standard for drinking water is less or equal to 500 CFU/mL

Simply using source water containing equal or less than 500 CFU/mL of bacteria in a self containing system will not eliminate bacterial contamination in treatment water if biofilms in water system are not controlled

Requires use of chemical germicides

45
Q

Categories of patient care instruments

A

Critical: penetrates soft tissue, contacts bone, enters or contacts bloodstream (scalers, scalpel, burs)

Semi-critical: contacts mucous membranes or non-intact skin (dental mirror, dental trays)

Non-critical: contacts intact skin (radiograph head)

46
Q

Sterilization definition

A

Destroy all microorganisms including bacterial spores

Heat automated High Temperature

Low temperature

Liquid immersion

47
Q

Heat automated high temperature sterilization

A

Ex: steam, dry heat

Can be used for heat tolerant critical and semi-critical instruments

48
Q

Low temperature sterilization

A

Ex: ethylene oxide gas, plasma sterilization

Can be used for heat sensitive critical and semi-critical

Takes 10-16 hours

49
Q

Liquid immersion sterilization

A

Ex: chemical sterilant, glutaraldehyde, hydrogen peroxide

Can be used for heat sensitive semi-critical instruments

50
Q

High-level disinfection definition

A

Destroy all microorganisms but no necessarily all spores

Heat automated (washer/disinfector)
Liquid immersion

Used for semi-critical

51
Q

Intermediate level disinfection definition

A

Destroy vegetative bacteria and majority of fungi and viruses

Liquid contact (EPA disinfectant with tuberculocidal activity, chlorine-containing products, quaternary ammonium compounds)

Can be used for non-critical items with visible blood

52
Q

Low level disinfection

A

Destroys vegetative bacteria and majority of fungi but does not inactivate mycobacterium

Liquid contact (EPA disinfectant without label claim of antituberculosis activity, chlorine containing products, quaternary ammonium compounds

Can be used for non-critical items with no blood

53
Q

How to disinfect a dental cast before sending to a lab?

A

Spray until wet

Use chlorine compounds

54
Q

How to disinfect alginate?

A

Disinfect by immersion

Only disinfectants with short term exposure time (chlorine compounds or iodophors)

ABPD 2021 (14 decks)

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