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test 3 & 4 Flashcards

1
Q

Surfaces that are touched frequently

can act as __________ for microorganisms.

A

Reservoirs

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2
Q

What is the primary source of contamination?

A

When a member of the dental team
touches surfaces with contaminated
gloves

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3
Q

What is the definition of

environmental surfaces?

A

surface within a healthcare facility that is not directly
involved in patient care, but that may become
contaminated during the course of treatment

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4
Q

What are some examples of

an environmental surface?

A

Countertops, floors, instrument

control panels, walls

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5
Q

Is it possible to predict accurately the
life span of microorganisms on the
surface of dental equipment?

A

No

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6
Q

What is the safest approach

for avoiding contamination?

A

Assuming the surface has

potentially infectious material on it

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7
Q

According to the CDC Guidelines for infection
control in dental healthcare settings, what are
the two categories of environmental surfaces?

A

clinical contact surfaces and

housekeeping surfaces

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8
Q

What does housekeeping

surfaces include?

A

Floors, walls, and sinks

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9
Q

Which category of environmental
surfaces has the lower risk of disease
transmission?

A

Housekeeping

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10
Q

What are the three categories

of clinical contact surfaces?

A

touch, transfer, and

splash/spatter/and droplet

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11
Q

What are touch surfaces?

A

Surfaces that are directly touched and

contaminated during procedures

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12
Q

What are some examples of

touch surfaces?

A

Light handles, dental unit controls, chair
switches, chaired computers, pens, telephones,
containers for dental material, and draw handles

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13
Q

What are transfer surfaces?

A

Surface not directly touched and

contaminated during procedures

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14
Q

What is an example of transfer

surfaces?

A

Instrument trays, hand piece

holders

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15
Q

What are splash, splatter, and

droplet surfaces?

A

Surface that does not contact members
of the dental team or contaminated
instruments or supplies

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16
Q

What is an example of splash,

splatter and droplet surfaces?

A

Countertops

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17
Q

Which of the three types of clinical
contact surfaces should be barrier
protected?

A

Touch and Transfer surfaces

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18
Q

At least how many times should splash,

splatter, droplet surfaces be cleaned?

A

At least once a day

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19
Q

What are the two methods to

dealing with contamination?

A

Surface barriers or preclean

and disinfect between patients

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20
Q

What type of surfaces should be

cleaned and not barrier protected?

A

Smooth, hard surfaces such as
countertops, trays, and supply
containers

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21
Q

If a surface has crevices or knobs, how
should it be protected from
contamination?

A

Barriers

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22
Q

Whose responsibility is it to make sure
the equipment and treatment room
surfaces are properly managed?

A

Dental Assistant

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23
Q

What is an important

characteristic in surface barriers?

A

Fluid resistant

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24
Q

When and how should you

remove barriers?

A

In-between patients and while

you are still gloved

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25
Q

Do surfaces with barriers ever need to
be disinfected, or are the barriers
enough?

A

Surfaces that are barriered still need to
be disinfected/ cleaned at the
beginning and end of each day

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26
Q

What are single use items?

A

aka disposable items, used only once
and then discarded (not intended to be
sterilized)

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27
Q

Why are single use items

recommended?

A

They reduce the chance of

patient to patient contamination

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28
Q

What should you do if a

surface barrier tears?

A

Take it off and prequel and

disinfect replace barrier

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29
Q

What regulation requires the

use of a surface disinfectant?

A

OSHA Blood Borne Pathogens

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30
Q

Why must surfaces be

precleaned?

A

Remove Bioburden, disinfectant’s
effectiveness can be decreased if even the
smallest amount of saliva is still present

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31
Q

What is disinfection intended

to do

A

Kill disease-causing microorganisms that

remain on the surface after precleaning

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32
Q

What is the term disinfectant

used for?

A

chemicals that are applied to inanimate
surfaces such as countertops and dental
equipment.

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33
Q

What are antiseptics used for?

A

antimicrobial agents applied

to living tissue

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34
Q

Why should disinfectants and antiseptics

never be used interchangeably?

A

Tissue toxicity and damage to

equipment

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35
Q

What kills all microorganisms?

A

sterilant

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36
Q

Who regulates disinfectants and
chemical sterilants according to
chemical classification?

A

Environmental Protection

Agency EPA

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37
Q

What does the word

pathogenic mean?

A

Disease causing

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38
Q

What are the only types of products that
should be used to disinfect treatment
rooms in dental offices ?

A

products registered by the EPA such as

hospital disinfectants and tuberculocidal

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39
Q

What type of bacteria is highly

resistant to disinfectants?

A

Mycobacterium Tuberculosis

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40
Q

What label would be given to

a product that can kill spores?

A

Sporicidal

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41
Q

What label would be given to a

product that can kill some viruses?

A

Virucidal

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42
Q

What label would be given to

a product that can kill fungi?

A

Fungicidal

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43
Q

What is the ideal surface disinfectant?
And is there any product on the market
that meets all of these expectations?

A

Rapidly kills broad spectrum of bacteria, minimal
toxicity, exhibit residual activity, not damage surface
being treated. No there is not one product that meets
all of these expectations

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44
Q

What are iodophors?

A

EPA registered intermediate level
hospital disinfectants with tuberculocidal
action

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45
Q

During patient treatment, surfaces in
equipment and treatment rooms are likely to
become what with blood and saliva?

A

Contaminated

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46
Q

What have laboratory studies shown
about the time microorganisms may
survive on environmental surfaces?

A

Period of time varies

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47
Q

What 4 things do we consider when
cleaning and disinfecting patient
treatment areas?

A
  1. )Amount of direct patient contact
  2. ) Type and frequency of hand contact
  3. ) Potential amount of contamination by aerosol and or spray
  4. ) Other sources of microorganisms (dust, water, soil etc.)
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48
Q

What can be directly contaminated either by spray or spatter generated during dental procedures or by contact with the dental professional’s gloved hands?

A

Contact Surfaces

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49
Q

Which organization recommended that
clinical surfaces be classified and
maintained under three categories?

A

OSAP

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50
Q

What are some common uses

for plastic barrier tape?

A

touch pads on equipment, electrical

switches on chairs, and X-ray equipment

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51
Q

What can be used instead of

barriers? Why?

A

Aluminum foil because it is formed easily around any shape

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52
Q

According to CDC guidelines, what
should be done if barriers can not be
used?

A

Pre-cleaning and disinfecting

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53
Q

What PPE should be worn when cleaning
and and disinfecting environmental
surfaces?

A

puncture resistant gloves, protective

eyewear, face shield, masks

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54
Q

why should you always wear PPE whiny are exposed to chemical disinfectants

A

Because of the risks associated with exposure to
chemicals and to prevent occupational exposure
to infectious materials.

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55
Q

What is bioburden?

A

Blood, saliva, and other body

fluids

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56
Q

Can regular soap and water

be used for precleaning?

A

yes

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57
Q

Can regular soap and water

be used for disinfecting?

A

no

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58
Q

What is not killed during

disinfection procedures?

A

Spores

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59
Q

What is the term disinfectant

used for?

A

inanimate surfaces

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60
Q

What is the term antiseptic

used for?

A

antimicrobial agents used on

living tissue

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61
Q

What is the process in which

all life forms are destroyed?

A

Sterliization

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62
Q

What are disinfectants?

A

chemicals that destroy or inactivate
most species of pathogenic
microorganisms

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63
Q

What are the only types of

disinfectants used in dentistry?

A

Ones that are registered with the EPA as
hospital disinfectants with tuberculocidal
claims

64
Q

What kills all microorganisms?

A

sterilants

65
Q

What is residual activity?

A

Action that continues long after initial

application, as with disinfectant

66
Q

What recommendations from a

manufacturer should you follow?

A

Mixing and diluting, application
technique, shelf life, activated use life,
and all safety warnings

67
Q

What is the difference between

disinfection and sterilization?

A

Disinfection only kills most
microorganisms while sterilization kills all
forms of life

68
Q

How resistant is

mycrobacterium tuberculosis?

A

Very resistant (that is why it is the benchmark
for disinfectants: if the disinfectant can kill it,
it can kill ALMOST everything else)

69
Q

What does iodophors contain that
causes them to discolor certain metals,
clothing, and other surfaces?

A

Iodine

70
Q

What are synthetic phenol

compounds?

A

EPA - registered intermediate level
hospital disinfectant with broad-spectrum
disinfecting action

71
Q

What can we use Phenols on?

A

metal, glass, rubber, or plastic

72
Q

Can Phenols be used as a

holding solution for instruments?

A

yes

73
Q

What is a disadvantage of

phenols?

A

They leave a residue film on treated
surfaces and they have to be prepared
daily to reduce battery growth

74
Q

What is another name for

Sodium Hypochlorite?

A

Household bleach

75
Q

What is sodium hypochlorite

classified as?

A

intermediate level disinfectant

76
Q

What are some advantages of

sodium hypochlorite?

A

fast acting, economical, and

broad spectrum

77
Q

What are some disadvantages

to sodium hypochlorite?

A

unstable, must be prepared daily, has a strong odor, and is
corrosive to metals, destructive to fabrics, irritating to eyes and
skin, may eventually cause plastic chairs to crack, NO LONGER
RECOMMENDED BY THE CDC AND IS NOT EPA REGISTERED

78
Q

Why is alcohol not effective as

disinfectant?

A

Its rapid rate of evaporation limits
antimicrobial activity, can be damaging to
certain surfaces

79
Q

Although alcohol is not a

disinfectant? What is it used as?

A

An antiseptic

80
Q

Who does not recommend

alcohol as disinfectant?

A

ADA, CDC, OSAP

81
Q

What is an immersion

disinfectant?

A

can be used for high level

disinfection or for sterilization

82
Q

What is an advantage of immersion
disinfectants when it is used as a
sterilant?

A

It kills all microbial life including

bacterial endospores

83
Q

What is an advantage of immersion
disinfectants when it is used as a high
level disinfectant?

A

It inactivates all microorganisms

except bacterial endospores

84
Q

What is a disadvantage of

immersion disinfectant?

A

toxic chemicals and can

irritate eyes, skin and lungs.

85
Q

What are immersion

disinfectants used for?

A

Heat sensitive items

86
Q

Can immersion disinfectants be

used as a surface disinfectant?

A

no

87
Q

How do you minimize the fumes

of immersion disinfectants?

A

Close the lid on the container in

which the materials are soaking in

88
Q

Depending on the type, what is the time
for sterilization of immersion
disinfectants?

A

6 hours to 30 hours

89
Q

How can you make immersion
disinfectants into high level
disinfectants?

A

Weaker concentration and

increased contact time

90
Q

What always must be worn while

handling immersion disinfectants?

A

PPE

91
Q

What is chlorine dioxide

A

Effective, rapid-acting environmental

surface disinfectant or chemical sterilant

92
Q

What is the time for sterilization when
using chlorine dioxide as a chemical
sterilant?

A

6 hours

93
Q

What is the time for disinfection when
using chlorine dioxide as a surface
disinfectant?

A

3 minutes

94
Q

What is Glutaraldehyde?

A

high level disinfectant sterilant that can
also be used as a liquid sterilant
registered by the EPA

95
Q

How can you make

glutaraldehyde a liquid sterilant?

A

Greatly increasing immersion

time

96
Q

What is the time for disinfection

using glutaraldehyde?

A

10-90 minutes

97
Q

What happens if contact of certain types
of instruments and glutaraldehyde are
prolonged?

A

Discoloration or corrosion of

instrument’s surfaces and cutting edges

98
Q

What is Orthojphthala Dehyde

or OPA?

A

chemical used as a high level

disinfectant (immersion disinfectant)

99
Q

At room temperature, how long does it
take for high level disinfection to occur
using OPA?

A

12 minutes

100
Q

What are some advantages of

Ortho Phthala Dehyde?

A

good alternative for individuals with a
sensitivity to glutaraldehydes, very little
odor, does not require mixing or activation

101
Q

What are some disadvantages

of Ortho Phthala Dehyde?

A

More expensive, can only be used half as long as most
glutaraldehydes, it may stain fabrics, plastics turn bluegreen color when proteins have been removed, and it
would require more than 30 hours to secure sterilization

102
Q

There is no scientific evidence showing
that housekeeping surfaces (e.g. floors,
walls, and sinks) pose a risk for what?

A

Disease transmission in dental

healthcare settings

103
Q

What are the majority of housekeeping

surfaces cleaned with?

A

Only a detergent and water or EPA
registered hospital
disinfectant/detergent

104
Q

Do you need to make fresh cleaning
solution each day or can you keep
leftovers for the next day?

A

You should discard of any remaining disinfectant
and allow the container to dry until the next day
when you make a fresh cleaning solution

105
Q

What should you try to avoid doing

while cleaning patient care areas?

A

Try to to produce mists, aerosols, or

disperse dust in patient care areas

106
Q

Can carpet be reliably

disinfected?

A

no

107
Q

What have studies found in

carpeting

A

Fungi and bacteria

108
Q

What does the CDC

recommend on carpeting?

A

Avoid using carpeting and cloth upholstered
furniture in dental operators, laboratories, and
instrument processing areas

109
Q

What causes the majority of

blood contamination in dentistry?

A

Spatter from procedures using

ultrasonic instruments

110
Q

Has it been proved that housekeeping
surfaces can lead to HIV, HBV, and
HCV?

A

No, but it is still important to use

good infection control practices

111
Q

What does OSHA require when it
comes to blood spills and other bodily
fluids?

A

It needs to be removed from the surface
and the surface should be properly
disinfected

112
Q

What should you aways wear when
cleaning up spills of blood or other
body fluid?

A

Gloves and other PPE

113
Q

What is greener infection

control?

A

Minimizing the environmental impact of
infection control products and
procedures

114
Q

What does going greener

require?

A

thoughtful planning, research,

and experimentation

115
Q

Are infection control procedures

usually environmentally friendly?

A

no

116
Q

How can we reduce paper use

in the office?

A

Using electronic records instead of
paper records that require 12.8 pages per
person

117
Q

How can we reduce radiology

in the office?

A

Using digital radiology instead of film
based radiology that requires the use of
chemicals and lead foil

118
Q

Which regulation requires the use

of surface disinfectant?

A

OSHA Blood borne pathogens

standard

119
Q

Why do you need to read all

labels carefully?

A

Statements may contradict each other,

you do not want to misuse product

120
Q

Autoclave

A

Instrument to sterilize by moist heat

under pressure.

121
Q

Biologic indicator

A

Vials or strips (spore test) that contains
harmless bacteria used to determine
whether sterilization has occured.

122
Q

Biologic monitoring

A

Verifies sterilization
All spore-forming microorganisms have
been destroyed.

123
Q

Chemical vapor sterilization

A

Hot formaldehyde vapors under

pressure.

124
Q

Clean area

A

Place where sterilized instruments, fresh
disposable supplies, & prepared trays are
stored.

125
Q

Contaminated area

A

Place where items are brought for

precleaning.

126
Q

Critical instrument

A

Sterilization
Instruments used to penetrate soft tissue
& bone.

127
Q

Dry heat sterilizer

A

heated air

128
Q

Noncritical instrument

A

Intermediate to low-level disinfection.

Contacts only intact skin.

129
Q

Semicritical instrument

A

Sterilization or high-level disinfection.
Come in contact with the oral tissues but
do not penetrate soft tissue or bone

130
Q

Ultrasonic cleaner

A

Instrument that loosens & removes
debris by sound waves traveling through
a liquid.

131
Q

CDC

A

Centers for Disease Control &

Prevention

132
Q

Seven steps for Instrument Processing

A 
Transport
Cleaning
Packaging
Sterilization
Storage
Delivery
Quality assurance program
133
Q

What are the three basics ways to
reduce transfer of organisms between
patients???

A

Sterilization
Disinfecting
Cleaning/sanitizing

134
Q

Transport

A

Transport contaminated instruments to the
processing area in a manner that minimizes the risk of
exposure to persons & the environment.
Use appropriate PPE & a rigid, leak proof container.

135
Q

cleaning

A

Clean instruments with a hands-free, mechanical process such an
ultrasonic clean or instrument washer.
If instruments cannot be cleaned immediately, use a holding
solution.
All debris must be removed before disinfecting or sterilizing.

136
Q

packaging

A

Packaging
In the clean area, wrap instruments in appropriate materials.
Place a chemical indicator inside the package next to the
instrument.
If an indicator is not visible on the outside of the package, place
an external process indicator on the package.

137
Q

Sterilization

A

Load the sterilize according to the manufacturer’s instructions.
Label packages.
Do not overload the sterilizer.
Place packages on their edges insingle layers. or on racks to increase circulation of the
sterilizing agent around the instruments.
Operate the sterilizer according to the manufacturer’s instructions.
Allow packages to cool handling.

138
Q

storage

A

Store instruments in a clean, dry environment in a manner that maintains the
integrity of the package.
Rotate packages so that those with the oldest sterilization dates will be used
first.
Do not store sterile instruments on an open tray or in a dental cabinet unless
they are covered.

139
Q

delivery

A

Delivery packages to point of use in a manner that
maintains sterility of the instrument until they are used.
Inspect each package for damage.
Open package aseptically.

140
Q

Quality assurance program

Should incorporate:

A

Training
Record keeping
Maintenance
Use of biologic indicators

141
Q

What are the three classification that are
used to determine the method of
sterilization???

A

Critical Instruments
Semicritical Instruments
Noncritical Instruments

142
Q

Identify the major sterilization.

A 
Liquid chemical sterilization
Glass (hot) bead sterilization
Dry heat sterilization
Rapid heat sterilization
Chemical vapor sterilization
Steam under pressure sterilization
Steam (flash) autoclave sterilization
143
Q

Liquid chemical sterilization

A

Glutaraldehyde

144
Q

What are the advantages &

disadvantages Glutaraldehyde???

A 
Advantages
-Disinfects
-Sterilize (6-10) hours
-Used for items that cannot endure heat sterilization
Disadvantages
-Difficult to monitor
-Toxic fumes
-Stains
145
Q

Glass (hot) bead sterilization

A

Small sterilizer-glass beads or salt

Temperature-450 degrees F (234 C

146
Q

what are the advantages & disadvantages

of Dry heat sterilization???

A 
Advantage
-Dried instrumentsndo not corrode or rust.
-Easily monitored
Disadvantage
-20 minutes to preheat
-2 hours to sterilize
-Solder joints melt
-Instruments must be thoroughly dried before placing them in a wrap or bag.
147
Q

Rapid heat sterilization

A

Temperature-375 f

148
Q

What are the advantages &
disadvantages of Rapid heat
sterilization???

A 
Advantages
-Sterilizes in 6-12 minutes
-No corrosion
Disadvantages
-Damage to some plastics
-Solder joints melt
-Pre-dry instruments
149
Q

Chemical vapor sterilization

A

Temperature-270 F (132 C)

150
Q

What are the advantages &
disadvantages of Chemical vapor
sterilization???

A 
Advantages
-20 minutes to sterilize
-Very reliable & can be easily monitored
-No corrosion-carbide & non-stainless steel
Disadvantages
-Formaldehyde & alcohol
-Must be vented
-Instruments must be thoroughly dry before placing in this sterilizer
151
Q

What instruments can go in the Chemical

vapor sterilizer???

A

Carbon steel/stainless steel
Surgical burs
Surgical instruments
Dental rotary handpieces

152
Q

Steam under pressure sterilizer

Autoclave

A

Temperature- 250-273 F (121 C) 15psi
Best method
Sterilize in a short period of time.

153
Q

What are the advantages & disadvantegs

of Autoclave???

A

Advantages
-10-30 minutes
-Good penetration of steam
-Easily monitored
Disadvantages
-Distilled water
-Rusts nonstainless (carbibe) steel instruments & burs-main disadvantage.
-15 minute drying cycle door must be cracked open for the drying process to take place at the end of each cycle.
-Has a corrosive effect on anything that is made of carbide steel.

154
Q

Steam (flash) autoclave sterilization

A

temperature - 270-273 F (132 C)

155
Q

What are the advantages &
disadvantages of the Steam (flash)
Autoclave sterilizer???

A 
advantages
-Easily monitored
-Sterilizes in 3 minutes unwrapped.
Disadvantages
-Instruments should be used promptly.
-Distilled water

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