Infection Control in Radiology and Dental Labs
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Questions and Answers

What is the primary requirement before items can enter the receiving area in a dental practice?

  • They must be documented in a log.
  • They must be approved by the dentist.
  • They must be disinfected properly. (correct)
  • They must be covered in plastic.

Which practice is recommended for the maintenance of the receiving area?

  • Limit access to the area to one staff member.
  • Regular cleaning and disinfection of surfaces. (correct)
  • Use of paper towels for cleaning.
  • Daily inspections by the dental team.

What is a recommended alternative for disinfecting prostheses that cannot withstand heat sterilization?

  • Chemical fumigation.
  • Hot water washing.
  • Microwave treatment.
  • Immersion in a disinfectant after thorough cleaning. (correct)

What minimum level of disinfectant activity should be used for cleaning dental prostheses?

<p>Intermediary level with tuberculocidal claim. (A)</p> Signup and view all the answers

What is the proper first step after removing impressions from the patient's mouth?

<p>Rinse with tap water. (B)</p> Signup and view all the answers

Why is it important to note the manufacturer's instructions regarding impression materials?

<p>To ensure effective disinfection procedures. (C)</p> Signup and view all the answers

What should be done with heavily soiled prostheses before disinfection?

<p>Clean or scrub them first. (A)</p> Signup and view all the answers

What personal protective equipment (PPE) is recommended when handling prostheses before disinfection?

<p>Gloves and protective outerwear. (A)</p> Signup and view all the answers

What should be done to impressions after soaking them in disinfectant for 15 minutes?

<p>Rinse them with tap water and shake them gently. (D)</p> Signup and view all the answers

Why is spraying disinfectant on some types of impressions considered less effective than immersion?

<p>It may not ensure constant contact with all surfaces. (C)</p> Signup and view all the answers

When handling hazardous chemicals, what type of personal protective equipment (PPE) is mandatory?

<p>Masks and protective eyewear. (C)</p> Signup and view all the answers

What is a potential drawback of using spray disinfection as mentioned in the content?

<p>It increases the chances of personnel exposure. (B)</p> Signup and view all the answers

In what situation is immersion preferred over spraying for disinfecting impressions?

<p>When disinfecting heat-tolerant items. (C)</p> Signup and view all the answers

Which type of impression materials should be sprayed rather than immersed?

<p>Those sensitive to immersion. (C)</p> Signup and view all the answers

What should be done if further hand-scrubbing is required after disinfecting?

<p>Keep personal barriers in place. (A)</p> Signup and view all the answers

What is the recommended duration for soaking impressions in disinfectant?

<p>15 minutes. (A)</p> Signup and view all the answers

What should prostheses never be returned in?

<p>Disinfectant solutions (D)</p> Signup and view all the answers

What is essential to prevent cross-contamination in the laboratory?

<p>Performing laboratory work on disinfected items (C)</p> Signup and view all the answers

What is the recommended air velocity for the air-suction motor during grinding?

<p>200 ft/min (C)</p> Signup and view all the answers

How often must the lathe unit be disinfected?

<p>Twice a day (D)</p> Signup and view all the answers

What type of agents should be obtained in small quantities to minimize the spread of microorganisms?

<p>Polishing agents (B)</p> Signup and view all the answers

What protective equipment is highly recommended when using a lathe?

<p>Protective eyewear and mask (A)</p> Signup and view all the answers

What is the purpose of using a metal enclosure with hand holes on the lathe?

<p>To maximize containment of aerosols (C)</p> Signup and view all the answers

What should be done with all attachments used in the lathe?

<p>Disinfect or dispose of them after use (A)</p> Signup and view all the answers

What type of disinfectant should be used for cleaning dental prostheses before handling?

<p>A hospital disinfectant with at least intermediate-level activity (A)</p> Signup and view all the answers

Which items should be cleaned and heat-sterilized if they are heat-tolerant?

<p>Metal impression trays (C)</p> Signup and view all the answers

What claim must a disinfectant solution have to be suitable for use on items contaminated with HIV or HBV?

<p>Low-level claim (A)</p> Signup and view all the answers

Which practice decreases the chances of exposure to infectious agents during dental procedures?

<p>Consistent use of appropriate PPE (B)</p> Signup and view all the answers

What should be done with heat-tolerant intraoral devices between patients?

<p>Clean and heat-sterilize them (A)</p> Signup and view all the answers

When sending laboratory cases off-site, what specific information should be included?

<p>The disinfection technique used (A)</p> Signup and view all the answers

What should exposed films be placed into after being held within barrier pouches?

<p>A disposable plastic cup (A)</p> Signup and view all the answers

Which item is typically not required to be sterilized in dental radiology?

<p>Exposed radiographic films (B)</p> Signup and view all the answers

What is the first step after removing contaminated barriers from film packs?

<p>Dropping the film packs onto a clean surface (D)</p> Signup and view all the answers

Which of the following is NOT a step in darkroom processing?

<p>Opening film packets with contaminated gloves (B)</p> Signup and view all the answers

During the daylight loader processing, which condition must be met for films to be processed?

<p>Only uncontaminated films are used (A)</p> Signup and view all the answers

How long should plastic film packets be soaked in a disinfectant solution?

<p>10 minutes (D)</p> Signup and view all the answers

What must be done after the films are processed in the darkroom?

<p>Place films into appropriate mounts with care (C)</p> Signup and view all the answers

Which of the following actions is taken first when preparing to process films in the darkroom?

<p>Carry the films to the darkroom (C)</p> Signup and view all the answers

What is the correct order of actions after opening film packets in the darkroom?

<p>Place films on a towel, discard wrappers, and process films (B)</p> Signup and view all the answers

Which precaution is essential while handling exposed film packets?

<p>Avoid contact with any surfaces with contaminated gloves (A)</p> Signup and view all the answers

What should be done with unused polishing attachments?

<p>Throw them away (C)</p> Signup and view all the answers

What safety measures should be taken when using materials like gypsum and pumice?

<p>Protect against respiratory and eye contact (D)</p> Signup and view all the answers

What should be done with microbially soiled prostheses before sending them back to the patient?

<p>Disinfect them properly (B)</p> Signup and view all the answers

Why should prostheses never be returned in disinfectant solutions?

<p>They can cause adverse tissue response (D)</p> Signup and view all the answers

What is a primary reason that returned appliances might not be free of microbial contamination?

<p>They can be contaminated by the operator's body (B)</p> Signup and view all the answers

What personal protective equipment (PPE) should be used until laboratory items are decontaminated?

<p>Gloves, mask, protective eyewear, and clothing (C)</p> Signup and view all the answers

What is the risk associated with patients who have open oral lesions during treatment?

<p>They facilitate easier microbial penetration (D)</p> Signup and view all the answers

What is one of the main functions of the deodorizing solution used for disinfected prostheses?

<p>To neutralize offensive odors (C)</p> Signup and view all the answers

Flashcards

Receiving Area

A designated area within a dental practice to receive and handle all items sent to the laboratory, ensuring proper disinfection before entry. It should be equipped with running water and handwashing facilities.

Covering the Receiving Area

Impervious paper is used to cover the receiving area and counter surfaces to prevent contamination and facilitate regular cleaning and disinfection.

Disinfection of Prostheses

Dental prostheses are potential sources of infection, requiring proper disinfection before handling. This is because they can harbor bacteria and viruses.

Disinfection Methods for Prostheses

Most prostheses and appliances cannot withstand heat sterilization, so disinfection by immersion after thorough cleaning is a common alternative.

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Disinfection Procedures for Prostheses

Cleaning, disinfection, and rinsing of dental prostheses and materials with a registered disinfectant having tuberculocidal activity is crucial before handling in the laboratory.

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PPE for Handling Prostheses

Always wear gloves and protective outerwear when handling prostheses until they are thoroughly disinfected. This helps prevent cross-contamination.

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Cleaning Heavily Soiled Prostheses

Heavily soiled prostheses with calculus or adhesive require cleaning or scrubbing before disinfection to remove debris effectively.

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Ultrasonic Cleaning for Prostheses

Placing prostheses in zippered plastic bags containing ultrasonic detergent and then using an ultrasonic cleaner is an efficient and safe method for cleaning and disinfecting.

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Impression Immersion Disinfection

A process of cleaning dental impressions by immersing them in a disinfectant solution for a specific time (usually 15 minutes).

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Disinfection Spraying

An alternative to immersion, where dental impressions are thoroughly sprayed with a disinfectant solution and then wrapped with moistened paper towels.

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Immersion vs. Spraying

The preferred disinfection method for dental impressions as it ensures consistent contact of the disinfectant with all surfaces.

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PPE for Disinfection

Protective measures that should be worn when handling disinfectants and cleaning dental prostheses.

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Sensitive Impressions

Special care should be taken when disinfecting sensitive impression materials, as prolonged immersion may damage them.

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Microorganisms in Dental Impressions

Microorganisms found in dental impressions and prostheses must be eliminated to prevent infection.

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Sterilizing Dental Tools

Cleaned prostheses and impression trays should be sterilized with heat to ensure complete removal of microorganisms.

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Disinfection of Dental Instruments

Instruments used for cleaning and disinfecting dental prostheses must also be properly sanitized.

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Returning Disinfected Prostheses

Dental prostheses that have been disinfected properly should be returned to the patient's office in a deodorizing solution, like a mouth rinse. Never send or receive prostheses in disinfectant solutions due to the increased risk of adverse tissue reactions.

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Disinfect Before Lab Work

Laboratory work should always be performed on previously disinfected impressions, appliances, and prostheses. Bringing untreated materials into the lab increases the risk of cross-contamination.

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Lathe Safety

Grinding, polishing, and blasting dental materials generates aerosols, spatter, and projectiles. Protect yourself with PPE, including eye protection, a Plexiglas shield, and a properly functioning ventilation system. A mask is highly recommended.

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Aerosol Containment

Use an air-suction motor with a minimum air velocity of 200 ft/min to contain aerosols and spatter. Consider using a metal enclosure with hand holes attached to the front of the lathe hood for maximum protection.

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Lathe Maintenance

Sterilize or disinfect all attachment tools like stones, wheels, and bands between uses or dispose of them. Disinfect the lathe unit twice daily and always use fresh pumice and pan liners for each case.

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Polish With Caution

Polishing dental appliances and prostheses before delivery is important but can expose the operator to cross-contamination and injury. If the item was prepared aseptically, the risks are minimized. Use small quantities of polishing agents to avoid spreading microorganisms.

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Prostheses Contamination

Dental prostheses are a potential source of infection and require proper disinfection before handling. Improper disinfection could lead to bacteria and viruses being transmitted to the patient or staff.

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Laboratory Asepsis

Involves disinfecting prostheses and impressions before handling them in the laboratory, ensuring they do not contaminate the environment or pose a risk to staff.

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Single-Use Disposable Items

Disposable items like brushes, wheels, and cups that are used once and then discarded.

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Wax Try-In

A step in dental prosthesis creation involving a trial fitting of the prosthesis before final cementation or soldering.

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Dental Impression

A type of dental impression that is taken of the mouth to create a mold for a prosthesis.

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Disinfection of Returned Prostheses

Dental appliances and prostheses returned to the patient can still carry microbes, requiring disinfection at the chairside to prevent cross-contamination.

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Deodorizing Solution

A solution that helps remove odors from prostheses and appliances.

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Sterilization

A process used to kill microorganisms and bacteria on instruments and surfaces, ensuring a sterile environment.

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Personal Protective Equipment (PPE)

Protective equipment like gloves, masks, and eyewear used to safeguard individuals from potential contamination or injury.

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Sterilizing Oral Items

Items used in the mouth, like metal impression trays and face-bow forks, need to be cleaned and sterilized with heat to kill all germs.

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Cleaning Non-Oral Items

For disposable items, follow the manufacturer's instructions. If not available, clean and sterilize with heat or use a disinfectant with low-level to intermediate-level activity.

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Protecting Yourself

Gloves, masks, gowns, and eyeglasses protect you from germs. Always wear them during patient care and use protective covers for surfaces.

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Sterilizing Radiographic Tools

Dental tools like film holding devices should be sterilized with heat. Use heat-tolerant or disposable options whenever possible.

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X-ray Film Safety

Films used for taking X-rays are placed in barrier pouches and then into a disposable cup or on a labeled paper towel to prevent spreading germs.

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Disinfecting Prostheses

Dental prostheses and materials (impressions, bite registrations, etc.) must undergo cleaning, disinfection, and rinsing with an EPA-registered disinfectant. This ensures they're free of germs before handling.

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Manufacturer Guidelines for Disinfection

Always check the manufacturer's instructions for disinfecting specific materials, like impression materials.

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Disinfection Record Keeping

When sending lab cases off-site or receiving them back, include details on the disinfection technique used. This ensures everyone knows how the items were cleaned.

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Film Packet Disinfection

After exposure, film packs are rinsed with water, soaked in a bleach or iodophor solution for 10 minutes, rinsed again, and dried with a clean paper towel before being placed in the loader.

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Pre-Exposure Wrapping

Film packs are pre-wrapped with a removable plastic barrier. After exposure, the outer wrapping is removed, and the film packet is dropped onto a clean surface, avoiding contact with contaminated gloves.

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Daylight Loader - Contamination Prevention

Only films that are not contaminated should be placed in the daylight loader, because it cannot be fully disinfected.

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Darkroom Processing - Gloves

Gloves are donned before handling films in a darkroom, and care is taken not to touch contaminated surfaces with the gloves.

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Darkroom Processing - Film Handling

After opening the film packet, the films are placed on a clean paper towel, and the contaminated wrapper is disposed of properly.

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Darkroom Processing - Film Placement

Films are placed in the processor with gloved hands, and hand hygiene is performed immediately after.

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Darkroom Processing - Mount Placement

After processing, the films are placed into their mounts using care not to contaminate them with instruments used during the procedure.

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Surface Barrier Removal and Disinfection

Surface barriers are removed from equipment, or contaminated surfaces are cleaned and disinfected after each use, ensuring a clean environment.

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Study Notes

Strategies Within Contaminated Zones

  • The presentation covers basic infection control measures for the Radiology Unit and Dental Lab, specifically for handling and disinfecting items that come into contact with potentially contaminated material.
  • The presentation emphasizes maintaining aseptic procedures throughout the process to prevent cross-infection.
  • All items originating from the oral cavity (e.g., prostheses, impressions) are to be sterilized or disinfected before entering the lab and before returning to the patient.
  • Aseptic procedures will vary depending on the type of dental material.

Laboratory Asepsis

  • Any instrument or equipment used in the oral cavity or on orally soiled prosthetic devices or impressions may be a source of cross-infection
  • It's practically impossible to identify all infectious patients based on histories or conversations. All patients should be treated as potentially infectious.
  • Contaminated items introduced into the lab environment may spread to other patients' prostheses/appliances and potentially expose lab personnel to infectious materials.

Microbially Soiled Prostheses and Impressions

  • All prostheses from the oral cavity are potential infection sources.
  • Most prostheses and appliances cannot withstand standard heat-sterilization procedures.
  • A technique involving proper cleaning followed by disinfection by immersion is recommended.

Protective Barriers

  • All items from the oral cavity need sterilization or disinfection before use in the lab and before return to the patient.
  • Guidelines or recommendations for specific types of dental materials may be available (specific procedures may need to be followed according to different materials).
  • Infection control also involves proper PPE (dependent on the situation) such as gloves, safety eyewear, gowns, and masks during laboratory procedures.

Receiving Areas

  • A receiving area needs to be established to handle all items coming to the lab.

  • No item should enter the area before proper disinfection.

  • The area needs running water and handwashing facilities.

  • The area should be covered and the counter with impervious paper and cleaned and disinfected regularly to control the rate of disinfection.

  • The amount of cleaning and disinfecting will vary based on the rate of use.

  • Use Personal Protective Equipment (PPE) when handling items received in the lab until the items have been disinfected.

Spraying

  • Spraying is a treatment method for some dental materials; it often utilizes the same disinfectant for general disinfection of environmental surfaces.
  • It is frequently considered less effective than immersion in disinfection, as constant contact with all surfaces to ensure disinfection may be difficult and impossible to achieve effectively.
  • Spraying may increase personnel exposure risks due to disinfectant release into the air.

Grinding, Polishing, and Blasting

  • Perform laboratory interventions (e.g., grinding, polishing, blasting) on previously disinfected items, avoiding potential cross-contamination from untreated items.

  • The tools used in these procedures need to be properly sterilized.

  • Protect against aerosols, spatter, and projectiles by using a mask, protective eyewear (Plexiglas shield), and correct ventilation systems.

  • The air suction motor velocity should be at least 200 ft/min.

  • Use fresh pumice, pan liners for each individual case, and disinfect the lathe unit twice daily.

Intermediate Cases

  • Dentures, crowns, and various other appliances will undergo an intermediate wax try-in phase.
  • If these procedures involve oral fluids and materials, disinfection before moving the materials to the lab for further processing is required.
  • Procedures generally follow similar guidelines to complete projects.

Digital Radiographic Sensors

  • Digital sensors are not heat-sterilizable or chemically disinfected
  • The alternative is to prevent contamination using a protective barrier over the sensor and wire.
  • These sensors provide an alternative to traditional x-rays and can be used repeatedly.

Radiographic Asepsis

  • Consistent use of appropriate PPE (e.g., gloves, masks, gowns, eyewear) is vital to prevent exposure to infectious agents.
  • Environmental surfaces should be cleaned and disinfected appropriately.

Taking Radiographs

  • Use X-ray films within FDA-cleared barrier pouches and place them on a labeled paper towel or disposable plastic cups.

Darkroom Processing

  • Use fresh gloves, ensuring caution not to contaminate darkroom surfaces.
  • Carefully open film packets, dropping films onto a clean paper towel.
  • Contaminated film wrappers should be placed in designated refuse containers.
  • After processing, place films into appropriate mounts or charts without contaminating them.

Daylight Loader Processing

  • Due to the limited processing space, this method is only used on non-contaminated films.
  • For disinfected films a bleach or iodine solution may be used, and the films are thoroughly rinsed, dried, and then placed into the loader.

Return of Completed Cases

  • Appliances and prostheses are not free of contamination. Microbial contamination may be from patients or the operator if aseptic procedures are not followed consistently.
  • Patients' status (open oral lesions, impaired immune systems, or those undergoing chemotherapy treatments) and procedures may pose a risk of easily transmitting microbial infections.
  • Chairside disinfection is the best location for this process.

Laboratory Asepsis (detailed)

  • Gloves, masks, protective eyewear, and protective clothing are necessary and should be used, until items are decontaminated.
  • All prosthetics and prothodontic items (e.g., impressions, bite registrations, occlusal rims, extracted teeth) are to be thoroughly cleaned, disinfected, and rinsed with a hospital-grade disinfectant. The product should be EPA registered with at least an intermediate disinfection level and ideally tuberculocidal activity.
  • Consult manufacturers' instructions for material stability relative to the chosen disinfection procedures.
  • Procedures, solutions used, and duration of the cleaning/disinfection technique are included in the procedure documents and are essential for proper off-site laboratory cases.

Heat-Tolerant Items

  • Heat-tolerant oral items (e.g., metal trays, facebow forks) should be cleaned and heat-sterilized.
  • Cleaning and/or disinfection of other laboratory items (not normally in contact with the patient, e.g.; burs, polishing points, rag wheels, articulators, case pans, and lathes) should follow manufacturer guidelines (with an emphasis on disposable items when possible). Use EPA-registered hospital disinfectants with low/intermediate level action as necessary.

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Description

This presentation explores essential infection control strategies for the Radiology Unit and Dental Lab. It covers the disinfection and sterilization processes for items in contact with potentially contaminated materials and emphasizes the importance of maintaining aseptic procedures to prevent cross-infection.

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