Community Lec3

Lecture 1 review 1
 Health Concept and Dental Public Health

 Definitions and dimensions of Health
 Definitions of oral health and oral diseases
 Community Dentistry and its applications
 Preventive Dentistry
 Individual care versus dental public Health
 Procedural steps in community dentistry (survey, analysis, program
planning, program operation, funding and program appraisal).
Lecture 2 review 2
 Infection control (why, why it is important, definition, Goals).
 Disease transmission in Dental office (Direct contact, indirect contact,
contact with human fluids, inhalation of airborne MO).
 Infection control program
 Recommendations for IC in dental settings.
 Hand Hygiene
 Plain soaps and its types.
 Hand antiseptics
 Personal Protective Equipment (PPE).
 Gloves and gloving.
3
Infection Control 2
DR. FOUAD YOUNIS
BDS, MSC, PHD
Instrument processing 4
 Processing of dental instrument is

achieved through a collection of
procedures that prepare
contaminated instrument for reuse. It
must be performed to prevent
infection from one patient to another,
from the patient to the dental team.
Processing of instruments aims also to
minimize their damage because of
frequent sterilization and/or
disinfection.
Steps of instrument processing 5
1. Holding (presoaking):
Facilitates the cleaning process by
preventing dryness of debris. The
holding solution can be a
disinfectant/detergent or an
enzymatic cleaner.
2. Pre-cleaning:
to remove bioburden for proper subsequent
sterilization . Removal of debris and contamination
is achieved either by:
 Scrubbing with a detergent, and water.
 By an automated process (e.g., ultrasonic
cleaner or washer-disinfector) using chemical
agents.
3. Corrosion control, drying, lubrication:

to reduce damage to instruments and ensure proper
functioning of the instruments.
4. Packaging:
to maintain sterility of instrument following sterilizations.
5.Sterilizations or high level of disinfections:

to kill all microbes and ensure patient safety .
6. Sterilizations monitoring:
measures the use and functioning of the sterilizer .
 External indicators applied to the outside of a package (e.g., chemical indicator
tape or special markings) change color rapidly when a specific parameter is
reached, and they verify that the package has been exposed to the sterilization
process.
 Internal chemical indicators should be used inside each package to ensure the
sterilizing agent has penetrated the packaging material and actually reached
the instruments inside.
7. Storage and handling processed instruments:

to maintain the sterility of dental instruments during storage until use. The storage
area should contain enclosed storage for sterile items and disposable (single-use)
items.
Sterilization 12
 The sterilization section of the processing area

should include the sterilizers and related
supplies, with adequate space for loading,
unloading, and cool down. The area can also
include incubators for analyzing spore tests and
enclosed storage for sterile items and disposable
(single-use) items.
13
Sterilization can be achieved by one of the

followings:
1- Steam under pressure (autoclaving)

2- Dry heat
3- Unsaturated chemical vapor
Autoclaving: 14
Steam sterilization requires exposure of each item to direct steam
contact at a required temperature and pressure for a specified time
needed to kill microorganisms.
 A typical cycle for wrapped instruments includes heat-up and
pressurization time, followed by a 15-to-30-minute cycle during
which sterilization is taking place (121°C at 15 psi).
PSI= Pound per square Inch

Dry heat: 15
Employs high temperatures for

extended periods to achieve
sterilization of instruments. The proper
time and temperature for Dry-Heat
sterilization is 160°C for 2 hours or 170°C
for 1 hour. Instruments should be dry
before sterilization since water will
interfere with the process.
Unsaturated chemical vapor: 16
It involves heating a
chemical solution of
primarily alcohol with 0.23%
formaldehyde in a closed
pressurized chamber.
Critical instruments 17
Include forceps, scalpels, bone chisels, scalers and
surgical burs. Sterilization is achieved by steam
under pressure (autoclaving), dry heat, or
heat/chemical vapor.
Semi-critical instruments: 18
 such as mirrors, reusable impression trays and amalgam

condensers. In some cases, however, sterilization is not
feasible and, therefore, high-level disinfection is
appropriate.
Non-critical instruments: 19
 such as external components of x-ray heads, blood pressure

cuffs and pulse oximeters. Such devices have a relatively low
risk of transmitting infection may be reprocessed between
patients by intermediate-level or low-level disinfection
Clinical Contact Surfaces 20
 These surfaces can be directly
contaminated from patient
materials either by direct spray or
spatter generated during dental
procedures or by contact with
DHCP's gloved hands. These
surfaces can subsequently
contaminate other instruments,
devices, hands, or gloves.
Surfaces should be cleaned and
disinfected between patients by
using disinfectant.
Clinical contact surfaces 21
 Dental chair, light handles and switches

 dental radiograph equipment
 dental chair-side computers
 reusable containers of dental materials
 drawer and faucet handles
 countertops
 pens
 Telephones
 Door knobs.
Housekeeping Surfaces 22
 The majority of housekeeping surfaces need to be cleaned only with a

detergent and water or disinfectant/detergent.
 Schedules and methods vary according to the area surface, and amount
and type of contamination.
 However, when housekeeping surfaces are visibly contaminated by blood
or saliva or patient tissues, prompt removal and surface disinfection is
needed.
 The person assigned to clean the spill should wear gloves and other PPE as
needed.
 Visible organic material should be removed with absorbent material (e.g.,
disposable paper towels discarded in a leak-proof, appropriately labeled
container).
Regulated Medical Waste 23
(Bio-hazardous)
Regulated medical waste (RMW)is the portion of the waste stream that may pose a significant
risk of transmitting infection. RMW includes:
1. Swabs or dressings saturated with blood, disposed in "red bag".
2. Body fluids and liquid blood; these fluids can be disposed of into the sanitary sewer system.
3. Extracted teeth; placed in a red bag or sharps container.
4. Used sharps, including needles, scalpels, and other sharp objects that can puncture the skin.
This type of waste should be placed in a rigid puncture-resistant labeled container.
Dental Laboratory 24
 Dental prostheses, impressions, orthodontic
appliances, and other prosthodontic materials
(e.g., occlusal rims, temporary prostheses, bite
registrations, or extracted teeth) should be
thoroughly cleaned (i.e., blood and bioburden
removed), disinfected with a tuberculocidal
claim, and thoroughly rinsed before being
handled in the in-office laboratory or sent to an
off-site laboratory .
Assignment 2 (Graded) 25
 Searchthe internet for a disinfectant other

than the ones mentioned in these lectures
and write one page about it and send the
assignment on google classroom.
 Thedeadline for the assignment is
03/01/2021

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Lecture 1 review 1

 Health Concept and Dental Public Health

 Processing of dental instrument is

3. Corrosion control, drying, lubrication:

5.Sterilizations or high level of disinfections:

7. Storage and handling processed instruments:

 The sterilization section of the processing area

Sterilization can be achieved by one of the

1- Steam under pressure (autoclaving)

PSI= Pound per square Inch

Employs high temperatures for

 such as mirrors, reusable impression trays and amalgam

 such as external components of x-ray heads, blood pressure

 Dental chair, light handles and switches

 The majority of housekeeping surfaces need to be cleaned only with a

 Searchthe internet for a disinfectant other

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