Asepsis in orthodontics/ dental implant courses by Indian dental academy

ASEPSIS IN ORTHODONTICS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com

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INTRODUCTION : 

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Re-emphasis of infection control in dentistry that occurred in mid 1980’s has now resulted in impressive approaches to prevention of disease spread in office Because of repeated exposure to micro-organisms in blood and saliva, incidence of certain infectious disease has been significantly higher among dental professionals than observed for general population.

Hepatitis B, TB, herpes simplex viral infections are well recognized and indicate need for increased understanding of modes of disease transmission and infection control procedures by dental care providers.

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HISTORY ď Ź

Louis Pasteur (1822-95) was the first scientist to show clearly that bacteria and moulds never generate spontaneously and that no growth of any kind occurs in sterilized media when precautions are taken to separate organisms from the surrounding air

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Joseph Lister (1827-1912) did most of his pioneer work on antiseptic methods in surgery ď Ź Robert Koch (1843-1910) was the first to make photomicrographs of stained smears, and in addition he pioneered methods of growing bacteria on agar media. ď Ź

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Development of microbiology in dentistry : 

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In recent years there has been an upsuge of interest in the microbiological aspects of dentistry Antonie van Leeuwenhoek in 1683 was first described microorganisms in human mouth Willoughby Dayton Miller in 1890 advanced the theory of the bacterial fermentation of sugar as the cause of dental caries

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STERILIZATION METHODS Sterilization is defined as the destruction or removal of all forms of life, with particular reference to microbial organisms ď Ź Disinfection refers only to the inhibition or destruction of pathogens ď Ź

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“All critical and semicritical dental instruments that are heat stable should be sterilized routinely between uses by steam under pressure (autoclaving), dry heat, or chemical vapor, following the instructions of the manufacturers of the instruments and the sterilizers”.

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Physical methods of sterilization    

Steam sterilization Dry heat Rapid heat transfer sterilization Unsaturated chemical vapor sterilization

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CHEMICAL STERILANTS

ETHYLENE OXIDE  GLUTARALDEHYDE 

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CHEMICAL DISINFECTANTS ALCOHOLS  IODINE & IODOPHORS  CHLORINE AGENTS  PHENOL DERIVATIVES 

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INSTRUMENT PROCESSING HOLDING(PRE SOAKING)  PRE CLEANING  PACKAGING  STERILIZATION  STERILIZATION MONITORING  HANDLING PROCESSED INSTRUMENTS 

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PERSONAL BARRIER TECHNIQUES GLOVES  MASKS  EYE GLASS  CLOTHING 

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SURFACE ASEPSIS

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Surface covers for Light handles Chair switches Head rests Handpiece hoses Unit controls Air – water syringe controls

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Use of disposables

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STERILIZATION OF ORTHODONTIC MATERIALS AND INSTRUMENTS Dental impression:Iodophor or 0.5% sodium hypochlorite.  Dental cast: disinfected with 1:10 dil of sodium hypochlorite  Plastic imp tray: chemical sterilization/disinfection  Orthodontic bands, arch wires, brackets, pliers : autoclave, chemical vapour and ethylene oxide. 

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FUTURE METHODS OF STERILIZATION

Microwaves: It has major limitations for sterilizing metal items by either damaging machine or not reaching all sides of instruments. ď Ź UV light: It is not highly effective against RNA viruses such as HIV and bacterial spores. Incomplete exposures of all surfaces and poor penetration of oil and debris. ď Ź

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FUTURE MODIFICATION FOR DENTAL EQUIPMENT 

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Decorative seams and bulk storage bins are rapidly disappearing from dental office.

Molded seamless components are being designed and manufactured.

An absolute minimum of ‘ nooks and corners’ will be incorporated onto future design of equipments.

Use of foot controls for patient chairs and dynamic instruments so further hand controls will decline. www.indiandentalacademy.com

Future will provide a substantial increase in use of custom fitted barrier materials for existing and future equipments. ďƒ˜ Use of disposable equipments, drapes, and gowns will continue to increase. ďƒ˜

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CONCLUSION Technologic advances have facilitated the evolution of infection over the past 10 – 20 years.  Dental practitioners are challenged to implement effective infection control measures during all dental procedures.  The decade of 2000s may well become the period of meeting the formidable microbiological and regulatory challenges of 1980s. 

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