![]() Red poster paint is still used in dramatic training exercises, workshops, and poster displays to show or evaluate contamination control in dental operatories. 14, 15 The results showed how extensively the dental operatory surfaces were smeared how time consuming, expensive, and difficult it was to clean the contaminated surfaces and how difficult it was to identify, clean, and disinfect objects covered with actual films of invisible saliva. In this study, a hygienist was photographed treating a manikin fitted with dentures coated with red paint ( Online Fig. 12, 13Īnother study used water-soluble red-fluorescent poster paint (plain water-soluble fluorescent-red tempera in water) as a visible substitute for saliva to elevate awareness and facilitate problem solving in infection control. Cross-contamination of patients by such contaminated surfaces was documented in a clinical office radiology setting. Soiled surfaces that are poorly cleaned provide another source of gross environmental contamination and thus potential contamination of personnel and patients. The invisible trail of saliva left on such contaminated surfaces often defies either awareness or effective cleanup. With saliva-contaminated hands, the hygienist, the dentist, and the assistant could repeatedly contact or handle unprotected operatory surfaces during treatments. 9, 11 To help reduce exposure to air-borne particles capable of transmitting respiratory infections, adequate air circulation should be maintained, and masks should be kept in place until air exchange in the room has occurred or until personnel leave the operatory. A pretreatment mouthrinse, rubber dam, and high-velocity air evacuation also can reduce microbial exposure. 7, 11īarrier protection of personnel using masks, protective eyewear, gloves, and gowns is now a standard requirement for dental procedures. 9 Spatter or splashing of mucosa is considered a potential route of infection for dental personnel by blood-borne pathogens. Spatter has a distinct trajectory, usually falling within 3 feet (ft) of the patient’s mouth, having the potential for coating the face and outer garments of the attending personnel. 10 Spatter consists of particles generally larger than 50 mm and even visible splashes. 9 Aerosols and mists produced by the cough of a patient with unrecognized active pulmonary or pharyngeal tuberculosis are likely to transmit the infection. Heavy mists tend to settle gradually from the air after 5 to 15 minutes. 5– 8 Mists that become visible in a beam of light consist of droplets estimated to approach or exceed 50 mm. 3, 4 Transmission of human immunodeficiency virus (HIV) by aerosols is even less likely, as evidenced by the extremely low transmissibility of HIV in dental procedures and in the homes of infected persons. No scientific evidence indicates, however, that fine aerosols have transmitted the blood-borne infection caused by hepatitis B virus (HBV). 2 Aerosols and larger particles may carry agents of any respiratory infection carried by the patient. Aerosols consist of invisible particles ranging from 5 mm to approximately 50 mm that can remain suspended in the air and breathed for hours. With respect to size, these air-borne contaminants exist in the form of spatter, mists, and aerosols. 19-1).Ī high-speed handpiece is capable of creating air-borne contaminants from bacterial residents in the dental unit water spray system and from microbial contaminants from saliva, tissues, blood, plaque, and fine debris cut from carious teeth (see Online Fig. ![]() Universal use of treatment gloves, masks, protective eyewear, overgarments, plastic barriers to protect equipment, proper disinfectants, and instrument sterilization provides a professional health care atmosphere that conveys conscientious protection and treatment according to sound principles of infection control in keeping with current regulations ( Online Fig. ![]() Although that concern has not waned, emphasis now has expanded to ensuring and showing to patients that they are well protected from risks of infectious disease. Providing a supportive, informal, relaxed, and nonthreatening operatory environment has been one emphasis. 1Īlthough the objective of operative dentistry has been to provide the highest standard of care, a prevailing concern has been to minimize the patient’s anxiety with regard to treatment. The goal is to ensure compliance with standard precautions and other methods to minimize infection risks. Every health care specialty that involves contact with mucosa, blood, or blood-contaminated body fluids is now regulated. Pervasive increases in serious transmissible diseases over the last few decades have created global concern and have affected the treatment approach of all American health care practitioners. Exposure Risks and Effect of Infections on Dentistry ![]()
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