Chapter 10
Infection Control
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
ObjectivesDefine the key words.State the purpose of infection control.Describe the possible routes of disease
transmission.Identify conditions for the chain of
infection and methods of breaking the chain.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Objectives Identify agencies responsible for
recommending and regulating infection control guidelines.
List the personal protective equipment recommended for the dental radiographer.
Explain disinfection and sterilization. Differentiate between semicritical and
noncritical objects used during radiographic procedures.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
ObjectivesDemonstrate competency in following
infection control protocol prior to radiographic procedures.
Demonstrate competency in following infection control protocol during radiographic procedures.
Demonstrate competency in following infection control protocol after radiographic procedures.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
ObjectivesDemonstrate competency in following
infection control protocol for handling and processing intraoral image receptors.
Demonstrate competency in following the infection control protocol when using an automatic processor with a daylight loader attachment.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Key WordsAcquired immunodeficiency syndrome
(AIDS)AntisepticAsepsisBarrier envelopeContaminationCross-contamination
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Key WordsDisinfectHepatitis BHuman immunodeficiency virus (HIV)ImmunizationInfection controlIntraoral dental film
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Key Words Microbial aerosol Pathogen Personal protective equipment (PPE) Protective barrier Sepsis Standard precautions Sterilize Universal precautions
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Introduction The purpose of infection control procedures
used in oral health care is to prevent the transmission of disease among patients and between patients and oral health care practitioners.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Introduction The radiographer must possess a thorough
understanding of the recommended infection control protocols that should be followed before, during, and after radiographic exposures.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Introduction The specific steps of the recommended
infection control protocols require practice to achieve competency in skilled handling of contaminated radiographic equipment and supplies.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Purpose of Infection Control Routes of infection transmission
Direct contact with pathogens in open lesions, blood, saliva, or respiratory secretions
Direct contact with airborne contaminants present in aerosols of oral and respiratory fluids
Indirect contact with contaminated objects or instruments
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Figure 10-1 Chain of infection.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Purpose of Infection Control Breaking the chain of infection
Immunization Removing the pathogen Reducing sufficient numbers of pathogens Blocking the portal of entry
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Table 10-1 Terminology
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Guidelines for Infection Control Standard precaution “Treat everyone as if known to be
infectious” All body fluids (except sweat) of all
patients, whether known to be infected or not, are assumed to be infected and the necessary infection control procedures must be applied to all.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
BOX 10-1 The Centers for Disease Control and Prevention (CDC) Recommended Infection-Control Practices for Oral Radiography
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Guidelines for Infection Control Government agencies are responsible for
developing, recommending, and/or regulating infection control guidelines: Centers for Disease Control and Prevention
(CDC) Occupational Safety and Health
Administration(OHSA) Food and Drug Administration (FDA) Environmental Protection Agency (EPA)
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Personal Protective Equipment (PPE) Protective clothing Masks Protective eyeware Gloves
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Figure 10-2 Radiographer preparing x-ray equipment. Wearing PPE (barrier gown, protective eyewear, mask, gloves) to place barriers to cover the x-ray tube head and PID. In the background, note that image receptor holders have been assembled and placed on a plastic barrier on the countertop.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Procedure 10-1 Procedure for Handwashing for Radiographic Procedures
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Disinfection and Sterilization of Instruments and Equipment
Disinfection Sterilization Classification of objects used in radiographic
procedures
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Disinfection and Sterilization of Instruments and Equipment
EPA-registered sterilants-disinfectants are classified as: High-level disinfectant Intermediate-level disinfectant Low-level disinfectant
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Table 10-2 Risk of T`ransmitting Disease Classification of Objects Used in Radiographic Procedures
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Infection Control Protocol for Radiographic Procedure
Protocol prior to the radiographic procedure Protocol during the radiographic procedure Protocol after the radiographic procedure
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Procedure 10-2 Infection control prior to the radiographic procedure.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Procedure 10-2 (continued) Infection control prior to the radiographic procedure
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Procedure 10-2 Infection control prior to the radiographic procedure.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Figure 10-4 Barrier envelope. (left) Film available from manufacturer sealed in barrier packet ready for use. (right) Barrier envelopes may be purchased separately.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Figure 10-5 Opening the barrier envelope. A steady pull is used, allowing the film packet to drop into a clean cup.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Figure 10-6 Barrier envelopes for phosphor plates. (Courtesy of Air Techniques, Inc.)
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Figure 10-7 Using a disinfectant wipe to prepare a digital sensor prior to placing plastic barrier.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Procedure 10-3 (continued) Infection Control during the Radiographic Procedure
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Figure 10-8 Remove saliva. Radiographer is swiping the film packet across a disinfectant-soaked paper towel prior to dropping the film into the containment cup.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Figure 10-9 Removing the plastic barrier from a digital sensor. Removal of sticky-backed biteblocks is easier if the image receptor holder remains in place attached to the barrier. (A) Grasping the holder in the palm of one hand, press on the sensor with the thumb.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Figure 10-9 (continued) Removing the plastic barrier from a digital sensor. Removal of sticky-backed biteblocks is easier if the image receptor holder remains in place attached to the barrier. (B) As the sensor begins to move, guide it out of the plastic sheath with the other hand.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Infection Control Protocol for Radiographic Processing
Film handling without the use of barrier envelopes
Film handling with the use of barrier envelopes
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Procedure 10-5 (continued) Infection control for processing radiographic films without barrier envelopes
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Figure 10-10 Steps for removing film from packet without touching film with contaminated gloves. (A) Open the film packet by lifting the plastic tab. (B) Locate the folded tab of black paper and grasp with finger and thumb. (C) Gently pull on the black paper tab sliding the film out of the packet. (D) Allow the film to drop out onto the plastic or paper towel barrier placed on the counter. Separate the lead foil from the rest of the packet and dispose of all materials appropriately.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Procedure 10-6 (continued) Infection control for an automatic processor with the daylight loader attachment.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Figure 10-11 Daylight loader with cover opened. The operator placed clean, dry hands through the baffles. Note that gloves will be put on once the hands are inside the unit.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Review: Chapter SummaryThe purpose of infection control is to
prevent the transmission of disease between patients and operators and between patients.
Standard precautions treat every patient as if known to be infectious.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Review: Chapter SummaryThe chain of infection involves a
susceptible host, pathogens in sufficient numbers to initiate infection, and an appropriate route for the pathogen to enter the host.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Review: Chapter SummaryThe Centers for Disease Control and
Prevention (CDC), the Occupational Safety and Health Administration (OHSA), the U.S. Food and Drug Administration (FDA), and the U.S. Environmental Protection Agency (EPA) each play a role in developing, recommending, and/or enforcing guidelines for infection control.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Review: Chapter SummaryPersonal protective equipment (PPE) is
used to prevent the transmission of infective microorganisms.
Disinfection and sterilization breaks the chain of infection to prevent the transmission of infective microorganisms.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Review: Chapter SummarySpecific step-by-step infection control
procedures must be performed prior to, during, and after the radiographic procedure.
Strict infection control protocol must be followed when using an automatic processor with a daylight loader.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Recall: Study QuestionsGeneralChapter Review
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Reflect: Case Study While exposing a full mouth series of
radiographs on your patient, you accidentally drop the film-holding device on the floor. Since you still have additional exposures to complete, you need the use of this device. Explain in detail what infection control protocol you would follow to deal with this dilemma.
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Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth EditionEvelyn M. Thomson • Orlen N. Johnson
Relate: Laboratory Application Proceed to Chapter 10, Laboratory
Application, to complete this activity.