Dental Infection Control Question And Answers

Infection Control In Dental Clinics Essay Questions

Question 1. Personal protective barriers in dental practice.
Answer: Full Personal protective barriers (PPB) in clinical dentistry includes protective eyewear, masks, gown, and gloves.

Dental practice Protective Eyewear:

• Eyewear (goggles with/without shields) pro¬tects dental professionals against infectious agents like herpes simplex and hepatitis B virus present in sprays, spatter, and aerosol.
• It also protects from possible injuries from small restorative materials or tooth fragments from patients’ mouths during dental procedures.
• It protects the eyes during lab procedures like trimming and polishing of dentures.
• Protective eyewear is also helpful for the use of UV rays irradiation.
• Protective eyewear is used by the dentist and the dental team should be decontaminated before reuse.

Read And Learn More: Oral Medicine and Radiology Question And Answers

Dental practice Marks:

There are three series of masks with different filter efficiency:

1. N series—95%,
2. R series—99%, and
3. P series—99.97%

• The filterability is known as particle filtration efficiency or bacterial filtration efficiency.
• Wearing mask by dental professionals protect the mucous membrane of the mouth and nose from direct contact with the disease-causing microbes present in aerosol particles of blood and saliva, sprays and spatter of oral fluids from the patient or materials conta¬minated with oral fluids.
• It also reduces the patients from the risk of developing postoperative infection by microorganisms present in the respiratory tract of the dentist and the team.
• Wearing masks by the dental team is essentially important when they are performing procedures using headpieces, ultrasonic scalers, air/water syringes, instrument processing, prosthesis placement, and extraction.
• The mask should be changed for every patient because the droplets of the previous patient might contaminate the outer surface.

Dental practice Protective Clothing:

• Outer protective clothing protects the dental team from taking home contaminated clothing. Similarly, this clothing protects the patients from the spread of microbes in unsterile dresses with open wounds.
• The dentist should remove the protective clothing before leaving the clinical work side.
• Protective clothing includes the use of disposable gowns with long sleeves and a high neck to cover regular clothes.
  Reusable protective cloths like aprons and lab coats may also be used for regular work but should be removed before leaving the clinical area.

Dental practice Gloves:

• Gloves are helpful in preventing the direct contact of the dentist’s fingers in the patient’s oral cavity hence protecting patients from microbes present on dentists’ hands and fingers.
• The regular habit of wearing gloves will prevent blood and saliva contamination around the fingernails.
• The high incidence of cross-infection among the ungloved dentists and dental team members is the herpes simplex virus infection (herpetic whitlow).

Routine gloving prevents infection spread at three levels:

1. From patient to dentist and dental team members
2. From dentists to patient
3. From patient to patient.

 

• Gloves should never be reused in patient care procedures. Cleaning the gloves with chemical disinfectants or detergents will not be effective because this may cause inherent defects and leads to the penetration of fluids.
• Also, torn or damaged gloves should be removed immediately.  Different gloves are available (like sterile latex gloves and sterile non-latex gloves—sty- rene gloves, polyurethane gloves) in different sizes to provide a better fit.

The order of wearing and removing personal protective barriers:

Wearing:

• Protective clothing
• Protective eyewear
• Mask
• Gloves

Removing:

• Protective clothing
• Gloves
• Protective eyewear
• Mask.

Question 2. Describe the routine infection control measures to be performed in a dental clinic.
(or)
Describe the functional mode of dental clinics to execute asepsis protocol.
Answer: Asepsis protocols need to be followed in every aspect of patient management in a dental clinic.

Dental Clinic Before Examining the Patient:

• Wear the protective gown, eyewear, mask, and gloves
• Clean and disinfect the instruments and dental chair by spraying surface disinfectant
• Remove and discard the used mask and gloves
• Arrange the surface covers and sterile instrument pack
• Cover the headrest, light handles, unit control switches, and control buttons
• Remove the items that are not intended for treatment like prescription pads, articulators, etc.

During Patient Examination and Treatment:

• Immediately after seating the patient:
  • Adjust the chair and headrest.
  • Place napkin.
  • Open sterile instrument pack without touching instruments.
    Put on a mask and goggles.
  • Put on gloves.
• During patient treatment:
  • Use a rubber dam.
  • Use high-volume evacuation.
  • Remove the contaminated gloves and wash your hands before handling the radiographic unit.
  • Do not touch nonsterile surfaces.
  • In the case of using syringes, insert the needle into the cap using the one-handed scoop technique after usage to prevent contact of the needle with any other part of the body.
  • In case of using equipment like light cure apparatus, it should be disinfected before use.
  • Disinfect the impressions/dental prostheses before sending them to laboratories.
  • Remove the gloves and wash hands before touching case records and prescription or investigation slips.
  • If exposed to patients’ blood or saliva on bare skin or mucosa, or any injury with contaminated instruments, appropriate postexposure prophylaxis is mandatory.

Dental clinic After Treatment:

• Remove the gloves, mask and discard them in a waste disposal container.
• Put on a new mask and gloves and place all instruments back on the tray
• Place the disposable sharp items and needles directly into the sharp item container.
• After each patient, flush the air/water syringes, handpiece, and ultrasonic scalars for 30 seconds before removing them from the water lines.
• Remove all surface covers.
• Disinfect the patient care surfaces that are not covered.
• Remove gloves, wash, rinse, and dry hands Dental unit water quality: For routine care, the unit water containing below 500 CFU/mL of bacteria should be used.
• When multiple-dose vial medications are used (for example local anesthetic solution), the access diaphragm should be cleaned with 70% alcohol every time before inserting the needle into the vial.
• Each time, a sterile needle and syringe should be used and reusing the needle should never be practiced. Multiple dose vials should always be kept away from the treatment area to maintain the sterile condition.

Infection Control In Dental Clinics Short Notes

Question 1. Hand hygiene products in dentistry
(or)
Healthcare set up
(or)
Handwashing agents.
Answer:

Plain soap without an antimicrobial effect is sufficient for removing dirt and transient microorganisms. Alcohol-based hand rubs may be used after using plain soap rinse for effective antisepsis.

• Professional handwashing products contain microbial agents, and surgical scrubs contain the highest amount of antimicrobial agents.
• Antimicrobial agents used in handwash products include alcohols, chlorhexidine digluconate, iodophor, triclosan, and quaternary ammonium compounds.

Handwashing should be performed mandatorily in dental clinics:

• At the beginning of the working hour
• When hands are soiled
• After touching contaminated objects or surfaces
• Before donning and removing the gloves.
• Before leaving the working area.
• At the end of the working hour.

Question 2. Handwashing technique.
Answer: Adequate handwashing is a mandate necessary hygienic procedure for dentists and dental team members to reduce the microbial contamination of the hands and fingers.

Handwashing Materials:

• Liquid soap and alcohol-based hand rub
• Handwashing liquid with an antimicrobial agent
• Hands-free soap dispenser
• Soft brush for nail cleaning
• Soft sponge
• Sterile disposable towels.

Before Starting of Practice:

• Gently clean fingernails (hand and finger jewelry should be removed).
• A liquid antimicrobial product and a soft brush should be used for cleaning the hands, nails, and forearms.
• While rubbing hands simultaneously rinse with water for 15 seconds.
• Hands and forearms should be dried up using sterile towels.

Handwashing During the Practice (To Remove Dirt and Transient Microbes)

• Using a liquid antimicrobial soap, thoroughly wash the hands for 15 seconds.
• Rinse with water for 10 seconds while rubbing your hands.
• Dry hands and forearms using sterile paper towels.

Alternate Method: When no Dirt is Visible

• Use an alcohol-based hand rub agent to clean the palm of the hand.
• Rub hands together to make them dry.

Question 3. Processing of dental instruments.
Answer:

Dental instrument processing is a series of activities carried out to clean contaminated instruments. There are seven steps to be followed to prevent the infection spread from a patient to dental team members, to the next patient or to the environment.

1. Presoaking—To avoid debris from drying.
2. Precleaning—Mechanically remove the biological remains of saliva and blood. To make the subsequent sterilization effective.
3. Corrosion control, drying, and lubrication— To reduce instrumental damage and to enhance proper functioning.
4. Packaging—To maintain the instrument sterility alter sterilization until they are used for the next procedure.
5. Sterilization—Kills all remnant microbes in the instruments.
6. Sterilization monitoring—Measures the effective functioning of sterilizer and completeness of sterilization.
7. Handling the processed instruments— Maintaining the sterility of instruments until they are used.

Question 4. Sterilization in dental clinics.
Answer: Sterilization is the process of killing all microbes and bacterial endospores (including Mycobacterium tuberculosis, fungal spores, hepatitis virus, herpes virus, and HIV).

In dentistry, three types of sterilization are followed:

1. Heat sterilization: Operates at 250°F to 375°F and the effectiveness is monitored using bacterial spores.
2. Liquid chemical sterilization: Chemicals like sterilants, glutaraldehyde, hydrogen peroxide, and peracetic acid solution are the few effective sterilizers at room temperature and are used for instruments that cannot withstand high temperatures in heat sterilization. Though these agents are sporicidal, their effectiveness cannot be monitored in the dental clinic.
3. Gas sterilization: Ethylene oxide gas sterilizes between 72°F and 140°F. Though sporicidal; it is not widely used because it is a high-cost technique that requires a special handling method and needs a long exposure time.

Question 5. Disinfection in dental clinics.
Answer:

Disinfection is a process of killing all disease-causing microorganisms but not endospores. A disinfectant is a chemical that is not sporicidal but can kill all other microbes. They cannot provide sterilization.

Commonly used disinfectants in dental clinics are:

• High-level disinfectants and sterilants: They kill all microorganisms including bacterial spores on heat-sensitive reusable instruments, for example. glutaraldehyde, hydrogen peroxide, peracetic acid, and hydrogen peroxide with peracetic acid.
• Intermediate-level disinfectants: This group of chemicals destroys all vegetative bacteria, most fungi and viruses, and tuberculosis. They are used to disinfect clinical contact surfaces, and noncritical surfaces with blood, e.g. chlorine-based products, phenolics, iodophors, and quaternary ammonium compounds with alcohol and bromides.
• Low-level disinfectants: They destroy most vegetative bacteria, some fungi, and some viruses. Not effective against tuberculosis. Useful for housekeeping disinfection (floor and walls), and disinfecting noncritical surfaces without blood, for example, quaternary ammonium compounds.

Question 6. Latex allergy.
Answer:

• The use of productive latex gloves may manifest type I immediate hypersensitivity reactions and contact allergic stomatitis in latex-allergic patients.
• The affected individuals are allergic to proteins in the latex material. They will become sensitized to this protein antigen within the first few (one or two) exposure and antibody production takes place.
• These antibodies bind to mast cells, and on subsequent exposures to latex antigens, these mast cells get activated and cause adverse effects. Patients may experience burning sensation and soreness accompanied by erythema and sometimes with vesicles and ulcers. These symptoms will occur within 20 minutes of contact.
• Once identified, latex allergy should be documented in the patient’s record.

Latex allergy Management:

• It is advisable for sensitive people to avoid natural rubber latex and use nonlatex gloves.
• Use powder-free gloves to avoid airborne infections.
  Antihistamine medication.
• Get a physician’s advice if an allergic reaction develops.

Infection Control In Dental Clinics Multiple Choice Questions

Question 1. Father of infection control is.

1. Antoni van Leeuwenhoek
2. Louis Pasture
3. Hippocrates
4. Ignaz Semmelweis.

Answer: 4. Ignaz Semmelweis

Question 2. The high-risk group for acquiring cross¬infection among health professionals are.

1. Lab assistants
2. Clinical nurses
3. Dentists
4. Blood bank technicians

Answer: 3. Dentists

Question 3. Source for prion cross-infection in dentistry is contaminated.

1. Handpiece
2. Endodontic instruments
3. Ultrasonic scalars
4. Scalpel

Answer: 2. Endodontic instruments

Question 4. Heavy utility gloves should be used.

1. Disinfecting contaminated surfaces
2. Major surgical procedures
3. Sterilization procedure
4. Instrument check-up

(Note: Heavy utility gloves should be used during operatory clean up, handling contaminated instruments, precleaning, and disinfecting contaminated surfaces).

Answer: 1. Disinfecting contaminated surfaces

Question 5. When unloading sterilizers, one should use.

1. Heavy utility gloves
2. Heat resistant gloves
3. Dust-free gloves
4. Nitrile long gloves

Answer: 2. Heat-resistant gloves

Question 6. Extracted teeth used for educational purposes should be.

1. Sterilized with hydrogen peroxide
2. Heat sterilized
3. Sterilized using infrared waves
4. Thoroughly rinsed in water

Answer: 2. Heat sterilized

Question 7. Extracted teeth with amalgam restoration should not be disposed by.

1. Composting
2. Dumping in
3. Recycling
4. Incineration

Answer: 4. Incineration

Question 8. Allergic contact dermatitis to gloves is.

1. Type 1 hypersensitivity reaction
2. Type 1 and 4 hypersensitivity reaction
3. Type 3 hypersensitivity reaction
4. Type 1 and 3 hypersensitivity reaction

Answer: 2. Type 1 and 4 hypersensitivity reaction

Question 9. Powder-free gloves are used to reduce the spread of latex protein allergens.

1. Latex protein allergens
2. Nosocomial infection
3. Aerosol infection
4. Cross-contamination

Answer: 1. Latex protein allergens

Question 10. Critical and semicritical dental instruments must be.

1. Air-dried and sterilized
2. Cleaned and sterilized
3. Air-dried and disinfected
4. Cleaned and disinfected

Answer: 2. Cleaned and sterilized

Question 11. Heat-sensitive semicritical instruments must be cleaned and subjected to.

1. Autoclave
2. Chemical sterilization
3. High-level disinfectant
4. Ultrasonic waves

Answer: 3. High-level disinfectant

Question 12. Noncritical dental instruments with blood tint must be cleaned.

1. High-level disinfectant
2. Intermediate-level disinfectant
3. Dry heat sterilization
4. Cold sterilization

(Note: Noncritical dental instruments must be cleaned and with intermediate-level disinfectant (in case of blood tint) or low-level disinfectant in case of no blood tint).

Answer: 2. Intermediate-level disinfectant

Question 13. In dry heat sterilization, spore testing is done with.

1. Bacillus atrophaeus strips
2. Bacillus cereus strips
3. Bacillus anthracis strips
4. Bacillus coagulans strips

Answer: 1. Bacillus atrophaeus strips

Question 14. In steam autoclaves and unsaturated chemical vapor sterilization, are used for spore testing.

1. Geobacillus stearothermophillus strips
2. Pyrolobus fumaric strips
3. Thermoascus aurantiacus strips
4. Thermus thermophilus strips

Answer: 1. Geobacillus stearothermophillus strips

Question 15. Bead sterilizers should not be used for sterilizing instruments to.

1. Do invasive procedures
2. Reuse for other patients
3. Preserve the instrument
4. Avoid rusting

[Note: Bead sterilizers are used to sterilize the tips of endodontic instruments (endodontic files and broaches) as they provide dry heat up to 425°F].

Answer: 2. Reuse for other patients

Question 16. Dental plaque is known as.

1. Microbial deposit
2. Oral substrate
3. Oral biofilm
4. Dental nidus

Answer: 3. Oral biofilm

Question 17. When there is an accidental chemical exposure to the eyes, the immediate safety measure to be followed is.

1. Close your eyes and take a rest
2. Apply antipode
3. Copius saline irrigation of eyes
4. Flushing of eyes with water

(Note: Flushing of eyes with water for 10-15 minutes is the recommended protocol)

Answer: 4. Flushing of eyes with water

Question 18. Information about the handling of hazardous chemicals in dentistry is revealed in.

1. Chemical data information sheets
2. Drugs and chemicals charts
3. Material safety datasheets
4. Chemical incident report

Answer: 3. Material safety datasheets

Infection Control In Dental Clinics Viva Voce

Question 1. What is the difference between sterilization and disinfection?
Answer: Sterilization is the process of killing all microorganisms and disinfection is the process of killing only disease-producing microorganisms but not bacterial endospores.

Question 2. What are the possible adverse reactions that can occur with gloving?
Answer:

• Irritant contact dermatitis
• Allergic contact dermatitis
• Latex allergy.

Question 3. What are the critical patient care items in dentistry?
Answer: Dental surgical instruments that penetrate soft tissues, contact bone, and bloodstream, and other instruments that contact the oral tissues like scalers, dental burs, and blades.

Question 4. What are the semicritical patient care items in dentistry?
Answer: Dental instruments that contact with oral mucosa but will not penetrate the soft tissues, bone or enter the bloodstream. Mouth mirrors, tongue depressors, cheek retractors, amalgam condensers, handpieces, and impression trays are semicritical dental instruments.

Question 5. What are the non-critical patient care items in dentistry?
Answer: Apparatus that contact intact skin are non-critical instruments which include blood pressure cuff, and stethoscope.

Question 6. What are the microorganisms present in dental unit water?
Answer:

• Pseudomonas (opportunistic infective agent in urinary tract infections and wound infections) and can cause infection in medically compromised dental patients.
• Legionella, causative agent for legionnaires (a type of pneumonia).
• Nontuberculous mycobacterium can cause infection in dialysis patients.

Question 7. What are the three basic principles of infection control proposed by WHO?
Answer:

• Protect the patient
• Protect the practitioner
• Repeat when necessary.

Question 8. What is biofilm?
Answer: Biofilm is a mass of microorganisms attached to the surface exposed to moisture.

Infection Control In Dental Clinics Highlights

• Infection control measures include all the efforts taken to control the spread of infection by disease-causing microbes. It contains a standard set of procedures to minimize the infection spread in healthcare practices.
• This chapter highlights the strategies to prevent cross-contamination of pathogens and infection control methods to be adopted in dental practice.