Infection Control and Occupational Safety
Infection control and occupational safety: standard precautions every patient
Infection control is built on standard precautions: treat all blood and saliva as infectious. Perform hand hygiene before and after patient contact, wear gloves, masks, eye protection, and gowns as indicated, and avoid recapping needles. The chain of infection requires an infectious agent, reservoir, portal of exit, transmission, portal of entry, and susceptible host.
Instrument processing follows Spaulding classification. Critical items (surgical instruments, scalers, forceps) enter sterile tissue or blood and must be sterilized. Semicritical items (mirrors, impression trays) contact mucous membranes and require at least high-level disinfection, though sterilization is preferred. Noncritical items (countertops, blood pressure cuffs) contact intact skin and need low-level disinfection. Clean instruments before sterilization; debris protects microbes. Use biological indicators to monitor sterilizers, and do not use a sterilizer until the spore test is cleared.
Occupational safety includes sharps handling, hepatitis B vaccination, postexposure evaluation, and waste segregation. Dental unit waterlines need monitoring and flushing. Traps: confusing disinfection with sterilization; skipping biological monitoring; and wearing the same gloves from the operatory to the computer.
Rule of thumb: if an item touches broken skin or enters the body, it must be sterile. Example: a used surgical curette should be cleaned, packaged, sterilized, and monitored-not merely wiped with disinfectant.