Infection Control and Safety
Domain overview
Infection Control and Safety tests standard precautions, instrument processing, surface management, and workplace safety rules that apply in an orthodontic operatory. Expect questions on sterilization monitoring, disinfectant levels, PPE, sharps, exposure response, and radiation or chemical safety.
Standard precautions and PPE
Treat every patient as potentially infectious. Perform hand hygiene before and after patient contact and after glove removal. Wear gloves, mask, eye protection, and a gown when splash is likely. Do not recap needles by hand; use a one-handed scoop or safety device. The exposure control plan, hepatitis B vaccination offer, and post-exposure evaluation are OSHA requirements.
Instrument processing
Transport contaminated instruments in a closed container. Clean by ultrasonic cleaner or washer-disinfector, dry, inspect, package with a chemical indicator, and sterilize. Steam autoclave cycles are commonly 121°C for 15 minutes or 134°C for 3 minutes, but follow the manufacturer. Store sterile packs closed. Run a biological spore test at least weekly for each sterilizer and keep records.
Disinfection levels
Critical items (penetrate tissue) require sterilization. Semicritical items (contact mucosa) require high-level disinfection or sterilization. Noncritical surfaces require low- or intermediate-level disinfection or barriers. Follow contact time; a quick wipe is not disinfection. Do not use glutaraldehyde as a surface disinfectant.
Worked example
A band pusher has been used and is visibly contaminated with blood. It contacts oral mucosa and may contact broken tissue, so treat it as semicritical-to-critical: clean it, then sterilize it. Do not merely wipe it with an intermediate disinfectant. Package it with an indicator, autoclave, and document the cycle and spore-test results.
Traps
Wearing gloves without eye protection. Using a disinfectant wipe and immediately drying the surface. Assuming the autoclave bag's external indicator proves sterilization. Skipping spore testing. Storing sterile and contaminated items together. Ignoring chemical labels and safety data sheets.