Infection Control, Dental Public Health, Ethics, and Professional Regulation
What the exam tests
Sterilisation standards, sharps and exposure management, the principles of preventive dentistry at population level, and the legal-ethical duties of a licensed dentist.
Core rules
- Standard precautions apply to every patient. Hand hygiene at the WHO five moments, gloves, mask, eye protection, and single-use sharps. Instruments are cleaned, then sterilised: steam autoclave at 134°C for about 3-4 minutes (or 121°C for 15 minutes at 15 psi). Monitor with physical, chemical and biological indicators - Geobacillus stearothermophilus spores for steam.
- Handpieces and ultrasonic tips must be sterilised between patients; glutaraldehyde or chlorine-based disinfectants are for surfaces and heat-sensitive items, not for 'cold sterilisation' of critical instruments.
- Needlestick injury: encourage bleeding, wash with soap and water, do not scrub or suck, report immediately, check hepatitis B vaccination and source status, and start post-exposure prophylaxis within hours if indicated.
- Public health measures disease frequency with DMFT/dmft, plaque and bleeding indices; prevention is graded as primary, secondary and tertiary. Water fluoridation and fluoride toothpaste remain the most cost-effective caries prevention.
- Ethics: autonomy (valid informed consent, capacity, confidentiality), beneficence, non-maleficence and justice. Scope of practice, licensure and continuing education are regulated; advertising must not be false or misleading, and records must be accurate and retained.
Worked example
A dentist sustains a needlestick from a patient with unknown hepatitis B status. Reasoning: the immediate steps are to let it bleed briefly, wash with soap and water, report to the infection control officer and take a baseline blood sample. If the dentist is a non-responder to vaccination, hepatitis B immunoglobulin plus a vaccine booster is given as soon as possible; HIV post-exposure prophylaxis starts within hours. The incident is documented.
Traps that cost marks
- Wiping instruments with alcohol instead of autoclaving them.
- Skipping biological indicator monitoring of the autoclave.
- Discussing a patient's diagnosis with a third party without consent.