Infection control (hand washing _ gloves _ protection l

 

  1. 👉 Taking protection measures prior to beginning work .
  2. The dental staff must do the following before performing any dental work:
  3.  Get vaccinated against hepatitis B – It is an imperative.
     Take a detailed medical history. This is necessary to find out if the patient has been through
    some kind of active contamination or other diseases indicating immunosuppression or other
    systemic illnesses. Independently of the information you have collected from your patient, you
    must consider him/her potentially contaminated and take the precautions advised for all
    patients.
     Make sure all the instruments are sterilized. Any instruments used to penetrate soft tissues
    or bones, such as tweezers, chisels, cleaning scoops, scrapers, must be sterilized after use.
     Protect working surfaces.
     Make sure they have at their disposal all the disinfectant fluids and waste containers
    necessary.
    2. Hand washing
    Hand washing is the cornerstone of the ‘patient – doctor – auxiliary
    staff’ protection circle aiming at the prevention of cross infection.
    The dental personnel is obliged to wash their hands before and after coming in contact with the
    patient (or the instruments used) independently of wearing gloves or not during the operation.
    Hand washing must be performed meticulously so that every hand surface is adequately cleaned.
    Special attention must be paid to hand surfaces usually neglected when washed.
    The pictures illustrate the areas requiring special attention so that hands are properly cleaned.

After removing the gloves, hands must be carefully washed as very often there are pores in latex
allowing the penetration of contaminating matter.
Although frequent hand washing is a necessity, sometimes problems may appear such as dry skin and
dermatitis. To avoid such problems special moisturising lotions are recommended. These lotions,
moisturising creams etc. should be applied at the end of the day as they may cause the gloves to
develop pinholes, due to their chemical composition, in which case no protection is offered by the
gloves.
In most kinds of dental work, water and soap followed by an antimicrobial solution are sufficient.
In case of an injury, scratch or exudative injury, the person should postpone treating patients until
the wound is healed. If this is not possible, the use of a double pair of suitable and tolerable gloves
is recommended. As regards to antimicrobial solutions, although their use is not required,
solutions with prolonged action are preferable.
Their contribution to hand antisepsis is significant as pinholes may pre-exist or develop when
the gloves are in use allowing the penetration of oral fluids and blood. When an
antimicrobial solution remains effective for a long time after its application, adequate hand
protection from the development of germs on the skin surface below the gloves is provided.
Using antimicrobial solutions without prior meticulous hand washing is a defective and inefficient
procedure.
Alcohol antiseptic solutions or gels are effective in destroying the germs on the hand surface,
provided that their use is preceded by adequate cleaning.
It should be noted that a solution can have a prolonged antiseptic action only if it contains an
antiseptic agent such as chlorhexidine, quaternary ammonium compounds, octenidine or
triclosan.
 Hand washing before and after patient contact is absolutely necessary
 Antimicrobial solutions contribute to hand antisepsis !  Solutions are not used are the only antiseptic means .

3. Gloves
The medical and auxiliary staff is obliged to always wear latex (or vinyl or nitrile)
gloves during any dental work which involves contact with blood or saliva
containing blood or mucus. These gloves should not necessarily be sterilized unless
an operation is going to take place, particularly on patients with HIV infection.
Hands must be meticulously washed before wearing gloves.
The same procedure must be followed after removing gloves. Gloves are used during any dental
work, for a single patient only and, afterwards, they are removed and discarded.
Washing the gloves and performing any dental work to another patient is strictly forbidden.
Sterilizing examination gloves is also not allowed as manufacturally there is no guarantee of the
protection of their integrity. Disinfection fluids, essential oils, acrylic monomers, various dental
materials and instruments, several skin soaps and lotions may distort the cohesion of the glove
material.
In patients with confirmed HIV or HBV and HCV infection, it is recommended that double gloves
are used for the protection of the surgeon. If during any dental work it is necessary to use an extra
device or material, gloves should be covered with an extra pair of nylon gloves so that
contamination of those surfaces is prevented.
More often than not, aphylactic responses, at various levels, have been recorded due to latex
gloves.
In such cases the exact cause of this response must be searched (latex, talc, maize powder)
considering, also, agents facilitating aphylactic (anaphylactic?) responses (humidity). Finally,
appropriate hypoallergic gloves or vinyl/nitrile gloves should be provided. If there are injuries,
scratches or exudative injuries and the operation cannot be avoided, double gloving is
recommended for extra protection.
 Hand washing is necessary before wearing gloves
 Gloves are discarded after each patient !  Double gloves are recommended for patients with HIV, HBV, HCV infection .


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