9. Infection Control in Dental Radiology

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Infection Control in

Dental Radiology

Dr. Raghunath Puttaiah

& Dr. Hui Liang


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Introduction & Rationale

Most oral and maxillofacial radiologynormally consists of non-invasiveprocedures

Although exposure to blood is notcommon, contact with saliva doesoccur


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What are the risks?? Common viruses seen in the oral cavity

include cytomegalovirus, herpes simplex viruses-1 &

2, hepatitis-B and D viruses, hepatitis-C virus,influenza viruses, Epstein-Barr virus (infectiousmononucleosis), Rhinoviruses (common cold),and HIV

Common bacterial pathogens seen are Pseudomonas, Flavobacterium, Staphylococci,

Streptococci, Diplococci, Pneumococci,

Mycobacterium, Chlamydia, and Spirochetesfrom human or inanimate sources

Candidiasis is also very common amongdental patients


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Rationale Most of Oral and Maxillofacial radiology (OMR)

procedures fall mainly in the semicritical andnon-critical categories of Spaulding'sClassification of inanimate surfaces

BUT

Many contagious diseases such as

Infectious mononucleosis and hepatitis-B canpossibly be spread by simple contact withsaliva

Therefore, it is necessary for aseptic techniques

to reduce ambiguity within protocols The purpose of this module is to present the

most recent information regarding aseptictechniques in OMR.


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What PPE is needed

It is not usually necessary to wear PPE such asimpervious gowns, long sleeves, masks andprotective eyewear during routine OMRprocedures when no aerosols, droplets or spatterare generated

One may use gloves, gowns, masks andprotective eyewear while treating patients withgagging problems

While handling the processor and the chemicals,

use full PPE Stay out of the Radiation Hazard area (behind ashield)

Patients must be protected with a lead apron


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Disinfectants and Barriers

Barriered films should be used whenavailable

Between patients, frequently touchedareas must be

Barriered with plastic barriersOR

-Disinfected with an Intermediate level, HospitalDisinfectant using a Spray-Wipe-Spraytechnique

If barriers are used between patients,disinfection is only needed at thebeginning or end of the day


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Steps in Infection Control

Unit Dose

1. Pre-procedural mouthrinsefor patients

Make them rinse forabout 30 seconds to

reduce the microbesin the mouth

2. PPE-GlovesMasks

EyewearGown


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Steps in Infection Control

Prepackaged films with plastic barriers


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Unbarriered films


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Barriered Films


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Steps in Infection ControlSteps in Infection Control

1. Unit dose supplies and sterile equipment on to a clean bib/worksurface

2. Set up the films on to the positioning devices

3. Label cups as Exposed and Unexposed


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Use of Disinfectants and Barriers

Disinfect surfaces atthe beginning and endof each day, andbetween patients onlyif contaminated

Avoid sprayingelectrical switches,wipe with disinfectantmoistened paper towel

Apply surface coversto the yoke, tubehead, cone, controlunit, head rest, armrest, and any hand

held switches


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Aseptic Procedures Place the sanitized lead apron and collar on the

patient after seating the patient

Set the required mA, kVp and exposure time onthe control unit and reset as required

Use Foot Controlled Trigger Switch if possible


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Now Please expose theRadiograph

The whole purpose in dental radiology is to

Get the radiograph


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Inside a daylight loader

Place the cup withexposed films on

one side and theEmpty one on theotherPlace a clean bib ornapkin as a barrier

Dispense a pair ofgloves


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Daylight Loader with Films Inside

Be sure toclose the lid

before exposingthe films


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Donning Gloves inside the Loader


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Various layers inside the polysoft film cover

Polysoft cover

Radio-opaque metal foilon the rear of the film

Paper folder that securesthe film

Film


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Barriered FilmsProcessing Barriered Films

Exposed film

Wear glovesPeel the outer cover and dropthe film into the Exposed cup

This should be done chairside


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Step 1 Step 2

Step 4Step 3


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Bare hands with barriered filminside a daylight loader


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Bare hands to be used to handleexposed and peeled film


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Unbarriered Films

Step 1 Step 2

Step 4Step 3

N t thi i id d li ht


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Now try this inside a daylightloader


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Bare hands to be used to handleexposed and peeled film

Remove your gloves and then handle the film that hasbeen taken out of the Polysoft cover


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Clean up after loading films

Carefully hold the edge of the napkin or bib and fold it over the wasteYou need not wear gloves if you hold the non-contaminated corners

i i f h li h d


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Disinfect the Daylight Loaderonce or twice daily if barriers

are used


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Panoramic Radiography

In panoramic radiography,infection control proceduresare very simple

Patient needs to have a leadapron

No contact of film with

saliva

Only one barrier is needed


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Chin rest

Bite block Barriered positioning device


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Infection Control in Panoramicradiography is very simpleAll one needs is a barrier forthe bite block

Make sure the lead apron is onFilm loaded on to the cassetteStay outside of the activeradiation area


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This film does not come in contact with saliva


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Position the patient correctly


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Make the patient remove the barrier on the bite block


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Digital Radiography


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Digital Radiography

Sensor

Barrier or sleeve

Sensor being insertedinto barrier

Sensor Barriered


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Digital Radiography

1. Insert the barriered sensor in the film holder on the Rinn holder


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Digital Radiography

Slide this dooropen


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Digital Radiography

Peel open the barrier withouttouching the sensor


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Digital Radiography

Slide the sensor into thechamber for the computerto read the image


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Digital Radiography


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Digital Radiography

Image appears on the screen within seconds

9. Infection Control in Dental Radiology

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