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Dental Assistants 2013

Albert de Villiers

on 1 May 2013

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Transcript of Dental

Immunization How immunizations work – 101

Dental Offices and Immunization Infectious Disease IPC Community Water Fluoridation Boil Water Advisories Active
- induce active immunity by antibodies
- longer lasting

- immune globulin
- transient Type of Immunization Active

- stimulate the body to produce a primary immune response
- produces antibodies
- protects against disease
- boosters

- pneumococcal, influenza, hepatitis A+B, MMR, varicella
- toxoids: tetanus / diphtheria Passive
- administration of antibodies
- blood products
- short term

- Tetanus Immune Globulin
- Hepatitis B Immune Globulin All Dental Health Care Personnel should be ADEQUATELY immunized against:

Hepatitis B

What can they do to you or for you

Dr Albert de Villiers
Medical Officer of Health Influenza The i's are the window to the soul (of the dentist)

Infectious Diseases
Infection Control
Interesting tidbits A total of 108 cases have been confirmed in seven provinces, and 23 have died. "The H7N9 virus has infected 108 people in China since it was first detected in March, according to the Geneva-based WHO. Although it is not clear exactly how people have been infected, WHO experts see no evidence so far of the most worrisome scenario – sustained transmission between people." Incubation period 1-3 days

Transmitted by
- Large droplet/direct contact (2 meter)
- Indirect contact (secretions)

Can spread 24 hours before or 7 days after symptoms

Sick for 5-7 days (if uncomplicated) What is Influenza? Types of Influenza Type A
widespread epidemics & pandemics
has tendency to mutate
Type B
infrequently regional or widespread epidemics
Type C
sporadic cases So what do you have? An influenza pandemic occurs when:
• New virus
• High proportion of susceptible people
• Human to human spread
• Rapid international spread - high incidence Vaccine

- Seasonal
- Health Care Workers Lab Surveillance Influenza Surveillance Have a plan... MRSA Tuberculosis Hepatitis A Hepatitis B Hepatitis C Oral manifestations

- non specific
- learn what is normal
- refer abnormal Antibiotic Stewardship HIV BBFE ADAC IPC Standards Disinfectants and their limitations Biofilm in dental water lines Dental aerosols Hand Hygiene AHS North Zone Dental Program Significant exposures

- percutaneous (blood drawn)

- blood, saliva or other body fluid splashed
- non-intact skin, mucosa What to do? Remove what covers
Wash & Flush
Assess Risk ?PEP HIV
HepB have a plan you made
me sick Legal issue ?
Notify insurance company

Public Health

ADA guidelines
Keep records
spore tests
used sterilization process indicators for all critical and semi-critical dental instruments.

Good reason to follow the ADA+C guidelines for IPC! Disinfectants only work when the surface is clean and free of bioburden.
Two-step process (clean first, then wipe).
Caviwipes don't inactivate Norovirus

Accelerated hydrogen peroxide products do (check the label to be sure for each individual product).

AHS IPC guidelines for LTC facilities recommend 'Virox'.

'Excel TB wipes' also work.

Wiping with 1000 ppm 'Javex' will work too (but then the place smells like a swimming pool) The implications of biofilm in dental unit waterlines is the risk of legionella and possibly transmission of other diseases

Only patients with compromised or weak immune systems who are at risk.

A recent fatal case from Italy was in the dental news.

Dental assistants should follow the ADA+C guidelines for disinfecting dental unit waterlines (83) Limit them at the source

Antimicrobial mouth rinses (e.g., chlorhexidine gluconate, essential oils or povidone-iodine) should be used by a patient prior to a dental procedure.

This is done to reduce the number of microorganisms that might be released from the patient’s mouth in the form of aerosols or spatter, which can subsequently contaminate DHCP and equipment operatory environmental surfaces.

Pre-procedural mouth rinses can also decrease the number of microorganisms introduced in the patient's bloodstream during invasive dental procedures, thus reducing the risk of transient bacteremias.

This procedure may not be practical in those patients that cannot rinse or spit, and considerations may be given where the antimicrobial solution is first brushed or swabbed in the patient’s mouth prior to beginning oral health care Preventive fluoride varnish offered to targeted preschoolers (12-35 months); Kindergarten, Grade 1 & 2 children

Dental sealants offered to some targeted Grade 1 & 2 children

All services are free-of-charge and require parental consent

Participants are advised the public health service does not replace the child’s dental check-ups or cleanings; regular dental visits are recommended Parental Consent

Parents receive an information sheet about the services, and must sign a consent form.

The form advises “children who get regular dental visits may not need the preventive service at school”. Our common goal is to prevent caries.

Along with the CDA, the ADA+C, and Alberta’s pediatric dentists, we encourage all family dentists to see children for a first-year dental visit.

Too many young children appear in hospital for care of this preventable disease; general anesthetic for caries treatment is a poor use of health care dollars.

Let’s continue to work in a complementary way to reduce oral disease and improve the future health of Albertans. Visual observation

AHS staff look for dental disease (visual only – no explorer) before applying fluoride varnish

Advise visiting a dentist if they see obvious caries or other problem. Explorer assessment

Dental Hygienists use an explorer when assessing teeth for dental sealants. Report to parent

The post-visit report has one of these three messages:

- No visible cavities.
- Visible cavities. Please see your dentist.
- Urgent problem. Please see your dentist as soon as possible Questions?
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