Infection Control Manual – A Reference Book For All Of Your Questions.

The ultimate infection control ressource. 17 chapters, 209 explained concepts, 244 references, and innumerable tips and tricks.

A widespread refusal of parents to vaccinate their children, the emergence of new pathogens, and the development of antibiotic-resistant pathogens are indisputable reasons for a systematic and thorough hygiene in every dental practice. The importance of proper practice hygiene is made clear when the patient comes into contact with the practice's water systems or if high-speed treatment of teeth creates contaminated aerosol.

Above and beyond all medical and ethical requirements, proper hygiene is also regulated by a number of laws and regulations.  Some of the most important regulations are the Federal Law on Pharmaceuticals and Medical Products (Medicinal Law), the Chemicals Act, as well as the Biocidal Product Ordinance, which governs the sale of products that fight so-called pest organisms by chemical or biological means. Furthermore, the recommendations of institutions such as the Robert Koch Institute, the DGHM, and the VAH have set high standards that are not always easy to fulfill.  “Diseases do not simply occur out of the blue – rather, they develop from daily sins.  When these have accumulated, the disease will suddenly erupt.” This was already known by Hippocrates, the most well known doctor of antiquity.

So what should one do? - The “Infection Control Manual” is available to assist you every step of the way!

Contents of the Manual

An Introduction to Hygiene
Each and every day, the fight begins anew in the dental practice: the tiny pathogens must be combated and eliminated in order to prevent possible infections and diseases.  The potential victims include the patients, as well as the dentist and his dental team.  Only proper and consistent hygienic practices can eliminate the risk of infection.

Background
In 1918/1919, over 50 million people died worldwide from the Spanish flu. Such a grave epidemic could possibly occur again at any time.  The human defense mechanisms are limited and numerous pathogens have learned how to avoid medical antibodies such as medications. Elderly and immunocompromised individuals are at the highest risk.

Organisms
Meningitis, polio, tuberculosis, hepatitis, influenza, candidiasis, typhoid fever, AIDS: devastating illnesses, some of which are incurable or lethal. We would all be happy to see these diseases eradicated. Yet the truth is that these dangerous diseases can be very easily transmitted – even in a dental practice. Bacteria, viruses, and fungi can infect patients as well as the dental team.  Information about pathogens and corresponding preventative measures can help protect against the negligent transmission of serious diseases.

Medications against Microorganisms
The most aggressive substances are not always required in order to eliminate microorganisms.  Highly aggressive agents can cause serious damage to humans and the environment.  For proper practice hygiene, it is important to know the most important chemical agents and their possible applications.

Legal Framework Determines Practice Hygiene
For the practical realization of the hygienic measures, all legal regulations must be considered and observed.  In the event of the transmission of a disease, the dentist has the burden of proof. If the dentist cannot prove that the hygienic standards of his practice were strictly upheld, then he/she runs the risk of a legal conviction and a severe penalty.

General Practice Hygiene
Disinfection, cleaning, and sterilization alone are simply not enough: for good practice hygiene, general precautions and work procedures are absolutely necessary – they help to considerably reduce the risk of contamination and reduce the danger of infection in the dental practice.

Selecting the Right Disinfectant
Disinfectants are the Alpha and Omega of proper practice hygiene. The choice of product has a great impact on the effectiveness of all disinfection procedures. There are over 1,000 disinfectants on the market – it can be tough to make the right decision. It is always important to understand which disinfectant properties one needs when choosing a product.

Hand Hygiene
Wash, disinfect, and nurture: hand hygiene has many aspects. It is important that hands are cared for properly as to prevent gaps of disinfection or skin irritations. Hands are not only the most used transmission vehicle for germs, but they are also the most important “tool” of the dentist.

Surface Disinfection
Surfaces in the treatment room are considered to be contaminated and potentially infectious. All surfaces within a radius of 2 meters around the treatment chair should thus always be disinfected after every patient. Different disinfectants are required for the different types of surfaces: the delicate cover of the chair and large surfaces such as floors and walls cannot be treated in the same manner.

Treatment of Medical Instruments
Heat or chemicals? Clean, disinfect, or sterilize? The treatment of medical instruments is difficult, as not every instrument can be treated in the same fashion.  Manual and mechanical procedures allow various methods of treatment – the treatment procedure should always be clear and unambiguous in every practice.

Water Systems
Aqueous germs are right at home in water systems. Massive contaminations can occur in standing water (e.g. overnight) – this can be an extreme risk for immunocompromised patients. Routine measures help to reduce the population of pathogens in your water systems.

Hygienic Maintenance of Suction Units
Dental suction units help to remove blood, saliva, or tooth substances. Thereby these units can become heavily contaminated.  A regular cleaning and disinfection reduce both the risk of infection as well as the unpleasant odor, which sometimes occurs as a result of insufficient maintenance and cleaning.

Disinfection of Impression Materials
Direct application in the mouth: impression materials are heavily contaminated with blood and saliva. The disinfectant that is used must have a very high cleaning capacity. At the same time, the product must guarantee the form stability of the impressions.  New products make it possible to have a considerably more effective and gentler treatment.

Additional Hygienic Measures
Even when the patient has already left the office and the hands, surfaces, instruments, and equipment have been disinfected, the risk of infection is still present. All articles of clothing must be properly treated and used disposable materials must be safely disposed of. These additional hygienic measures help supplement the general practice hygiene.

Post-Exposure Prophylaxis
Despite all precautionary measures, accidents or unintentional contaminations can still occur. It is important to know how one should act in such a situation. The proper emergency treatment measures (known as PEP or post-exposure prophylaxis) can greatly reduce the risk of illness.

Developing a Hygiene Plan
The required procedures for proper hygiene in a dental practice are complex. It is far more important that all procedures are completely and unambiguously defined. A hygiene plan that is established pursuant to the guidelines guarantees that the measures are always performed in a similar fashion and according to the valid guidelines for the individual practice.

Glossary
Knowledge is power – especially when it concerns hygienic measures and your own safety. The more that you know about the dangers and their sources, the better you can react and respond to these dangers.