Dental Infection Control Program, Tooth Numbering System, PPE And Dietary Education

Overview of Dental Infection Control Program

Dental materials and medicament bottles should be stored in the clean zone of the treatment room and not left on the bench top of the working area majorly to control the rates of infection. The main objectives of the dental assistant to make sure the surgical tools are maintained. It is very important to establish protocols regarding the processing of instruments in dentistry. The first step includes cleaning of the instruments. Cleaning in dentistry can be done either by the process of Ultrasonic cleaning or through the process of Automatic washers. The second step includes inspection of the equipments. The equipments should be always clean and dry. The third step includes the packaging of the equipments. The equipments should be in zip lock bags, pouches or in rigid containers. The fourth step includes the sterilization of the equipments. The fifth step includes the sterile storage. The sterile storage is necessary because the packaged equipments can be compressed, punctured or damaged. These things are to be monitored by the dental assistants. The last steps include the assurance of the quality of the equipments that are delivered to the healthcare organization. The quality assurance includes the physical indicators, the chemical indicators and the biological indicators. However, if the equipments of the dentistry are not properly stored it will be damaged and there will be no scope of using the equipments for further dental treatments. 

The goal of the dental infection control p-program is to provide a safe and hea;lthy environment to the  patients that will reduce the infection rates in the health care sectors. The minimizations of the injuries caused by the percutaneous sharps are the primary focus for the infection control program. The dental offices and clinics need to form policies and guidelines that will to maintain the efficiency and control of infection in the fields of dentistry. The instruments cassettes are been used in the hospitals for many years in the hospitals to organize the instruments of the dentistry into forms of sets. The dental cassettes are used nowadays in dentistry for organizing a complete set of instruments for a specific procedure inside one single container. The cassette makes the packaging of the tools easier and it becomes convenient for the physician and the dental assistant for any dental operation. In addition using the cassettes makes the handling of the instruments in a streamline and makes contamination free work for the physician.

International Tooth Numbering System

International or FDI system has been adopted globally in tooth numbering systems. The system categorises tooth into two basic forms; primary and permanent teeth. In the permanent teeth, each tooth is numbered with the quadrant 1-4 and within the tooth quadrant of 1-8. The quadrant numbers are 1 for maxillary right, 2 for maxillary left, 4 for the mandibular left and 4 for the mandibular right. Tooth numbers within each quadrant start with number 1 and at the midline to number 8 third molar.

The designated digits have forty five as the maxillary left second premolar and forty two being the mandibular right lateral incisor. The primary or deciduous teeth are numbered from quadrant 5-8 to continue with the permanent quadrant numbers. The teeth are number within the location of each of quadrant. The quadrant numbers are with 5 representing maxillary right, 6 starting with maxillary left, 7 for the mandibular left and 8 for the mandibular right.

The tooth numbers in each of the quadrant start with a central incisor and number 5 being the second primary molar. The designated digits entails eight three being the mandibular right primary canine and sixty five being the second left primary maxillary molar. 

The advantages of FDI system are advantages in that they help in prevention errors during the differentiation process of the teeth and when differentiating between the upper and the lower dental acres. Further it is essential during typing and it is easier when incorporated into computer languages.

The following are the two columns were there are the anatomical names of the tooth with their abbreviations

Anatomical name                                                  Abbreviations

Anterior                                                                             Ant

Arrested Caries                                                                    AC

Bilateral(ly)                                                                        bilat

Buccal                                                                                B

Cardiovascular System                                                        CVS

Caries Free                                                                                      CF

Cemento-enamel junction                                                                   CEJ

Central Nervous System                                                                    CNS

Centric Occlusion                                                                             CO

Centric Relation                                                                                 CR

Distal                                                                                                D

Incisal                                                                                                I

Labial                                                                                               Lab

Lateral                                                                                              Lat

Left                                                                                                   L

Left Hand Side                                                                                  LHS

Lingual                                                                                          L

Lower Left                                                                                        LL

Lower Right                                                                                   LR

Answer to Q4

The code selected is 987. The five services allowed for the three-digit code number are, Dental Primary care, Dental Home, Early and the periodic screening and diagnostic treatment services, Direct Dental Referrals and first dental visits.

The personal protective equipment you routinely use in the dental surgery is just taking care of certain things to control the level of infection. For that the first thing that is important to maintain is the hand hygiene. The physicians should always wash their hands with good antiseptic hand washes to protect them from infections. The element used for hand care is using of the sterilized gloves. The dentist and the assistants both should take care of their hang hygiene to prevent further contamination. The second care that is taken is using the masks. The mask prevents the transmission of any airborne diseases during the operation process. Therefore, the dental practitioner and the support staffs must always wear the surgical masks that are fluid resistant that can block the several particles that are less in size than three microns to be inhaled by the physicians. The masks protects the several mucous membranes of the mouth and the nose, they are worn during the splashing, spraying of the blood or any saliva body substances. The third elements to be used are the eye protection spectacles. The dental practitioners and their assistants should always wear the eye wares for the protection of the mucous membranes of the eyes during the operation procedures where they are exposed to aerosols, spraying of blood and saliva. The eyewear protects the eye for protecting the hazards during clinical procedures of scaling using the rotary instruments. The dental should also use protection clothing to get rid from hazardous infections. The clothing generally includes the disposable gowns, laboratory coat and uniforms. The protections in the clothing are taken due to the generation of the contamination with the blood and saliva. The footwear is also to be taken care. The dental practitioners and their assistants should always wear an enclosed footwear for the protection from the injuries or contacts from the sharp objects and tools that are used in the procedures.

Personal Protective Equipment (PPE) in Dental Practice

The dietary education is very important for infants and babies, children and young adults, and the elderly. This is because, the dietary education can provide the people to eat healthy and live healthy. A bad diet can affect the teeth of the individual as well as their structure of health. The NT heath body has provided several resources for children, parents and adults about the oral healthcare of the individual. Health education posters teach the schoolchildren about the healthy diet plans and the effectiveness of brushing their teeth twice a day. They also provide facts sheets about the child’s oral health with their parents. Further for older persons and adults in general , loss of teeth is associated with poor nutritional status, through consumption of sugars, thus advice with regard to healthy foods is key.

Upper right		Upper left
18	Ext or EXO	21	D completed
17	O completed	22	M completed
16	MO and separate B completed	24	Ext or EXO completed
15	Ext or EXO space closed	25	MOD completed
14	DO Buccal separate B completed	26	MO and separate P completed
12	M completed	27	O completed
11	D completed	28	Ext or EXO completed
Lower right		Lower left
All teeth missing	All teeth missing

Charting diagram on the treatment protocols 

Answer to Q8

FDI	Anatomical tooth name – include whether permanent or deciduous
11	Central Incisor
36	First Molar
48	Third molar
25	Second Bicuspid
55	Maxillary second molar ‘right’
72	Mandibular lateral incisor ‘left’
Palmers	Anatomical tooth name – include if this is permanent or deciduous
2	Lateral Incisor
7	Second Molar
4	First Bicuspid
A	Central incisor
C	Lateral incisor
B	Canine
Tooth surface	Identify the tooth Surface Abbreviation
M	Mesial
I	Incisal
D	Distal
MOD	Mesio occluso distal
B	Buccal
P	Posterior teeth
Li	Lingual
BO	Bucco-occlusal
MI	Mesio-incisal

1. Crown	2. Root	3. Enamel	4 Dentin.
5. Pulp Cavity	6. Root Canal	7.Periodontal Ligament	8. Branches of alveolus vessels and nerve
9. Bone of alveolus	10. Gingiva	11. Cementum	12. Apical Foramen

Answer to Q10

1. Rubber Diaphragm	2. Aluminium cap
3.Neck	4. Cylindrical glass tube
5.Silicon rubber plunger	6. Rubber stopper

Several factors are needed to be taken care of before the insertion of the cartridge into the syringe.  Firstly, there are barrier techniques that are needed for the protection. The key element of barrier techniques includes wearing of the gloves, protection of the face and protection of the clothes for the dental physicians. The hands should not be dirty at all.  The infections can be transferred through the hands that can be contaminated by touching certain pathological objects. Therefore, to protect the inflection to form, the hands of the physicians as well the assistant physicians should be washed before and after wearing the gloves. The washing of the hands are to be done with good antiseptic hand washes. There should be always a prior stalk of hand washes in the dental clinic to avoid any further problems. The handlings of the sharp instrument are also of the risk factors in dentistry. The needle should also be recovered before its removal from the syringe. The repetitions of the needles with its cartilage syringe by the help of the plastic covers using both the hands are to be restricted for the physicians. All the disposable instruments in the dentistry are to be discarded in the containers that are puncture resistance or discarded in the inclinator. Before inserting the syringe few things should necessarily be taken care of by the assistant. The needles needs to be properly chosen an it should be sterilized. Then the carpulses should also be sterilized and it should be warmed to body temperature.

Importance of Dietary Education for Oral Health

Oral cavity assessment can be challenging with limited penetration of light. The illustration shows maxillary projection on the jaw. Chair is adjusted on the patient back. The optimal position is positioning the patient first and then positioning the operator tool. Practitioner position is neutral position which allows for neutral working conditions. The neutral position allows for sit back and spinal cord straight weight with even balanced weight, fore arms and thighs remain parallel to the floor and hips being at 90 degrees angle. The seat is preferably positioned low so as to allow for rest and helps the feet on the floor. Operator chair is adjusted so as the hips are slightly higher on the edges of the chair. This allows for back compression of thighs and reduces blood flow. Shoulders should be at relaxed position and remain close to the body.

Maintenance of straight back is achieved through the lumbar support of the chair, in case the chair has arms rest, elbows are adjusted in the neutral shoulder position this helps in reducing the decrease of neck and shoulder strain. Dentist position should adjust the patient head rest until mouth is at clinicians elbow height, this yields oral cavity being 15-22 inches from clinicians eyes.

Abbrasive Burs that are used in dentistry are used to cut the hard tissues of the bone or the tooth. They are generally made up of tungsten, steel, diamond grit and stainless steel. There are bewildering ranges of dental burs in the dental catalogues for the use of basic veterinary purposes and only few burs are needed for dentistry. All the burs that are used are having a shank and a head. They are long shaped straight shanks, latch type shanks and shanks that have a fiction grip. The long straight shanks are fit to the cone of the nose of the slow speed hand piece once the prophy angle or the contra angle is removed. They are used for the disc that are cut in diamond shape discs or long for the burs with 40mm. These kinds of burs are used for the trimming of the small herbivore cheek teeth. The fiction grip shanks are the shanks that are fit in turbine of the high speed that are hand piece.  The standard lengths of these are 20mm and they are longer than the surgical lengths and are used for the veterinary works. The latch type shanks are fit in the latch that are positioned in a contra angle and are 20mm long. They are same shapes as the4 fiction grip shanks. The Round head are used for the cavity preparation, are needed for creating the points of access, undercuts, and make channels for the extraction. The size ranges ¼ th to 9. The best sizes are 1, 2 and 4. The peer head are also used for the cavity preparation, access points and the splitting of the roots of the small teeth. The general size is 330 and 330L. The crosscut tapered fissures are used as the heads that are used for the multi rooted teeth and used for reducing the height of the crown. The general sizes are 700/700L and 701/701L. The finishing burs are the heads that re used for the finishing restorations and the recounting of the soft tissues. They are obtained as 12 to 30 bladed burs in the carbide steel or are used as diamond heads of various shapes. They are also available in white stones for the composites and the green stones for the amalgamations.

The personal care equipments that are used by the dental professional and the supporting staffs are protected clothing, eyewear and gloves.

References

Drummond, Michael F., Mark J. Sculpher, Karl Claxton, Greg L. Stoddart, and George W. Torrance. Methods for the economic evaluation of health care programmes. Oxford university press, 2015.

Fisher, Julian, and Michael Glick. “A new model for caries classification and management: the FDI World Dental Federation caries matrix.” The Journal of the American Dental Association 143, no. 6 (2012): 546-551.

Hammerling, Julie A. “A review of medical errors in laboratory diagnostics and where we are today.” Laboratory Medicine 43, no. 2 (2015): 41-44.

Hickel, Reinhard, Arnd Peschke, Martin Tyas, Ivar Mjör, Stephen Bayne, Mathilde Peters, Karl-Anton Hiller, Ross Randall, Guido Vanherle, and Siegward D. Heintze. “FDI World Dental Federation: clinical criteria for the evaluation of direct and indirect restorations—update and clinical examples.” Clinical oral investigations 14, no. 4 (2010): 349-366.

Morris, Melanie S., Rhiannon J. Deierhoi, Joshua S. Richman, Laura K. Altom, and Mary T. Hawn. “The relationship between timing of surgical complications and hospital readmission.” JAMA surgery 149, no. 4 (2014): 348-354.

Reames, Bradley N., Jonathan F. Finks, Daniel Bacal, Arthur M. Carlin, and Justin B. Dimick. “Changes in bariatric surgery procedure use in Michigan, 2006-2013.” Jama 312, no. 9 (2014): 959-961.

Tamayo, Sally, W. Frank Peacock, Manesh Patel, Nicholas Sicignano, Kathleen P. Hopf, Larry E. Fields, Troy Sarich, Shujian Wu, Daniel Yannicelli, and Zhong Yuan. “Characterizing major bleeding in patients with nonvalvular atrial fibrillation: a pharmacovigilance study of 27 467 patients taking rivaroxaban.” Clinical cardiology 38, no. 2 (2015): 63-68.

Thiele, Robert H., Kathleen M. Rea, Florence E. Turrentine, Charles M. Friel, Taryn E. Hassinger, Bernadette J. Goudreau, Bindu A. Umapathi et al. “Standardization of care: impact of an enhanced recovery protocol on length of stay, complications, and direct costs after colorectal surgery.” Journal of the American College of Surgeons 220, no. 4 (2015): 430-443.

Walsh, Margaret, and Michele Leonardi Darby. Dental hygiene: theory and practice. Elsevier Health Sciences, 2014.

Zimlichman, Eyal, Daniel Henderson, Orly Tamir, Calvin Franz, Peter Song, Cyrus K. Yamin, Carol Keohane, Charles R. Denham, and David W. Bates. “Health care–associated infections: a meta-analysis of costs and financial impact on the US health care system.” JAMA internal medicine 173, no. 22 (2013): 2039-2046.