Infection Control in Dental Radiology Dr. Raghunath Puttaiah
& Dr. Hui Liang
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Introduction & Rationale Most oral and maxillofacial
radiology normally consists of non-invasive procedures Although
exposure to blood is not common, contact with saliva does
occur
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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 (infectious mononucleosis), Rhinoviruses (common
cold), and HIV Common bacterial pathogens seen are Pseudomonas,
Flavobacterium, Staphylococci, Streptococci, Diplococci,
Pneumococci, Mycobacterium, Chlamydia, and Spirochetes from human
or inanimate sources Candidiasis is also very common among dental
patients
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Rationale Most of Oral and Maxillofacial radiology (OMR)
procedures fall mainly in the semicritical and non-critical
categories of Spaulding's Classification of inanimate surfaces BUT
Many contagious diseases such as Infectious mononucleosis and
hepatitis-B can possibly be spread by simple contact with saliva
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 aseptic techniques in
OMR.
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What PPE is needed It is not usually necessary to wear PPE such
as impervious gowns, long sleeves, masks and protective eyewear
during routine OMR procedures when no aerosols, droplets or spatter
are generated One may use gloves, gowns, masks and protective
eyewear while treating patients with gagging problems While
handling the processor and the chemicals, use full PPE Stay out of
the Radiation Hazard area (behind a shield) Patients must be
protected with a lead apron
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Disinfectants and Barriers Barriered films should be used when
available Between patients, frequently touched areas must be
Barriered with plastic barriers OR -Disinfected with an
Intermediate level, Hospital Disinfectant using a Spray-Wipe-Spray
technique If barriers are used between patients, disinfection is
only needed at the beginning or end of the day
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Steps in Infection Control Unit Dose 1. Pre-procedural
mouthrinse for patients Make them rinse for about 30 seconds to
reduce the microbes in the mouth 2. PPE- Gloves Masks Eyewear
Gown
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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 Control 1.Unit dose supplies and sterile
equipment on to a clean bib/work surface 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 at the
beginning and end of each day, and between patients only if
contaminated Avoid spraying electrical switches, wipe with
disinfectant moistened paper towel Apply surface covers to the
yoke, tube head, cone, control unit, head rest, arm rest, 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 on the control unit and reset as required Use Foot
Controlled Trigger Switch if possible
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Now Please expose the Radiograph The whole purpose in dental
radiology is to Get the radiograph
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Inside a daylight loader Place the cup with exposed films on
one side and the Empty one on the other Place a clean bib or napkin
as a barrier Dispense a pair of gloves
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Daylight Loader with Films Inside Be sure to close the lid
before exposing the 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 foil on the rear of the film Paper folder that
secures the film Film
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Processing Barriered Films Exposed film Wear gloves Peel the
outer cover and drop the film into the Exposed cup This should be
done chairside
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Step 1 Step 2 Step 4 Step 3
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Bare hands with barriered film inside a daylight loader
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Bare hands to be used to handle exposed and peeled film
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Unbarriered Films Step 1 Step 2 Step 4Step 3
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Now try this inside a daylight loader
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Bare hands to be used to handle exposed and peeled film Remove
your gloves and then handle the film that has been 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 waste You need not wear gloves
if you hold the non-contaminated corners
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Disinfect the Daylight Loader once or twice daily if barriers
are used Barriers limit the use of disinfectants
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Panoramic Radiography In panoramic radiography, infection
control procedures are very simple Patient needs to have a lead
apron No contact of film with saliva Only one barrier is
needed
Panoramic Radiography Infection Control in Panoramic
radiography is very simple All one needs is a barrier for the bite
block Make sure the lead apron is on Film loaded on to the cassette
Stay outside of the active radiation area
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Panoramic Radiography This film does not come in contact with
saliva
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Panoramic Radiography Position the patient correctly
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Panoramic Radiography Make the patient remove the barrier on
the bite block
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Digital Radiography
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Sensor Barrier or sleeve Sensor being inserted into 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 door open
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Digital Radiography Peel open the barrier without touching the
sensor
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Digital Radiography Slide the sensor into the chamber for the
computer to read the image
