Fourteen of 15 employees in the practice showed evidence of hepatitis B vaccination, and none had a history of the disease. Molecular epidemiology techniques determined that the same virus caused hepatitis B in both women. After, she has some teeth extracted the same oral surgeon, and staff extracted seven teeth from another patient (a 61-year-old female) who later developed hepatitis B. 9 The source patient was an asymptomatic carrier of the HBV and did not tell anyone in the office she was a carrier. 8 In another incident, the CDC confirmed that hepatitis B was spread from one patient to another on the same day in 2001 in an oral surgery practice. This pathway, involving improperly washed hands of a dental hygienist, has been documented in the spread of herpes simplex virus from a herpes labialis lesion of one patient to the mouths of several other patients, resulting in herpes gingivostomatitis. Thus, the pathways for cross-contamination in dentistry involve numerous possible combinations of modes of microbe spread and entrance into the body, all of which must be addressed in a dental infection prevention program.Ĭross-contamination from one patient to another patient may occur by indirect routes through contaminated instruments, surfaces, equipment, or the hands of dental personnel. In the dental setting, microbes can enter the body through (1) needlesticks and instrument punctures and cuts (2) invisible breaks or cuts in the skin (3) mucous membranes of the mouth, nose, eyes (4) through open lesions (5) inhalation and (6) ingestion. 1 These pathways involve one or more of the four major modes by which microorganisms may be shared between individuals: (1) direct contact (touching oral surfaces and fluids), (2) droplet infection (airborne contamination with larger droplets of aerosols or spatter of oral and respiratory fluids), (3) indirect contact (contact with contaminated instruments, needles, environmental surfaces or hands), (4) airborne (spread of smaller particles of respiratory fluids such as droplet nuclei through the air). Cross-contamination is the spread of microorganisms from one person to another, and there are three main pathways by which this may occur in dentistry: (1) patient to dental personnel, (2) dental personnel to patient, and (3) patient to patient. The main source of potential pathogenic microbes in dental facilities is the patients’ mouths. Standard procedures of sterilization, disinfection, and asepsis must be applied to all types of dental care to reduce the chances of cross-contamination that may lead to serious infectious diseases. The practice of dentistry spans a wide variety of oral treatments, ranging from the simple polishing of a restoration (filling) to complex and extensive surgery of the osseous and soft orofacial tissues.
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