FOR DENTISTS PRACTICE AIR BORNE INFECTIONSCategory: Health
Article posted by: Jawad Amjad
INTRODUCTION
In today's world, the need for infection control has never been greater. Dentists, their staff and patients are more concerned about the transmission of infection than ever before. Controlling bacterial contamination through proper air filtration has long been considered the most essential component in the infection control process and vital to patient safety. In dental practices diseases can be transmitted from patient to patient, patient to dental healthcare workers and from dental healthcare workers to patients. Dentists therefore have an obligatory duty of ensuring that proper infection control procedures are followed. “Failure to employ adequate methods of cross-infection control would almost certainly render a dentist liable to a charge of serious professional misconduct”.
Aerosols containing microbes from the oral cavity of the patient are created when using modern high-speed rotating instruments in restorative dentistry. How far these aerosols spread and what level of contamination they cause in the dental surgery has become a growing concern . A study conducted to determine how far airborne bacteria spread during dental treatment, and the level of contamination showed that bacteria density was found to be higher in the more remote sampling points. Gram-positive cocci, namely viridans streptococci and staphylococci were the most common findings. The area that becomes contaminated during dental procedures encompasses the whole room . Theses results emphasize the need for developing new means for preventing microbial aerosols in dentistry and protection of all items stored temporarily on work surface. [1]
Best Medical Practice
Health Care department or surgeries get information from Health Technical Memorandum (HTMs) regarding design installation and work place operations. It covers the decontamination of reusable instruments within dental facilities and also proper ventilation systems that should be in place to maintain adequate air flow from clean to dirty space outlets. Air purifiers can be used to ensure that air being vented is decontaminated and also to ensure that during dental procedures air purifiers can remove any harmful elements like bacteria, viruses, volatile organic compounds etc. Although best medical practice management recommends dental practices use proper ventilation input and output vents, it does not mention air purifiers and how they can be used to control procedures that generate the risk of exposure to aerosol dispersion.
New research published (C. Chen Dec 2009) explains that potentially infectious droplets from dental patient's mouth circulate around clinics and infect staff. The use of air purifiers can make a significant difference to the health of dental workers. Central air conditioners and cross infection from patients mean that air borne infectious particles can easily spread.Researchers suggest that to control droplet and particle dispersion in dental clinics, the positioning of an air purifier is very important. [2]
IMPORTANT NEWS ON DENTAL CLINICSBACK TO TOP
- A study conducted to determine how far airborne bacteria spread during dental treatment, and the level of contamination showed that bacteria density was found to be higher in the more remote sampling points. Gram-positive cocci, namely viridans streptococci and staphylococci were the most common findings. The area that becomes contaminated during dental procedures encompasses the whole room.
- Although best medical practice management recommends dental practices use proper ventilation input and output vents, it does not mention air purifiers and how they can be used to control procedures that generate the risk of exposure to aerosol dispersion.
- New research published (C. Chen Dec 2009) explains that potentially infectious droplets from dental patient's mouth circulate around clinics and infect staff. The use of air purifiers can make a significant difference to the health of dental workers.
- Researchers suggest that to control droplet and particle dispersion in dental clinics, the positioning of an air purifier is very important.
- The National Institute for Occupational Safety and Health (NIOSH) recommends using air particular-filter or air purifiers that have the ability of filtering 1µm particles with a filter efficiency of greater than 95%. The infectious particle size measures 1-5µm, therefore, air cleaners used in health care settings should be able to efficiently filter the smallest particles in this range.
CURRENT PROBLEMS
Transmission of diseases among dental health care workers and their patients remains a major threat that needs to be constantly dealt with and kept in check. Infections are spread if the following criteria are satisfied:
(i) the presence of a susceptible host;
(ii) the presence of pathogenic micro-organisms;
(iii) a portal of entry via which the organisms invade and colonize the susceptible host
Absence of any one of these criteria will prevent the transmission of an infectious disease. Dental practices therefore have a huge task of ensuring that one, two, or all of these criteria are eliminated.
The following are current and emerging infections in dental practices, which continue to pose as huge problems and remain a cause of concern:
M. Tuberculosis
Outpatient dental settings receive more patients who have M. Tuberculosis. Understanding of the pathogen helps DHCP determine how to manage such patients.
M.Tuberculosis is a bacterium that causes respiratory infection. It is an airborne infection that can be generated when persons with pulmonary or laryngeal TB sneeze, cough or speak. The particles measure 1-5 µm and can stay suspended in the air for hours. The infection occurs when a susceptible person inhales droplet nuclei containing M.Tuberculosis. These tiny droplets travel to the lungs and usually within 2-12 weeks after initial infection, immune response prevents further spread of the TB bacterium and the patient is diagnosed as having a latent TB infection which persists for years. However, they can develop active disease later in life if they do not receive treatment for their latent infection. [4]
If urgent dental care is provided for a patient who has or is suspected of having active TB disease, then care should be provided in a facility that provides airborne infection isolation. CDC recommends using HEPA air filters [4].
Methicillin-resistant Staphylococcus Aureus (MRSA)
MRSA is a bacterium that is resistant to common antibiotics. “Meticillin-resistant” means the bacteria are unaffected by meticillin, a type of antibiotic that used to be able to kill MRSA. Therefore MRSA is more difficult to treat than other bacterial infections. It is not normally found in the oral cavity but may occasionally be isolated from oral infections according to the department of health best dental practice. There is no special infection control precautions necessary for the dental treatment of patients colonised with MRSA but DHCP should not undertake or assist in invasive procedures. [4]
Transmissible Spongiform Encephalopathies
Creutzfeldt-Jakob disease (CJD) is an infective neurological disease that is caused by a unusual pathogen called prion. They are proteins that are capable of self-propagation although they lack nucleic acid. In Humans the disease causes fatal encephalopathy. From the dental interest the disease is caused by patient to patient cross infection of unsterilized or contaminated instruments. [4]
Disinfectants
Various chemicals containing aldehydes and phenol are used in dental practices to clean hands, floors and surfaces. These disinfectants kill virus, bacteria, fungal spores but at the same time vapours emitted from these chemical may cause sensitization and inhalation toxicity. Continuous exposure to aldehyde fumes for longer periods of time may lead to chronic toxic effects that lead to various symptoms ranging from nausea, impairment of memory and slow reflexes.
Latex Glove Allergy
Latex gloves used in dental practices can cause latex allergy due to contact or inhalation of latex allergens. The allergens adhere to the talcum powder particles of the glove and can thus become airborne.
X-Ray Development Chemicals
Dentists have to use X-Rays to conduct various dental procedures. Gultaraldehyde is one of the organic chemicals used for the development of x-ray films. These chemicals give off gases that can contribute to the contamination of the ambient air in dental environments.
MERCURY POISONING
Mercury is a naturally occurring element found in air, water and soil. It exists in several forms - elemental or metallic mercury, inorganic mercury compounds, and organic mercury compounds. Pure mercury is a liquid metal, sometimes referred to as quicksilver and has traditionally been used to make products like thermometers, switches, and some light bulbs. Dentist make use of silver fillings to restore teeth, these are composed of 'amalgam', a metal containing roughly 50% elemental mercury and 50% of mostly silver with some tin and copper. Amalgam is one of the most commonly used tooth fillings, and is considered to be a safe, sound, and effective treatment for tooth decay. Amalgam has been the most widely used tooth filling material for decades and remains popular because it is strong, lasting and low-cost. Over the years however, the mercury found in amalgam fillings has raised some safety concerns; this is because amalgam can release small amounts of mercury vapor over time, and patients can absorb these vapors by inhaling or ingesting them. The dental practice itself can become a secondary source of mercury vapour exposure to dentists and staff.
Numerous researches showed that mercury vapours can cause various psychomotor and neurological impairments. In 1992, a researcher in Singapore determined the mercury vapour level in the surgeries of 98 dentists in practice for an average of 5.5 years. The average mercury level was found to be 0.014mg per cubic metre, one third of the threshold limit value (TLV). When the dentist were subjected to a series of psychomotor and neurological tests they scored an average of 14% worse in the tests than unexposed control subjects. Tremors were the most readily induced, which occur due to mercury vapour concentration in excess of 0.1mg per cubic meter, twice the threshold limit value (TLV). It has been found that tooth grinding increases mercury release from the fillings. WHO recommends that there is no evidence that there is a safe level of mercury in the body that does not kill cells and harm body processes, as mercury transforms from solid to gas at room temperature, the dangers of chronic exposure to mercury can easily remain undetected. [5]
CURRENT SOLUTIONSBACK TO TOP
Good Medical Practice recommend the following procedures for cleanliness and hygiene, and to protect both staff and patients alike:
- Hand sanitizers should be used by practitioners and the public to reduce the levels of pathogens that would cause cross infection.
- Sharp instruments and needle should be handled with great care to prevent unintentional injury. Needles should never be recapped by using both hands in direct contact or by any other technique that involves moving the point of a used needle towards any part of the body. The needle can be recapped by laying the cap on the tray, placing the cap in a resheathing device or holding the cap with forceps
before guiding the needle into the cap.
- Sterilisation equipment that comprises of autoclave machines and ultra-violet and gamma rays that can destroy pathogens which reside on the equipment should be used by the health care practitioners in their daily practice.
- Protective clothing like gloves, caps, protective glasses, gowns should be worn by dentists, dental surgery assistants, dental nurses or any staff members in close proximity, to protect the eyes against the spatter and aerosols which may occur during cavity preparation, scaling and the cleaning of instruments. Uniforms should be changed regularly and whenever soiled. Gowns or aprons
should be worn during procedures that are likely to cause spattering of blood.
- Special chemical detergents and wipes should be used to reduce the contaminants on surfaces.
- Proper ventilation systems are to be used to ensure a high level of air quality.
THE CASE FOR AIR PURIFIERSBACK TO TOP
According to the National Centre for Chronic Disease Prevention and Health Promotion, CDC, dental patients and dental health-care personnel (DHCP) can be exposed to pathogenic microorganisms that include hepatitis B virus (HBV), hepatitis C virus (HCV), cytomegalovirus, herpes simplex virus types 1 and 2, HIV, Mycobacterium tuberculosis, staphylococci, streptococci, and other virus and bacteria that colonize or infect the oral cavity and respiratory tract. Of all the routes of cross infection that are in direct contact with blood, oral fluids, other patient materials, or indirect contact with contaminated objects , inhalation still remains one of the chief modes of transmission when it comes to cross infections. Contact of conjunctival, nasal or oral mucosa with droplets containing microorganisms generated from an infected person and propelled a short distance by coughing, sneezing or talking and inhalation of airborne microorganisms that can remain suspended in the air for long periods, lead to dental health care practitioners developing various illnesses. Other measures might be necessary to prevent potential spread of certain diseases (e.g., TB, influenza and varicella) that are transmitted through airborne, droplet or contact transmission (sneezing, coughing and contact with skin). So necessary transmission-based precautions might include adequate room ventilation and air cleaning equipment that is able to remove harmful pathogens from the air and make the working environment pathogen free for both the dental patient and the dental health-care personnel's (DHCP). [3]
The National Institute for Occupational Safety and Health (NIOSH) recommends using air particular-filter or air purifiers that have the ability of filtering 1µm particles with a filter efficiency of greater than 95%. The infectious particle size measures 1-5µm, therefore, air cleaners used in health care settings should be able to efficiently filter the smallest particles in this range. [3]
At Allergymatters we have the solution for eradicating air borne infections and allergens by using air purifiers that are specially designed for dental health care practices (DHCP).
Air Purifiers
Dental Surgeries have patients coming from all different ages, backgrounds and might carry with them various diseases. Why not have a dental environment that can give you that confidence of breathing filtered air, free from bacteria, viruses, mould, odours and even toxic mercury vapours. The professional IQAir Air Purifiers for dental environment help protect dentists, dental staff and patients from airborne infections.
The Dental Series Air Purifiers are used for the following applications:
Microbial Control
- Bacteria and Viruses
- Fungal/Mould spores
Volatile Organic Compounds
Volatile Organic Compounds (VOC) coming from products like petroleum, glue, paints, shoe polish, carpeting, cupboards, furniture, cleaning agents, solvents, pesticides and also Oral Volatile Sulphur Compounds (VSC) that cause malodours.
Drilled aerosol control
- Dispersed tissue and fluids
- Dispersed viruses and bacteria
Mercury control
- Mercury vapours
Disinfectant control
- Formaldehyde
- Alcohol
General particle control
- Powder particles
- Polishing particles
- Combustion particles
- Dust Mite Allergens
- Pollen
- Pet Allergy
- Tobacco smoke
IQAIR - THE BEST IN THE CLASS OF AIR PURIFIERS FOR DENTAL PRACTICESBACK TO TOP
A king among princes, IQAir rules supreme. When this air purifier was tested by IQAir, virtually nothing escaped its Hyper-HEPA filter. Packed with superior technological features such as a huge capacity pre-filter, filter change indicator lights, a HEPA filter efficiency rating second to none we have tested, and six fan-speed settings, the IQair is as good as it gets.
IQ Air's Swiss made range of air cleaners achieve what is known as Hyper HEPA performance, which means that the whole machine has been classified as HEPA standard, not just the filter. This results in a matchless quality of air output. When we tested this air purifier, virtually nothing escaped its Hyper-HEPA filter. Packed with superior technological features such as a huge capacity pre-filter, filter change indicator lights, a HEPA filter efficiency rating second to none and six fan-speed settings, the IQAir is as good as it gets.
The Hyper-HEPA filters out smaller particulates than other filters, and these tiny particles are the ones which are actually injurious to your health. We are particularly impressed with its robust pre-filter which screens out 90% of all larger allergens. We can find no equal in any other purifier. The quality of its carbon fill is the best you can find, so simply put, it does a better job. Warning lights tell you when to change any of the filters. No expense has been spared in the manufacturing of this machine. The IQAir air purifier's series filters out pet dander, viruses, pollen, dust mites, mould spores, odours, and bacteria. This air purifier is for those who know their health deserves only the very best and who want to ensure clean air.
HEPA Filters
HEPA stands for High Efficiency Particulate Arrested Filter. A specially constructed filter membrane that allows high volume of airflow. These filters are designed to remove 99.7% of all airborne pollutants with an efficiency of 0.3 µm. IQAir has the advantage of intelligent individual filter change sensors, which enables you to change each filter individually as it becomes used.
Filter Configuration
Pre-filter Type : high efficiency HEPA fine dust pre-filter
Media : HEPA class H11, mini-pleated with solvent-free separators
Surface area : 2.8m2
Gas and odour filter Type : 4 gas and odour control filter cartridges (GC-technology)
Media : MultiGas granular activated carbon & KMnO4
HEPA-Filter Type : 4 GC post-filter sleeves
Media : electrostatically charged fiber
Surface area : 0.5m 2
What Makes IQAir the Best?
Targeted Technology
Different indoor environments have different air cleaning needs. IQAir® has custom designed specific air purifier models to target specific groups of air pollutants. This approach maximizes effectiveness and minimizes cost.
Certified Performance
IQAir individually tests each stand-alone air purifier to ensure that its performance meets its strict specifications. The results of the tests are detailed in a hand-signed Certificate of Performance, which ships with every air purifier.
Ultra-Quiet Design
IQAir's "fan-in-center" design places the fan motor in-between sound attenuating filters. The double-walled housing effectively reduces sound transmission. Rubber suspension pads systematically isolate motor vibration from the air cleaner housing. The result is an air purifier quiet enough for even the most noise sensitive environments.
Advanced Controls
Every IQAir stand-alone air purifier features six fan speeds and allows you to program the system for automatic operation via a day/night timer. The intelligent filter life monitor precisely forecasts filter replacement based on actual usage. A sleek remote control allows you to operate the air purifier from afar.
Molecular Control
In addition to removing pollution particles, such as dust, bacteria and viruses, select IQAir models are highly effective in remove molecular air pollutants, such as volatile organic compounds (VOCs) and other gaseous chemicals and unpleasant odors.
IQAIR DENTIST AIR PURIFIERSBACK TO TOP
The IQAir Dental Series has been specifically developed to deal with contaminants commonly found in dental environments. These high-efficiency air cleaning systems feature state-of-the-art filtration technologies which effectively remove harmful airborne contaminants and unpleasant odours.
Dental surgeries are offered two distinct models; the IQAir Dental Hg with FlexVac and the IQAir Dental Pro. The Dental Pro is a room air purifier that uses five filtration stages to help eliminate common dental office contaminants, such as bacteria, viruses, VOCs, disinfectant odors and mercury vapors. It is designed to be placed anywhere in a dental office and clean the air by constant recirculation within the office. The Dental Hg FlexVac is a mobile air cleaning system with a flexible suction duct. The unit is designed to capture drill aerosols, abrasion powder and mercury vapors during dental procedures. The flexible suction duct is typically placed on the patient's chest from where it directly captures drill aerosols and mercury vapors before they can spread. Both units are based on the IQAir GC design and contain filter cartridges, which optimize them for the pollutants found in dental offices. The neutral white and light grey design integrate perfectly in all dental offices.
IQAIR TESTS AND AWARDS
IQAir has received more No.1 product reviews than any other air purifier manufacturer.
- Consumer Search: Best Air Purifier (2005 / 2006)
- Allergy Buyer's Club: Category Winner (2003 / 2004 / 2005 / 2006)
- Wired Magazine Test: Best Air Purifier (9/2006)
- Consumer Guide - Best Buy (2006)
- Reviewboard Magazine: Product of the Year (2004/2005)
- Consumer Digest - Best Buy (12/2004)
- Test Magazine: Category Winner (1998)
- The American Lung Association uses IQAir as their educational partner in their effort to create awareness about indoor air pollution.
Professional Air Purifiers - Trusted by Hospitals
Hospitals around the world rely on IQAir to help protect staff and patients from infectious diseases like tuberculosis and MRSA. When the dreaded disease SARS began to spread in Hong Kong hospitals in 2004, the Hong Kong Hospital Authority tested dozens of air cleaners. They determined that IQAir made the only room air cleaners suitable to be used in the fight against SARS.
Find out more at http://www.dentist-hygiene.co.uk/acatalog/Air_Purifiers_For_Dental_Practices.html
Desired Allergy Purifiers - 100% Ozone-Free Technology
All IQAir air purifiers are 100% ozone-free. They are certified by the IAACM (International Association of Air Cleaner Manufacturers) to produce absolutely no ozone. Ozone is a lung irritant emitted from ionic and electronic air cleaners. Even small amounts of ozone are undesirable for allergy and asthma sufferers.
Study Shows IQAir Room Air Purifiers Cut Spread of a Deadly Infection
The use of IQAir portable air purifiers can dramatically cut the spread of invasive aspergillosis (IA) , an often-fatal infection threatening those with severely compromised immune systems, according to a study published recently in a leading medical journal. The study measured the ability of the IQAir devices to stop the spread of a fungal infection that is increasing among organ-transplant patients as well as those with various blood diseases and other patients receiving immunosuppressive therapy.
The study, titled “The impact of portable high-efficiency particulate air filters on the incidence of invasive aspergillosis in a large acute tertiary-care hospital,” concluded that the IQAir portable air purifiers reduced IA infections by more than 50 percent. The study was published in the February 2010 issue of the American Journal of Infection Control .
Certificate of Performance
IQair tests and certifies each and every IQair Dental Series air purifier. In their state-of-the-art Swiss production facility, each IQair Dental Series air purifier is tested for particle filtration efficiency, filter leakage and air delivery. They come with their very own two-page certificate of performance, detailing the test results for each specific machine.
EN 1822 Certified & Tested
The IQAir Dental air purifiers have passed the world's most stringent HEPA filter test - EN 1822. Used in laboratories and hospitals, IQAir brings certified performance to your dental office. With IQAir's EN1822 certification, you can rest assured that your unit will hold back up to 100 times more allergens and more pollution particles than conventional HEPA air cleaners.
If you want to find out more visit our site at http://www.dentist-hygiene.co.uk
Posted By: Jawad Amjad
Web: http://www.dentist-hygiene.co.uk
Contact: e-mail
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