• Jaundice (yellow eyes, skin)
• fever
• abdominal pain
• liver damage
• liver cancer
• death

• Pathogen
• Source - Antibiotics
• Mode - Disinfection/hand washing
• Entry - PPE
• Host

1.  Center nasion relator assembly
2. Attach indirect transfer assembly
3. Loosen thumb screw at center of facebow
4. Loosen thumb screws on bite fork holder

1. Attend wound - force it to bleed
2. Inform patient and ask to test blood
3. Inform clinical operations
4. Arrange for patient to go to employee health
5. Return to SOD and finish procedure

1. Chill the wax under tap water
2. Inspect for soft tissue or deep occlusal registrations (only want cusp tips)
3. Trim excess wax with Bard Parker knife
4. Reinsert in patient's mouth to verify stability of record

1. Chlorine compounds
2. Iodine
3. Silver
4. Hydrogen peroxide

1. Contact
2. Cleanliness
3. Compromised skin integrity
4. Contaminated object
5. Crowded living

1. Cover, keep clean
2. Physician clearance (needed at UABSOD)
3. Eradication therapy

1. Eliminate - unnecessary steps, equipment, movements
2. Combine - double ended instruments, 2 step procedure in 1 step
3. Rearrange - equipment, patient scheduling, steps of procedures
4. Simplify - equipment and procedures

1. Explain procedure
2. Place bite fork in mouth
3. Support underneath with cotton rolls
4. Place facebow in ears, pt. holds side arms
5. Place bite fork shaft into holder
6. Tighten thumb screw on top of facebow
7. Center nose piece on nasion and tighten
8. Slide toggle on fork shaft near lips & tighten
9. Tighten screw on vertical rod

1. Fingers only
2. fingers and wrist
3. fingers, wrist, elbow
4. entire arm from shoulder
5. entire arm and twisting of body

1. Given 3 doses
2. Test for antibodies 1-2 months later
3. If inadequate, re-dose and re-test 

1. Hearing the message
2. Interpreting the message
3. Evaluating the message content
4. Retaining and responding to the message

1. Helps restore proper contour
2. Helps restore proper contact
3. Prevents gingival amalgam overhang

1. Increases efficiency through use of asst.
2. Decrease in muscular stress
3. Increase in dentist's concentration on skill and judgment
4. Increases production by 100%
5. Decreases stress and fatigue by 50-70%

1. Individual feels valued and empowered
2. You gain insight into the situation and perspective of the individual
3. You formulate a more appropriate response in accordance to the needs of others

1. Loosen top screw and nasion screw         (don't touch bite fork holder screws)
2. Have pt. hold facebow steady while removing bite fork
3. Disinfect wax and fork that were in mouth

1. Patient's treatment is organized and tasks are simplified
2. Patient and dental team are seated and positioned properly
3. Dentist utilizes skills of trained chair-side assistant
4. Assistant performs all legally allowable duties

1. Person-person via hands
2. Patient and PPE
3. Environmental contamination

1. Placed interproximally before etching and bonding of tooth
2. band pulled tight after placement of composite material
3. clear plastic band allows penetration by curing light

1. To control water used as coolant for high speed handpiece
2. To control debris from slow speed handpiece
3. To remove fluids from mouth
4. To prevent moisture contamination w/ materials

1. Viremia - already in the bloodstream
2. Injury
3. Entry - DHCP blood into pt. wound

1. Warm one sheet base plate wax at 140^o 
2. Fold rectangle sheet into square
3. Place wax on bite fork
4. Fold excess underneath

1. Wash hands
2. Keep wounds covered
3. Eliminate sharing of personal items
4. Stress clean facilities

1. lack of interest
2. distracting delivery
3. external and internal noise
4. arrogance and disrespect
5. pre-programmed emotional responses
6. ambushing
7. listening for facts
8. faking attention
9. thought speed

1. paraphrase (repeat back in your own words)
2. express understanding
3. ask questions
4. communicate nonverbally

> 1 million

21% are unaware

1. Contaminated area: receiving, cleaning,     decontamination
2. Sterilization: sterilizer and autoclave
3. Preparation and packaging
4. Storage: cabinet for sterilized tools

1. Use only FDA approved sterilization devices
2. Clean and heat sterilize critical instruments
3. Clean and heat sterilize semi-critical instruments
4. Allow packages to dry in sterilizer before handling
5. Ensure non-critical items are cleaned or barrier-protected

1. talk first about yourself ("I" not "you")
2. use descriptive statements without judgment
3. state facts
4. only say things you know for certain
5. use statements, not questions
6. provide positive and negative feedback

0

(the long line)

0.08%

(very low)

1. Assume any and all human blood is infected

2. Always wear PPE

1. Barrier protection

2. Low level disinfectants

3. Intermediate level disinfectants

1. Cleaning ear pieces with Caviwipes

2. Using latex finger cot over earpieces

1. The facebow

2. Transfer assembley

3. Bite fork

4. Pink face plate wax

5. Registration material (compound)

6. Bard Parker Knife

1. autoclaving (steam under pressure)

2. dry heat

3. unsaturated chemical vapor

What % of Americans have Hep C?

What % are asymptomatic?

1.6%

80%

250 degrees F

15 psi

270 degrees F 

3 min (unwrapped) or 7 min (wrapped)

30%

1.25 million chronically infected

8-11 operator

11-2 static zone

2-5 assistant

5-8 transfer zone

·      Outer knob: tightens or loosens matrix 

·      Inner knob: adjust size of loop

·      Spindle: tightens end of band

·      Diagonal slot: always faces gingival

·      Guide slot: determine which quadrant

A patient giving it to DHCP

(many patients don't even know they have it)

Blood - Blood borne pathogens

OPIM - other potentially infectious material

Celluloid matrix

Mylar strip

Community Associated Methicillin Resistant Staph Aureus

- Resistant to beta lactam and non-beta lactam antibiotic families

Cuts or punctures by contaminated sharps

*second is splashes to mucous membranes

Direct - entire facebow is used

Indirect - only the transfer assembly is used

Health care workers, athletes, military, prisoners, children

(Nurses are the highest - 9%)

Healthcare Associated Methicillin Resistant Staph Aureus

70% ICU infections in 2007

19,000 deaths

Hep B

Hep C

HIV

Hep B - 30%

Hep C - 2%

HIV - 0.3%

Occlusal, Buccal, and Lingual of posterior teeth

Lingual of anterior teeth

Only involves proximal surfaces of anterior teeth

(does NOT involve incisal edge)

Other humans

(not common from pets)

Same except they are slow onset symptoms

(> 6 months)

Standard precautions

(PPE and careful with sharps)

Those surfaces that can be directly contaminated from patient materials

(spray or splatter - light switch, handle, doorknob, telephone, etc)

Universal retainer

Tofflemire retainer

an autoclave for smaller items with a pre vacuum that allows for shorter start up time

270 degrees, 4-10 min (wrapped)

Takes 45 min overall

contacts only intact skin

(is effective enough barrier to microorganism)

hollow bore needles

(dentist use when giving anesthesia)

How long does a light load need to be sterilized?

A heavy load?

light - 15 min

heavy - 30 min

occurs on incisal edge of anterior teeth and cusp tips of posterior teeth

rare, caused by enamel defects

spinal fluid, semen, breast milk, amniotic fluid, saliva

(has to be contaminated with blood)