• 제목/요약/키워드: Dental Infection Control

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제주지역 치위생과 학생의 COVID-19와 감염관리 임상실습 수행 실태 (Clinical Practice of COVID-19 and Infection Control by Dental Hygiene Students in Jeju Province)

  • 백수정;우재만;김성준
    • 한국콘텐츠학회논문지
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    • 제22권2호
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    • pp.370-378
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    • 2022
  • 본 연구의 목적은 제주 치위생과 학생을 대상으로 COVID-19 상황에 임상 실습 수행 중 감염관리에 영향을 미치는 요인을 분석하는 데 있다. 112명의 온라인 자기 기입식 설문 응답을 SPSS 20.0을 이용하여 빈도분석, T-test, one-way ANOVA와 더미 회귀분석을 하였다. 감염관리 인식도와 실천도는 2학년이 3학년보다 '청소 및 표면 소독', '의료폐기물 처리', 'COVID-19 감염관리' 항목에서 통계적으로 유의하게 높았다. 임상실습기관별 결과는 '청소 및 표면 소독', '기구 소독 및 멸균', '개인 및 환자 방호', 'COVID-19 감염관리' 항목에서 대형병원이 통계적으로 유의하게 높았다. 임상실습 지역은 의료폐기물 처리' 항목에서만 수도권이 제주지역보다 높았다. COVID-19 감염관리 요인 분석 결과, 3학년보다 2학년, 실습 기관 중 대형병원, 실습 지역 중 수도권 지역, 보호장구 애로사항이 없던 학생이 통계적으로 높은 영향을 미치는 것으로 나타났다. 본 연구는 제주지역 치위생과 학생들의 임상 실습시의 감염관리와 COVID-19의 현장을 대상으로 한 첫 번째 실태 조사 연구로 의의를 두며, 임상 실습 지침 개선을 위한 연구가 지속되어야 할 것이다.

임상실습 교육내용 및 업무중요도에 관한 치과위생사의 인식 (The awareness of dental hygienist regarding the content of clinical practice education and importance of duty)

  • 김창희;신선정;신명숙
    • 한국치위생학회지
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    • 제17권6호
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    • pp.1067-1080
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    • 2017
  • Objectives: This study analyzed the perception towards clinical practice education content held by dental hygiene students in dental institutions and their perceived importance of dental hygienists' clinical duties. Methods: The subjects of this study were 182 dental hygienists who were working at dental institutions in Seoul, Gyeonggi, and Chungcheong areas. A survey was conducted with a self-administered questionnaire. In the questionnaire, the clinical practice contents were classified into observation, preparation, and performance, and the importance of clinical duty was measured with a 3-point scale. For the clinical practice contents and the importance of duty, descriptive statistics and chi-square test were performed, and the study results were analyzed using STATA 11.0. Results: With regard to clinical practice contents, observation was mainly performed in oral & maxillofacilal radiology, preventive dentistry, periodontal medicine and oral medicine. In primary care and infection control, practice and observation were mainly performed. In the department of orthodontics and pediatric dentistry, observation and preparation were mainly conducted, while in oral surgery, conservative dentistry observation, preparation and practice were all conducted. With regard to clinical practice contents according to the dental institution, there were statistically significant differences in the type of dental institution and the duty (p>0.05). In terms of the importance of dental hygienist's duty, infection control, toothbrushing education for each patient, removal of plaque, and patient education after surgery were considered important. Conclusions: For clinical practice of the dental hygiene department, the education contents should be standardized in accordance with the importance of the dental hygienist's duty, a protocol for operation of practice should be developed, and a method of standardization of evaluation should be sought in the future.

A comparative study of the prevalence of Helicobacter pylori in the oral biofilms of a group of dental and non-dental undergraduates from Sri Lanka

  • Mallikaarachchi, MADKS;Rajapakse, Sanath;Gunawardhana, KSND;Jayatilake, JAMS
    • International Journal of Oral Biology
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    • 제46권1호
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    • pp.60-65
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    • 2021
  • Dental health care workers (DHCW) are at a risk of occupational exposure to Helicobacter pylori from the aerosolized oral biofilms and saliva of patients. We designed this study to investigate the prevalence of H. pylori in the oral biofilms of a group of dental and non-dental undergraduates from Sri Lanka. After obtaining informed consent, oral biofilms were collected from 38 dental undergraduates (19 males and 19 females) undergoing clinical training and 33 non-dental undergraduates (14 males and 19 females). The participants were in the age range of 22-27 years and had healthy periodontium. Total DNA from the oral biofilms were extracted, and H. pylori DNA was detected using polymerase chain reaction (PCR) amplification of 16S rRNA gene of H. pylori using JW22-JW23 primers, and the results were confirmed using PCR amplification of H. pylori-urease specific HPU1-HPU2 primers. Out of 71 participants, 11 (28.95%) dental and 3 (9.09%) non-dental undergraduates had H. pylori in their oral biofilms indicating an overall prevalence rate of 19.72% (14/71). Thus, the prevalence of H. pylori in oral biofilms was significantly higher in dental undergraduates than in non-dental undergraduates (p < 0.05). An odds ratio of 4.07 indicated that dental undergraduates were four times more likely to harbor H. pylori in their oral biofilms than non-dental undergraduates. Foregoing data support the fact that there may be greater occupational risk of exposure to H. pylori for dental undergraduates during clinical training than that for non-dental undergraduates, warranting meticulous infection control practices during clinical dentistry.

코로나 바이러스 대유행에 따른 치과 의료 관리 가이드라인 (Guidelines for dental clinic infection prevention during COVID-19 pandemic)

  • 김진
    • 대한치과의료관리학회지
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    • 제8권1호
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    • pp.1-7
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    • 2020
  • Dental settings have unique characteristics that warrant specific infection control considerations, including (1) prioritizing the most critical dental services and provide care in a way that minimizes harm to patients due to delayed care, or harm to personnel from potential exposure to persons infected with the COVID-19 disease, and (2) proactively communicate to both personnel and patients the need for them to stay at home if sick. For health care, an interim infection prevention and control recommendation (COVID-19) is recommended for patients suspected of having coronavirus or those whose status has been confirmed. SARS-CoV-2, which is the virus that causes COVID-19, is thought to be spread primarily between people who are in close contact with one another (within 6 feet) through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease, and there remain uncertainties about its mode of spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for several hours, and on some surfaces for days under laboratory conditions. COVID-19 may also be spread by people who are asymptomatic. The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers, and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. While KF 94 masks protect the mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne infectious agents. If the patient is afebrile (temperature <100.4°F)* and otherwise without symptoms consistent with COVID-19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations. It is necessary to provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%~95% alcohol, tissues, and no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins. There is also the need to install physical barriers (e.g., glass or plastic windows) in reception areas to limit close contact between triage personnel and potentially infectious patients. Ideally, dental treatment should be provided in individual rooms whenever possible, with a spacing of at least 6 feet between the patient chairs. Further, the use of easy-to-clean floor-to-ceiling barriers will enhance the effectiveness of portable HEPA air filtration systems. Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment, including gloves, hand hygiene after removal is particularly important to remove any pathogens that may have been transferred to the bare hands during the removal process. ABHR with 60~95% alcohol is to be used, or hands should be washed with soap and water for at least 20 s.

감염 조절용 차단막의 두께가 광중합기의 중합광에 미치는 영향 (Effect of infection control barrier thickness on light curing units)

  • 장훈상;이석련;홍성옥;류현욱;송창규;민경산
    • Restorative Dentistry and Endodontics
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    • 제35권5호
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    • pp.368-373
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    • 2010
  • 연구목적: 본 연구는 감염 조절용 차단막을 여러 겹으로 사용했을 때 광중합기의 광강도와 파장, light diffusion 등에 미치는 영향에 대해 조사하였다. 연구 재료 및 방법: 감염 조절용 차단막은 투명 랩 (크린랩)을 사용하였고 광중합기는 할로겐 광중합기 (Optilux 360)와 LED 광중합기 (Elipar FreeLight 2)를 사용하였다. 차단막을 1겹, 2겹, 4겹, 8겹으로 광중합기의 광섬유말단을 감싸고 휴대용 광강도 측정기 (Cure Rite)로 광중합기의 광강도를 측정하였다. 광중합기를 주문제작한 optical breadboard에 고정시킨 후 휴대용 spectroradiometer (CS-1000)를 이용하여 광중합기의 파장을 측정하였고, DSLR (Nikon D70s)을 이용하여 광중합기의 light diffusion을 사진 촬영하였다. 결과: 광강도 측정 결과는 차단막의 두께가 증가할수록 광강도가 유의하게 감소하였으나 할로겐 광중합기에서 1겹과 2겹 사이에는 유의차가 없었으며, 4겹 이상의 차단막을 투과할 때 광강도가 더 많이 감소하였다. 여러 겹의 차단막을 투과한 광중합기의 전체적인 파장 형태와 peak wavelength의 변화는 관찰되지 않았다. Light diffusion 사진 촬영 시, LED 광중합기에서는 차단막의 두께가 미치는 영향이 없었으나 할로겐 광중합기에서는 차단막을 4겹 사용했을 때부터 중합광이 조사되는 각도가 감소하기 시작하여 8겹 사용했을 때 통계적으로 유의하게 감소하는 것을 볼 수 있었다 (p < 0.05). 결론: 광중합형 복합레진을 광중합할 경우 감염 조절용 차단막이 찢어지는 경우를 대비하여 1겹으로 사용하기 보다는 2겹으로 사용하는 것이 환자간의 교차감염을 예방하는데 유리할 것으로 사료된다.

A comparative analysis of odontogenic maxillofacial infections in diabetic and nondiabetic patients: an institutional study

  • Kamat, Rahul D.;Dhupar, Vikas;Akkara, Francis;Shetye, Omkar
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권4호
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    • pp.176-180
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    • 2015
  • Objectives: The increased prevalence of antibiotic resistance is an outcome of evolution. Most patients presenting with odontogenic space infections also have associated systemic co-morbidities such as diabetes mellitus resulting in impaired host defense. The present study aims to compare the odontogenic spaces involved, antibiotic susceptibility of microorganisms, length of hospital stay, and the influence of systemic comorbidities on treatment outcome in diabetic patients. Materials and Methods: A 2-year prospective study from January 2012 to January 2014 was conducted on patients with odontogenic maxillofacial space infections. The patients were divided into two groups based on their glycemic levels. The data were compiled and statistically analyzed. Results: A total of 188 patients were included in the study that underwent surgical incision and drainage, removal of infection source, specimen collection for culture-sensitivity, and evaluation of diabetic status. Sixty-one out of 188 patients were found to be diabetic. The submandibular space was the most commonly involved space, and the most prevalent microorganism was Klebsiella pneumoniae in diabetics and group D Streptococcus in the nondiabetic group. Conclusion: The submandibular space was found to be the most commonly involved space, irrespective of glycemic control. Empiric antibiotic therapy with amoxicillin plus clavulanic acid combined with metronidazole with optimal glycemic control and surgical drainage of infection led to resolution of infection in diabetic as well as nondiabetic patients. The average length of hospital stay was found to be relatively longer in diabetic individuals.

치위생과 학생들의 B형 간염 바이러스의 표지자와 인지도에 관한 연구 (A Study on occurrence rates from serologic marker of hepatitis B virus and on perception in dental hygiene students)

  • 강은주;신상희;장선희
    • 한국학교보건학회지
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    • 제15권2호
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    • pp.183-191
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    • 2002
  • This study is aimed at offering basic data about prevention of Hepatitis B virus and infection control to dental hygiene students who will work mostly at dental offices which are characteristically exposed to a high risk of HBV infection. For this study, surveyed were 188 sophomores and juniors of the dental hygiene department who volunteered to undergo the tests of HBsAg and HBsAb. The examination of the blood collected from the samples and analysis of their perception about hygiene resulted in following conclusion: Positive HBsAg Four was found in 4 testees(2.1%) while 118(62.8%) revealed positive HBsAb. Juniors showed higher positive rate in HBsAg whereas sophomores had higher positive rate in HBsAb. But such difference has statistically no significance. Generally, students seemed to pay little attention to HBV, judging from the survey of their perception about the present state of HBsAg and HBsAb(p>0.05), conduct of infection(p<0.05), completion of 3 requested vaccinations(p>0.05), and formation of antibody(p>0.05). With regard to the infection routes of HBV, most students(92.4%) replied "through blood", which is statistically insignificant, though. Next ratio goes to the reply "through contaminated injectors". This reply came more from sophomores than from juniors, a difference which is statistically significant(p<0.05). The lowest rate of possible infection(29.2%) was thought to be "through breast-feeding of a positive mother"(p<0.05). In general, it turned out that sophomores had more knowledge about the infection routes of HBV than juniors. In terms of clinical history among family members, 6(3.1%) reported that some of their family members are currently suffering from a liver complaint, 3(1.6%) replied their family members were once afflicted, and 4(2.1%) said their members died of hepatitis. Except 10(4.7%), all the surveyees replied that their states of health are better than normal. Generally, sophomores are healthier than juniors except for the very health case, a difference which is statistically of no value.

종격동염의 증례보고 (Mediastinitis: a case report)

  • 김재환;류동목;지유진;이정우;이덕원
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권6호
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    • pp.538-542
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    • 2010
  • Acute mediastinitis is a fatal infection which occurs related to connective tissue of mediastium, in the thoratic organs. Occurrence of mediastinitis due to craniocervical infection is very rare, and is defined as descending necrotizing mediastinitis. November 8th, 2008, man in his early fifties visited ER due to severe swelling on left neck area and dyspnea. Antibiotic were administered immediately, and vast amount of abscess formation on pneumomediastinum and adjacent tissues were observed via chest computed tomography. With cooperation of thoracic and cardiovascular surgery department, emergency incision and drainage with drain insertion was done to remove abscess, and control the infection. After surgery, everyday saline irrigation through drain was done during hospitalization, with continues antibiotic therapy. Descending necrotising mediastinitis is a most rare and dangerous infection which occurs on oropharyngeal area. In case of descending necrotising mediastinitis, accurate diagnosis, airway maintenance, remove of abscess by incision and drainage, aggressive antibiotic therapy and continuous saline irrigation is necessary to increase patient survivability. Also, computed tomography with contrast media is essential to figure out the size and location of the infection and abscess formation.

항응고제 투여중인 다발성 장애환자에서 골수이식전 발치창 출혈부의 전색과 배농술을 통한 출혈과 감염의 조절 : 증례보고 (BLEEDING & INFECTION CONTROL BY THE PACKING AND DRAINAGE ON BLEEDING EXTRACTION SOCKET BEFORE BONE MARROW TRANSPLANTATION IN A MULTIPLE DISABLED PATIENT WITH ANTICOAGULATION DRUG : REPORT OF A CASE)

  • 유재하;손정석;김종배
    • 대한장애인치과학회지
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    • 제8권1호
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    • pp.15-21
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    • 2012
  • Extraction of all nonrestorable teeth prior to bone marrow transplantation is the major dental management of the patient being prepared for the transplantation. But, there are four principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (3) Thrombocytopenic purpuras (4) Disorders of coagulation (liver disease, anticoagulation drug-heparin, coumarin, aspirin, plavix) If the hemorrhage from postextraction wound is unusually aggressive, the socket must be packed with local hemostatic agent and wound closure & pressure dressing are applied. But, in dental alveoli, local hemostatic agent (gelfoam, surgcel etc) may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by suture, pressure packing and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 57-years-old multiple disabled patient with anticoagulation drug.

장애아동 전신마취에 대한 Critical Pathway적용 (CRITICAL PATHWAY ON GENERAL ANESTHESIA FOR DISABLED CHILDREN)

  • 금진은;이수진;허정애;정태성
    • 대한장애인치과학회지
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    • 제3권2호
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    • pp.80-86
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    • 2007
  • A critical pathway (CP) defines the optimal care process, sequencing and timing of intervention by multi-disciplinary health care teams for a particular diagnosis and procedure. It plays an important role as a cost-effective health care delivery system and a tool for quality control of medical and dental services by means of standardizing medical practices. The aim of this study is to investigate the satisfaction of patients and medical/dental staff after implementation of a critical pathway for dental treatment of disabled children under general anesthesia and its cost effectiveness. Ten patients who underwent dental treatment under general anesthesia were included in the CP group between August and December 2006. The pre-CP group included 20 patients who underwent the same procedure from February 2003. The satisfaction of parent of child patient and medical staff members were compared between two groups. The parents' satisfaction was significantly improved after the implementation of CP and medical/dental staff members were highly satisfied with the usefulness of the critical pathway. In conclusion, the critical pathway for the dental treatment of disabled treatment under general anesthesia can highly improve the satisfaction of parents and medical/ dental staff members.

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