Saccucci Matteo, Ierardo Gaetano, Protano Carmela, Vitali Matteo, Polimeni Antonella
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy -
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy.
Minerva Stomatol. 2017 Oct;66(5):232-239. doi: 10.23736/S0026-4970.17.04087-0. Epub 2017 Jun 23.
Dental personnel (DP) may be exposed to pathogens during dental treatment, either through contact contaminated equipment, or with blood and respiratory secretion. On the other hand, health care professionals are constantly exposed to pathogens and opportunists in their work environment. Consequently, the dental healthcare environment is connected with the risk of exposure to biological agents both for patients and dental workers, and involves a wide number of microorganisms that can be present in biological matrices (gingival fluids, saliva, blood), contaminated and/or non-sanitized surfaces, water used in the dental unit, or emitted by patients suffering or carrier of a transmissible disease. The main determinants of exposure to biological agents in dentistry are related, therefore, to several factors, such as the lack in the application of disinfection/sterilization procedures for surfaces, reusable tools, water, etc.; the lack in the use of protective equipment by workers; an insufficient or inefficient training of personnel; the use of non-targeted, too diluted, or expired biocides. Therefore, each single patient needs to be treated as a potential communicable infectious disease carrier and each case must receive high level of attention in compliance with preventive and hygiene standards, following disinfection and sterilization procedures, and always wearing personal protective equipment. The goal of this article was to discuss on the infection risks related to dental practice both for patients and workers, and to evaluate the state of the art and future perspectives, with particular attention to disinfection procedures, for occupational biological hazards and HAIs prevention in this setting.
牙科工作人员（DP）在牙科治疗过程中可能会接触到病原体，要么是通过接触受污染的设备，要么是接触血液和呼吸道分泌物。另一方面，医护人员在其工作环境中也经常接触病原体和机会致病菌。因此，牙科医疗环境对于患者和牙科工作人员都存在接触生物制剂的风险，并且涉及大量可能存在于生物基质（龈沟液、唾液、血液）、受污染和/或未消毒表面、牙科设备中使用的水或由患有传染病或携带传染病的患者散发的微生物。因此，牙科中接触生物制剂的主要决定因素与几个因素有关，例如在对表面、可重复使用工具、水等应用消毒/灭菌程序方面的不足；工作人员缺乏使用防护设备；人员培训不足或效率低下；使用非针对性、稀释过度或过期的杀菌剂。因此，每一位患者都需要被视为潜在的传染病携带者，并且每一个病例都必须按照预防和卫生标准、遵循消毒和灭菌程序并始终佩戴个人防护设备，给予高度关注。本文的目的是讨论牙科实践中患者和工作人员面临的感染风险，并评估在这种情况下职业生物危害和医院感染预防的现状及未来前景，特别关注消毒程序。
