The oral cavity is a natural habitat for a large number of micro-organisms. This ecological pocket can be a reservoir for opportunistic micro-organisms and pathogens which could pose a risk of cross contamination and cause systemic infections.<\/p>\n\n\n\n\n\n\n\n
This is of particular importance\nin everyday dental practice, because the risk\nof exposure <\/strong>to micro-organisms in the oral cavity increases due to the open\nand invasive nature of procedures. It is important to consider that the paths\nof contamination can be two-directional; an infected micro-organism can be\ntransferred from the patient to the\nmembers of the dental surgery team, but also vice versa<\/strong>.<\/p>\n\n\n\n In addition, another infectious\nassociation is the transfer of pathogens from\npatient to patient<\/strong>, without the mediation of the dental surgery staff, but\nrather through a surface located in the dental surgery, or a device or tool\nused during procedures for dental treatment.<\/p>\n\n\n\n This condition occurs in the case\nof inadequate sterilisation of dental instruments or inappropriate disinfection\nof the dental unit. There is also the possibility that the pathogens present in the dental unit water lines<\/strong> may be\ndisseminated by aerosol created by dental handpieces, posing a risk for both\nthe patient and the members of the dental surgery team.<\/p>\n\n\n\n There are many ways in which\nviral and bacterial pathogens can be transmitted in a dental surgery. The\npatient\u2019s saliva and blood are the main carriers of cross transmission.\nBlood-borne contamination can be caused by exposure to infected material\nthrough cutaneous lesions and broken mucous membranes. The higher risk of\ninfection of this type of contamination is associated with accidental punctures\ncaused by contaminated needles or wounds from sharp instruments.1<\/sup><\/p>\n\n\n\n Monitoring the quality of the\nwater used in the dental unit is crucial: patients and healthcare operators are\nregularly exposed to the water and aerosols generated in the dental unit, which\ncould be a potential source of contamination with opportunistic organisms\nespecially in the case of immuno-compromised patients.2<\/sup><\/p>\n\n\n\n The water that circulates in the\ndistribution networks is far from being a pure and stable product. In fact, the\ndensity of micro-organisms in this water increases with time and the distance\nbetween the water treatment station and the end consumer.3<\/sup><\/p>\n\n\n\n So, stagnating water, the\nproduction of biofilm and lack of disinfection could help the micro-organisms\nproliferate in the water systems of dental units.4<\/sup><\/p>\n\n\n\n Bacteria, fungi and protozoa can\nfind favourable conditions to thrive in dental units. Literature documents have\nreported quantities of micro-organisms that range from 100 to 400,000 CFU\/mL in\ndental units.5-6<\/sup><\/p>\n\n\n\n A scientific study has evaluated\nliterature to determine the risk of cross contamination and viral and bacterial\ninfection of particular relevance in the dental surgery environment (HSV, VZV, HIV, hepatitis B, C and D,\nMycobacterium spp., Pseudomonas spp., Legionella spp<\/strong>). Based on the number\nof reported cases, most of which were blood-borne viruses, the actual risk of\ndeveloping an infectious disease through the dental surgery seems to be low.<\/p>\n\n\n\n However, the speed of the actual\ntransmission of viruses and bacteria discussed in this study is probably\nhigher. As long as there are no accurate data, the dental surgery team must be\nfully aware of the risk of dissemination of potentially dangerous\nmicro-organisms and ensure that efficient procedures for the control of cross-infection\nare properly implemented.7<\/sup><\/p>\n\n\n\n Every team member must follow the standard procedures required in order to\nprevent the transmission of micro-organisms<\/strong>. In addition to preventing\ndiseases by vaccination, these include hand hygiene, use of PPE, disinfection\nof instruments and sterilisation protocols, strategies for surface\ndecontamination, approaches to maintain the quality of the DUWL and emergency\nprocedures in the event of incidents that could increase the risk of cross\ntransmission. These procedures considerably reduce the risk of transmission of\nmicro-organisms.<\/p>\n\n\n\n 1<\/sup><\/em>A.M.G.A. Laheij*, J.O. Kistler, G.N. Belibasakis, H. Va \u0308limaa,\nand J.J. de Soet, European Oral Microbiology Workshop (EOMW) 2011\n-Healthcare-associated viral and bacterial infections in dentistry.<\/em><\/em><\/p>\n\n\n\n 2<\/sup><\/em>M. Arvand and A. Hack, \u201cMicrobial contamination of dental unit\nwaterlines in dental practices in Hesse, Germany: a cross-sectional study,\u201d\nEuropean Journal of Microbiology and Immunology, vol. 3, pp. 49\u201352, 2013.<\/em><\/em><\/p>\n\n\n\n 3<\/sup><\/em>M.W. LeChevallier,T.M.Babcock, and R.G.Lee, \u201cExamination and\ncharacterization of distribution system biofilms,\u201d Applied and Environmental\nMicrobiology, vol. 53, no. 12, pp. 2714\u20132724, 1987.<\/em><\/em><\/p>\n\n\n\n 4<\/sup><\/em>P. Castiglia, G. Liguori, M. T. Montagna et al., SItI Working\nGroup Hygiene in Dentistry. Italian multicenter study on infection hazards\nduring dental practice: control of environmental microbial contamination in\npublic dental surgeries, vol. 29, no. 8, article 187, 2008.<\/em><\/em><\/p>\n\n\n\n 5<\/sup><\/em>P. J. Kim, R. A. Cederberg, and R. Puttaiah, \u201cA pilot study of 2\nmethods for control of dental unit biofilms,\u201d Quintessence International, vol.\n31, no. 1, pp. 41-48, 2000.<\/em><\/em><\/p>\n\n\n\n Articolo a cura di Stefania Barbieri<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" The oral cavity is a natural habitat for a large number of micro-organisms. 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