By: Dr. Ipsa Singh (P.G. 1st year)

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Introduction

Definition and terminologies
Methods of sterilization and disinfection Physical methods Chemical methods Physiochemical method

Sterilization and Disinfection of dental
instruments

with introduction of steam sterilization. in early 1850’s. surgical masks. and later applied it in all surgical wounds and also in operating room by nebulization. . He initially used phenol (dilute carbolic acid) for contaminated wounds. These principles were accepted after John Lister’s studies on prevention of wound infection. sterile drapes. The general principles for asepsis were laid down by Hungarian obstetrician. sterile gloves. sterile gowns. Ignaz Semmelweiss in Europe and Oliver Holmes in USA. carried out in between 1865 to 1891. Further developments occurred .     The concept of asepsis and its role in infection control was put forward nearly 2 centuries ago.

   Cleaning: It is the process which removes visible contamination but not destroy microorganisms. or surface is freed of all microorganism(bacteria. Sterilisation : It is the process by which an article. object. Asepsis: is the employment of techniques (such as usage of gloves. air filters. uv rays etc) to achieve microbe-free environment. It is a necessary prerequisite for effective disinfection or sterilization. . virus) in vegetative form or in spore state. fungi.

 Antiseptic: It is a chemical agent that can be safely applied to living tissues.  Antisepsis: is the use of chemicals (antiseptics) to make skin or mucus membranes devoid of pathogenic microorganisms . or organism capable of giving rise to infection. such as skin or mucous membrane to reduce number of microorganism present. Rarely does this process kills spores and must never be used if sterilisation possible. Disinfection: It means the destruction or removal of all pathogenic microorganism. . by inhibition of their activity or by their destruction.

Anantnarayanan . chemisterilants :These are the chemicals that Textbook of microbiology . Some chemical have very narrow spectrum of activity and some have very wide.  can sterilize. Disinfectants :These are the chemicals that destroy pathogenic bacteria from inanimate surfaces.

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In tropical countries. the sunlight is more effective in killing germs due to combination of ultraviolet rays and heat. .   The microbicidal activity is mainly due to the presence of ultra violet rays in it. Sunlight is not sporicidal.

   Most reliable method of sterilization of articles that can withstand heat. It acts by oxidative effects as well as denaturation and coagulation of proteins. Those articles that cannot withstand high temperatures can still be sterilized at lower temperature by prolonging the duration of exposure. .

Number of microorganisms: More the number of microorganisms. Nature of heat: Moist heat is more effective than dry heat  Temperature and time: temperature and time are  inversely proportional. higher the temperature or longer the duration required. . As temperature increases the time taken decreases.

sugars. Nature of microorganism: Depends on species and strain of microorganism. Type of material: Articles that are heavily contaminated require higher temperature or prolonged exposure. sensitivity to heat may vary.   . Spores are highly resistant to heat.Certain heat sensitive articles must be sterilized at lower temperature. oils and fats increase the time required. Presence of organic material: Organic materials such as protein.

The moist heat acts by coagulation and denaturation of proteins.     Dry heat acts by protein denaturation. Temperature required to kill microbe by dry heat is more than the moist heat. Thermal death time is the minimum time required to kill a suspension of organisms at a predetermined temperature in a specified environment. Moist heat is superior to dry heat in action. . oxidative damage.

. tips of forceps and searing spatulas are sterilized by holding them in Bunsen flame till they become red hot. straight wires. This is a simple method for effective sterilization of such articles. Red heat   Articles such as bacteriological loops.1. but is limited to those articles that can be heated to redness in flame.

. glass slides and cover slips are passed through the flame a few times. mouth of test tubes. limited to those articles that can be exposed to flame. most vegetative cells are killed but there is no guarantee that spores too would die on such short exposure. but not heated to redness. flasks.    the articles passed over a Bunsen flame. Articles such as scalpels.

and hence they should not be incinerated. should be subjected to incineration. pathological material and bedding etc. animal carcasses. . hence is suitable only for those articles that have to be disposed. This technique results in the loss of the article. This is a method of destroying contaminated material by burning them in incinerator. Articles such assoiled dressings. Burning of polystyrene materials emits dense smoke.

Diagrammatic representation of a incinerator .

even distribution of heat throughout the chamber is achieved by a fan. meshed shelves and must have adequate insulation. The oven should be fitted with a thermostat control. Articles to be sterilized are exposed to high temperature (160 deg Celsius) for duration of one hour in an electrically heated oven. The heat is transferred to the article by radiation. conduction and convection. . temperature indicator.    Introduced by Louis Pasteur. Since air is poor conductor of heat.

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swabs.   Sterilization process :   Articles to be sterilized must be perfectly dry before placing them inside to avoid breakage. Mouths of flasks. Articles must be placed at sufficient distance so as to allow free circulation of air in between. oils. petroleum jelly and some pharmaceutical products. pipettes. test tubes and both ends of pipettes must be plugged with cotton wool. flasks. scissors). allglass syringes).Articles sterilized :  Metallic instruments (like forceps. . glassware (such as petri-dishes. scalpels. grease.

40 minutes at 170 degree Celsius and 20 minutes at 180 degree Celsius . Sterilization cycle:     Articles such as petri dishes and pipettes may be arranged inside metal canisters and then placed. Increasing temperature by 10 degrees shortens the sterilizing time by 50 percent. 60 minutes at 160 degree Celsius. The hot air oven must not be opened until the temperature inside has fallen below 60 degree Celsius to prevent breakage of glasswares.  .

Proper sterilization kill the spores and there is no growth. the efficacy of sterilization process. . Chemical: Browne’s tube No. color changes from red to green) Biological: 10^6 spores of Bacillus subtilis var niger or Clostridium tetani on paper strips are placed inside envelopes and then placed inside the hot air oven.Sterilization control:  1.can be checked by following methods: Physical: Temperature chart recorder and thermocouple. the strips are removed and inoculated into thioglycollate broth or cooked meat medium and incubated at 37 degree Celsius for 3-5 days.3 (green spot. 2. 3. Upon completion of sterilization cycle.

   . Since air is poor conductor of heat. The articles remain dry after sterilization. This is the only method of sterilizing oils and powders. hot air has poor penetration.Advantages:    Disadvantages:  It is an effective method of sterilization of heat stable articles. Cotton wool and paper may get slightly charred. Glasses may become smoky. Takes longer time compared to autoclave.

4 (blue spot). Method: Articles are placed in a moving conveyer belt and passed through a tunnel that is heated by infrared radiators to a temperature of 180 degree Celsius. The articles are exposed to that temperature for a period of 7. . hence is not applicable in diagnostic laboratory. It is mainly used in central sterile supply department. Articles sterilized : metallic instruments and glassware.5 minutes.     Infrared rays bring about sterilization by generation of heat. It requires special equipments. Efficiency can be checked using Browne’s tube No.

burrs Only part of instrument in contact with glass bead or steel balls sterilizes. Suitable for small instruments like root canal instruments. . Not suitable for plastic and hollow instruments.Glass bead sterilizer      Contain small glass beads or steel balls in a chamber into which the instrument is inserted for 10-30 seconds Temperature maintained at 210 – 230 degree celsius.6.

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holder method (heated at 63 degree celsius for 30 minutes) 2. Currently this procedure is employed in food and dairy industry.5 sec.At temperature below 100 degree celsius 1. however Coxiella may survive pasteurization. Pasteurization      This process was originally employed by Louis Pasteur. Mycobacteria. flash method (heated at 72 degree celsius for 15 seconds followed by quickly cooling to 13 degree Celsius. Staphylococci and Brucella. Ultra-High Temperature (UHT) method heated at 140 degree celsius for 15 sec and 149 degree Celsius for 0. Methods of pasteurization: 1. This method destroy most of the milk borne pathogens like Salmonella. streptococci. .

Pasteurisation process .

3. Vaccine bath The contaminating bacteria in a vaccine preparation can be inactivated by heating in a water bath at 60 degree Celsius for one hour. Only vegetative bacteria are killed and spores survive.  2. . Proteins in the serum will coagulate at higher temperature. Serum bath The contaminating bacteria in a serum preparation can be inactivated by heating in a water bath at 56 degree Celsius for one hour on several successive days. Only vegetative bacteria are killed and spores survive.

PICTURE OF INSPISSATOR WITH TB CULTURE MEDIUM .

If the spores fail to germinate then this technique cannot be considered sterilization. On the first day. . The process depends on germination of spores in between inspissation. the vegetative bacteria would die and those spores that germinate by next day are then killed the following day. Inspissation:     Used to solidify as well as disinfect egg and serum containing media.4. The medium is placed in the slopes of an inspissator and heated at 80-85 degree celsius for 30 minutes on three successive days.

At temperature 100 degree celsius :
1. Boiling

Boiling water (100 degree celsius ) kills most vegetative bacteria and viruses immediately. Certain bacterial toxins such as Staphylococcal enterotoxin are also heat resistant and some bacterial spores are resistant to boiling and survive; hence this is not a substitute for sterilization. The killing activity can be enhanced by addition of 2% sodium bicarbonate. When absolute sterility is not required, certain metal articles and glasswares can be disinfected by placing them in boiling water for 10-20 minutes. The lid of the boiler must not be opened during the period.

2.Steam at 100 degree Celsius

Instead of keeping the articles in boiling water, they are subjected to free steam at 100 degree celsius Traditionally Arnold’s and Koch’s steamers were used. An autoclave (with discharge tap open) can also serve the same purpose. A steamer is a metal cabinet with perforated trays to hold the articles and a conical lid. The bottom of steamer is filled with water and heated. The steam that is generated sterilizes the articles when exposed for a period of 90 minutes. Media such as TCBS, DCA and selenite broth are sterilized by steaming. Sugar and gelatin in medium may get decomposed on autoclaving, hence they are exposed to free steaming for 20 minutes for three successive days. This process is known as tyndallisation (after John Tyndall) or fractional sterilization or intermittent sterilization. The vegetative bacteria are killed in the first exposure and the spores that germinate by next day are killed in subsequent days. The success of process depends on the germination of spores.

At temperature above 100 degree Celsius: 1.Autoclave  Sterilization can be effectively achieved at a temperature above 100 degree Celsius using an autoclave. Water boils at 100 degree Celsius at atmospheric pressure, but if pressure is raised, the temperature at which the water boils also increases.  In an autoclave the water is boiled in a closed chamber. As the pressure rises, the boiling point of water also raises.  At a pressure of 15 lbs inside the autoclave, the temperature is said to be 121 degree Celsius . Exposure of articles to this temperature for 15 minutes sterilizes them.  To destroy the infective agents associated with spongiform encephalopathies (prions), higher temperatures or longer times are used; 135 degree Celsius or 121 degree Celsius for at least one hour are recommended.

Advantages of steam:
It has more penetrative power than dry air, it moistens the spores (moisture is essential for coagulation of proteins), condensation of steam on cooler surface releases latent heat, condensation of steam draws in fresh steam. Different types of autoclave: a. Simple “pressure-cooker type” laboratory autoclave, b. Steam jacketed downward displacement laboratory autoclave c. high pressure pre-vacuum autoclave.

Initially lid close and discharge tap kept open and water is heated. As water start boiling the steam drives the air out of discharge tap once the steam start appearing from the discharge tap close it. Pressure inside is allowed to rise upto 15 lbs per square inch at this pressure articles held for 15 mins after which heating is stopped and autoclave allowed to cool. Once the pressure gauge shows pressure equal to atmospheric pressure the discharge tap opened to let the air come in. The lid is then opened and article removed.

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autoclave must not be opened until the pressure has fallen or else the contents will boil over. the autoclave must not be overloaded. Advantage: Very effective way of sterilization. air discharge must be complete and there should not be any residual air trapped inside.Articles sterilized:   Culture media. . Whenever possible autoclaving is preferred mode of sterilisation for most of the instrument used in dentistry Precautions:      Articles should not be tightly packed. articles must be wrapped in paper to prevent drenching. dressings. certain equipment. quicker than hot air oven. linen etc.

takes long time to cool. Physical method : automatic process control. Chemical method: Browne’s tube No. thermocouple and temperature chart recorder.Disadvantages:      Sterilization control: Drenching and wetting or articles may occur.1 (black spot) and succinic acid (whose melting point is 121 degree Celsius ) and Bowie Dick tape. If the process has been satisfactory.  . Bowie Dick tape is applied to articles being autoclaved. dark brown stripes will appear across the tape. Biological method : a paper strip containing 10 ^6 spores of Geobacillus stearothermophilus. trapped air may reduce the efficacy.

   Sound waves of frequency >20. This method is not reliable since many viruses and bacteriophages are not affected by these waves. . They are used to clean and disinfect instruments as well as to reduce microbial load. High frequency sound waves disrupt cells.000 cycle/second kills certain bacteria and some viruses on exposing for one hour.

Two types: a.  Since radiation does not generate heat. In some parts of Europe. non-ionizing : low energy rays with poor penetrative power. Ionizing : high-energy rays with good penetrative power. fruits and vegetables are irradiated to increase their shelf life up to 500 percent. it is termed "cold sterilization".  . b.

    Rays of wavelength longer than the visible light are non-ionizing. UV rays are generated using a high-pressure mercury vapor lamp. . which results in the germicidal effect. which ultimately inhibits DNA replication. UV readily induces mutations in cells irradiated with a non-lethal dose. It is at this wavelength that the absorption by the microorganisms is at its maximum. Microbicidal wavelength of UV rays lie in the range of 200-280 nm. UV rays induce formation of thymine-thymine dimers. with 260 nm being most effective.

 some bacteria have DNA repair enzymes that can overcome damage caused by uv rays. that are exposed to the effective UV radiation are inactivated within seconds. yeast. viruses.  . paper or plastic. etc. organic matter and dust prevents its reach.  It doesn't penetrate glass. corridors. Disadvantages  low penetrative power  limited life of the uv bulb. operation theatres. etc. UV rays are employed to disinfect hospital wards. they are considered to be of use in surface disinfection.Microorganisms such as bacteria. Since UV rays don’t kill spores. rays are harmful to skin and eyes. virus laboratories.

particulate  Electron beams are particulate in nature.two types: 1.  Electron beams are employed to sterilize articles like syringes.  Sterilization is accomplished in few seconds. electromagnetic rays.  . foods and pharmaceuticals.  Highspeed electrons are produced by a linear accelerator from a heated cathode.  Disadvantage: poor penetrative power and requirement of sophisticated equipment. dressing packs. gloves. Particulate 2.

viruses and spores. plastic syringes. glasswares tend to become brownish. they can’t be switched off. antibiotics.  Disadvantages 1. glasswares and fabrics. vitamins.Electromagnetic rays  gamma rays emited from nuclear disintegration of certain radioactive isotopes (Co 60. 2.5 megarads kills all bacteria. It is used commercially to sterilize disposable petri dishes. 4. 3.  Bacillus pumilus E601 is used to evaluate sterilization process. loss of tensile strength in fabric. Cs 137). Gamma irradiation impairs the flavour of certain foods. fungi. hormones.  They have more penetrative power but require longer time of exposure.  A dosage of 2. .  These high-energy radiations damage the nucleic acid of the microorganism.

DISRUPTION OF DNA VIA NON IONISING RADIATION DISRUPTION OF DNA VIA IONISING RADIATION .

sugar solutions. Filtration is aided by using either positive or negative pressure using vacuum pumps. urea solution. preparing suspensions of viruses . antibiotic solutions.     Filtration does not kill microbes.measuring sizes of viruses. separating toxins from culture filtrates. . it separates them out.45 μm are commonly used. clarifying fluids and purifying hydatid fluid. Other applications of filtration include removing bacteria from ingredients of culture media.. Membrane filters with pore sizes between 0. remove microbes from heat labile liquids such as serum.2-0.

which are graded as L1. L7. L3. Pasteur-Chamberland filter: These candle filters are from France and are made up of porcelain (sand and kaolin).Different types of filters are: 1. L5. L1a. They are usually baked into the shape of candle. Doulton filters are P2. L2. Different types of earthenware filters are: a. . Chamberland filters are made with various porosities. Earthenware filters: These filters are made up of diatomaceous earth or porcelain. L9 and L11. Similar filter from Britain is Doulton. P5 and P11.

W (wenig). a fossilized diatomaceous earth found in Germany. V (veil).Berkefeld filter:  made of Kieselguhr.75 μm). asbestos and plaster of Paris. they are 1. Mandler filter:  This filter from America is made of kieselguhr.  Quality of V grade filter is checked using culture suspension of Serrtiamarcescens (0.  available in three grades depending on their porosity (pore size).b. N(normal) and 3. c. . 2.

Pasteur chamberland filter Berkefeld filter .

2. HP/PYR (for removal of pyrogens). The disc is held inside a metal mount. chemically composed of magnesium silicate. Asbestos filters: made from chrysotile type of asbestos. They are available in following grades: 1.  They are pressed to form disc. HP/EK (for claryfying).2.  . which is sterilized by autoclaving. HP/EKS (for absolute sterility) and 3. which are to be used only once.

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They are washed in running water in reverse direction and cleaned with warm concentrated sulphuric acid and sterilized by autoclaving.5 μm. available in the form of disc fused into a glass funnel.3. . Filters of Grade 5 have average pore diameter of 1-1. Sintered glass filters:     made from finely ground glass that are fused sufficiently to make small particles adhere to each other.

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The older type of membrane. . These membranes have a pore diameter ranging from 0. these filters are sterilized by autoclaving. The newer ones are composed of cellulose diacetate. polycarbonate and polyester.015 μm to 12 μm.    made from a variety of polymeric materials such as cellulose nitrate. Gradocol membranes have average pore diameter of 3-10 μm. called gradocol (graded colloidion) membrane was composed of cellulose nitrate. cellulose diacetate. Membrane filters are made in two ways. the capillary pore membranes have pores produced by radiation while the labyrinthine pore membranes are produced by forced evaporation of solvents from cellulose esters.

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2.  known porosity. no retention of fluids. reusable after autoclaving and compatible with many chemicals. membrane filters have little loading capacity and are fragile. 2. absorption or retention of certain volume of liquid by the filters. 3.Disadvantages 1. However. migration of filter material into the filtrate. . 3. pore sizes are not definite and viruses and mycoplasma could pass through. Advantages 1.

They are usually used in biological safety cabinets. HEPA filters are at least 99.97% efficient for removing particles >0.     Air can be filtered using HEPA (High Efficiency Particle Air) filters.3 μm in diameter. Examples of areas where HEPA filters are used include rooms housing severely neutropenic patients and those operating rooms designated for orthopedic implant procedures.3 μm in diameter. . efficiency is monitored with the dioctylphthalate (DOP) particle test using particles that are 0.

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non-allergenic. 13. 2. 9. 6. 10. Should have wide spectrum of activity Should be able to destroy microbes within practical period of time Should be active in the presence of organic matter Should make effective contact and be wettable Should be active in any pH Should be stable Should have long shelf life Should be speedy Should have high penetrating power Should be non-toxic. 3. 4. 5. 12. 7. 14. non-irritative or non-corrosive Should not have bad odour Should not leave non-volatile residue or stain Efficacy should not be lost on reasonable dilution Should not be expensive and must be available easily .1. 8. 11.

     Concentration of the substance Time of action pH of the medium Temperature Presence of extraneous material .

damage.loss of the content Removal of free sulfydryl groups essential for the functioning of enzyme Substrate competition .     Disinfectants can act by: Protein coagulation Cell membrane disruption leading to exposure.

1. Phenols) Gaseous (Formaldehyde vapor. Based on consistency a) b) 2.g. Ethylene oxide) High level Intermediate level Low level b) c) . Alcohols.. Based on spectrum of activity a) Liquid (E.

g. Formaldehyde) Damage to nucleic acids (Ethylene Oxide.and hydroxyl group (E. H2O2...g.g.3.. Alcohol.g. Ethylene Oxide.microrao.com) . carboxyl. Halogens) Alkylation of amino-.N (www. detergent) Denaturation of cellular proteins (E. Based on mechanism of action a) b) c) d) e) Action on membrane (E. Formaldehyde) © Sridhar Rao P. Phenol) Oxidation of essential sulphydryl groups of enzymes (E. Alcohol..

inflammable . Isopropyl alcohol is preferred to ethanol. Methyl alcohol kills fungal spores. 70% ethyl alcohol (spirit) is used as antiseptic on skin. Application: Disadvantages:    Skin irritant. isopropyl alcohol methyl alcohol A 70% aqueous solution is more effective at killing microbes than absolute alcohols. It is used to disinfect clinical thermometers. disrupt membranes and cause coagulation of protein. It can also be used to disinfect surfaces.Mode of action:  Examples:        Alcohols dehydrate cells. volatile (evaporates rapidly). hence is useful in disinfecting inoculation hoods. Ethyl alcohol.

5% tetraborate sterilizes clean metal instruments. furniture and books. It also sterilizes bedding. and probably damages nucleic acids. sick rooms etc. wards.  10% formalin with 0.  heating paraformaldehyde or treating formalin with potassium permanganate. carboxyl. including spores. biological safety cabinets. . chambers.Mode of action:  Acts through alkylation of amino-. Examples:  Formaldehyde  Gluteraldehyde Application:  40% Formaldehyde (formalin) is used for surface disinfection and fumigation of rooms. Fumigation is achieved by boiling formalin. operation theatres.or hydroxyl group. It kills all microorganisms.

An exposure of at least 3 hours at alkaline pH is required for action by gluteraldehyde.  leaves non-volatile residue.25% at 60 degree celsius for six hours to disinfect animal hair and bristles.  activity is reduced in the presence of protein.2% gluteraldehyde (cidex) is used to sterilize thermometers. Disadvantages:  Vapors are irritating (must be neutralized by ammonia).  2% formaldehyde at 40 degree Celsius for 20 minutes is used to disinfect wool and 0. bronchoscopes. centrifuges.  Gluteraldehyde requires alkaline pH and only those articles that are wettable can be sterilized. cystoscopes. anaesthetic equipments etc.  .  has poor penetration.

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 The corrosive phenolics are used for disinfection of ward floors.  1-5% Cresol.  They act as disinfectants at high concentration and as antiseptics at low concentrations. precipitation of proteins and inactivation of enzymes.  5% Lysol (a saponified cresol). mycobactericidal but are inactive against spores and most viruses. fungicidal. .  They are bactericidal.Mode of action:  Act by disruption of membranes.  chlorhexidine.  They are not readily inactivated by organic matter.  hexachlorophene.  Chloroxylenol (Dettol) Applications:  Phenols are coal-tar derivatives. Examples:  5% phenol. in discarding jars in laboratories and disinfection of bedpans.

. Hexachlorophene is chlorinated diphenyl and is much less irritant. fungi and viruses. Chloroxylenols are less irritant and can be used for topical purposes and are more effective against gram positive bacteria than gram negative bacteria.2% chlorohexidine gluconate solution used as mouthwash (clohex ) Chlorhexidine gluconate is also mixed with quaternary ammonium compounds such as cetrimide to get stronger and broader antimicrobial effects (eg. 0. mycobacteria. Triclosan is an organic phenyl ether with good activity against gram positive bacteria and effective to some extent against many gram negative bacteria including Pseudomonas. It has marked effect over gram positive bacteria but poor effect over gram negative bacteria.      20% Chlorhexidine gluconate solution is used for pre-operative hand and skin preparation and for general skin disinfection.It also has fair activity on fungi and viruses. Savlon).

. corrosive and skin irritant.Disadvantages:    It is toxic. Chloroxylenol is inactivated by hard water. Chlorhexidine is inactivated by anionic soaps.

 iodophores : Eg: Iodine + polyvinylpyrrolidone k/a povidone-iodine( BETADINE) . Examples:  Chlorine compounds (chlorine. which is microbicidal. For hand washing iodophores are diluted in 50% alcohol.Mode of action:  They are oxidizing agents and cause damage by oxidation of essential sulfydryl groups of enzymes.  Chlorine reacts with water to form hypochlorous acid. bleach. iodophores) Applications:  Tincture of iodine (2% iodine in 70% alcohol) is an antiseptic. .Iodophores permit slow release and reduce the irritation of the antiseptic. hypochlorite) and iodine compounds (tincture iodine.

Bleach solution is corrosive and will corrode stainless steel surfaces. Disadvantages: They are rapidly inactivated in the presence of organic matter.        10% Povidone Iodine is used undiluted in pre and post operative skin disinfection. . Mercuric chloride is used as a disinfectant. Used at a dilution of 1:10 in decontamination of spillage of infectious material. 0.5% sodium hypochlorite is used in serology and virology. Household bleach can be used to disinfect floors. In higher concentrations chlorine is used to disinfect swimming pools. Iodine is corrosive and staining. Household bleach used in a stock dilution of 1:10. Chlorine gas is used to bleach water.

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merthiolate) Applications:  1% silver nitrate solution can be applied on eyes as treatment for opthalmia neonatorum (Crede’s method).  copper sulfate.  Merthiolate at a concentration of 1:10000 is used in preservation of serum. Method no longer followed. Disadvantages: Mercuric chloride is highly toxic.  Mercurials are active against viruses at dilution of 1:500 to 1:1000. mercurochrome.  Silver sulphadiazine is used topically to help to prevent colonization and infection of burn tissues. are readily inactivated by organic matter..  organic mercury salts (e.Mode of action:  Act by precipitation of proteins and oxidation of sulfydryl groups.  silver nitrate. Examples:  Mercuric chloride.  They are bacteriostatic.  Copper salts are used as a fungicide. .g.

Could be soaps or detergents. Detergents can be anionic or cationic. it is called cationic detergents. they Concentrate at interfaces between lipid containing membrane of bacterial cell and surrounding aqueous medium causing disruption of membrane resulting in leakage of cell constituents. If the fat-soluble part is made to have a positive charge by combining with a quaternary nitrogen atom. Detergents containing negatively charged long chain hydrocarbon are called anionic detergents. Cationic detergents are known as quaternary ammonium compounds (or quat).Mode of actions:   Examples:   These have long chain hydrocarbons that are fat soluble and charged ions that are water-soluble. These include soaps and bile salts. Eg: Cetrimide and benzalkonium chloride.  .

widely used as disinfectants at dilution of 1-2% for domestic use and in hospitals. using them as a carbon. nitrogen and energy source. Mycobacteria and enveloped viruses. Pseudomonas can metabolise cetrimide. Disadvantages:   . activity is reduced by hard water. anionic detergents and organic matter.Application:   active against vegetative cells.

Can be: 1. proflavine  Acridine dyes act against gram positive and gram negative organism and not affected by pus. malachite green. Acridine dyes Eg: Acriflavine.  . Aniline dyes Eg: brilliant green.crystal violet 2.  Aniline dyes more active against gram positive organism and its activity inhibited by pus.

 Disadvantages:  Decomposes in light.  broken down by catalase.Mode of action:  acts on the microorganisms through its release of nascent oxygen.  3% Hydrogen Peroxide Solution is used for skin disinfection and deodorising wounds and ulcers. equipments such as ventilators.  Strong solutions are sporicidal. proteinaceous organic matter .  produces hydroxyl-free radical that damages proteins and DNA. Application:  used at 6% concentration to decontaminate the instruments.

disposable petri dishes. hence combined with carbon dioxide (10% CO2+ 90% EO) or dichlorodifluoromethane. complex apparatus like heart-lung machine. highly flammable. readily polymerizes and is flammable. Properties:  It is a cyclic molecule. syringes.groups.  Efficiency testing is done using Bacillus subtilis var niger. skin. 2. amino-. Articles sterilized:  heat labile articles such as bedding. . 3. It acts by alkylating sulfydryl-. respiratory and dental equipments. irritating to eyes. mutagenic and carcinogenic. Disadvantages:  It is highly toxic.Mode of action:  It is an alkylating agent. It has a sweet ethereal odor. which is a colorless liquid at room temperature. highly flammable. highly effective chemisterilant.and hydroxyl. capable of killing spores. textiles. plastics. rubber. Application: 1. carboxyl.

and hydroxyl.2% is used to sterilize biological products. It is a condensation product of ketane with  formaldehyde.Mode of action:  It is an alkylating agent and acts through alkylation of carboxyl. surgical instruments and enzymes Disadvantages:  It has poor penetrating power and is a carcinogen. Properties:  It is a colorless liquid with pungent to slightly sweetish smell. Application:  It is an effective sporicidal agent. It is used to sterilize vaccines. 0. tissue grafts. .groups. and has broad-spectrum activity. It is more efficient in fumigation that formaldehyde.

Mode of action:  A physio-chemical method adopts both physical and chemical method.  The air is removed from the autoclave chamber and saturated steam at sub-atmospheric pressure is flushed in.  Saturated steam at a pressure of 263 mm of Hg has a temperature of 70 degree celsius. . which takes into account action of steam as well as that of formaldehyde.  Use of steamformaldehyde is a physio-chemical method of sterilization.

each of 5-10 minutes.stearothermophilus . Formaldehyde is then injected with steam in a series of pulses. The articles are held at this holding temperature for one hour. Sterilization control:  using paper strips containing 10^6 spores of G. Disadvantages:  Condensation of formaldehyde occurs and induction of large volume of formaldehyde wets the steam resulting in loss of latent heat. Formaldehyde is then flushed by inflow of steam.

 Should be sterilized after each use via steam under pressure (autoclaving). or heat/chemical vapor. dental instruments are classified into three categories depending on the risk of transmitting infection. dry heat. scalers and surgical burs. scalpels.According to the Centers for Disease Control. or enter into or contact the bloodstream or other normally sterile tissue. 1) Critical instruments :  Instruments that penetrate soft tissue or bone. bone chisels.  .  Includes forceps.

Mouth mirrors.However.  Eg. .2) Semi-critical instruments  Instruments that do not penetrate soft tissues or bone but contact mucous membranes or nonintact skin.. some time sterilization is not feasible and.  Should be sterilized after each use. reusable impression trays and amalgam condensers. therefore. high-level disinfection is appropriate.

and chlorinecontaining compounds)..g. . may be reprocessed between patients by intermediate-level or low-level disinfectiant (e. and.  Eg: external components of x-ray heads. therefore. iodophors. phenolics. blood pressure cuffs and pulse oximeters.  Such devices have a relatively low risk of transmitting infection.3) Non-critical instruments  Instrument that come into contact only with intact skin.

Disinfection of all surfaces and items in immediate vicinity.    The success of prevention and control of infection in healthcare areas is largely dependant on aseptic technique of all personnel who perform invasive procedures. . Sterility of all items directly concerned in such procedures.

com Images from Google Images .Krygier Center for disease control and prevention.Guideline for infection control in dental health care settings-2003 www.       Textbook of Microbiology – Anantnarayan Manipal manual of dental surgery for dental students – Shenoy Principals of oral and maxillofacial surgery.microrao. Anil.Samarnayake.Neelima A Malik Infection control in dental practice.s.

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