DENTISTRY

ANTISEPTICS &
DISINFECTANTS
Zenaida N. Maglaya, MD
 Goals of infection control programs:
• 1. To reduce the numbers of
pathogenic microorganisms to levels
where patients’ normal defense
mechanisms can prevent infection.
• 2. To break the cycle of infection &
eliminate cross-contamination
Goals of infection control programs:

• 3. To treat every patient &

instrument as capable of
transmitting infectious disease
• 4. To protect patients and health
care workers from infection and
its consequences
STERILIZATION
• Ultimate goal of any infection control
protocol because it is the killing of all
forms of microorganism
• In dental clinic: dry heat, steam &
chemical vapor sterilization units
• In medicine: ethylene oxide &
formaldehyde gases, UV & gamma
radiation & filtration
DISINFECTION
• Is the application of chemicals
to destroy most pathogenic
organism on inanimate
surfaces (Environmental
Protection Agency)
ANTISEPTICS
• Is the use of chemicals to
destroy or inhibit pathogenic
organism on skin or living
tissue (under FDA)
HALOGENS & HALOGEN –
RELEASING COMPONDS
• MOA: depend on the free halogen
reacting covalently with key microbail
enzyme systems
• Sites of Actions: reactions with
sulfhydryls & disulfides within protiens
• CHLORINE
• IODINE
 CHLORINES
• Salts of (sodium, calcium & Lithium) of
hypochlorite in the form chloride lime
• Sodium hypochloride: disinfectant
• 1:10 to 1:100 IN WATER
• For HBV in hospitals
• Disadv: offensive odor, corrode metals, &
need to prepare diluted solution fresh daily
IODINE & IODOPHORS
• Non toxic & noncorrosive
• Broad spectrum of activity
• Disadv: discoloration of skin & other
materials, having an odor, & painful
to open wounds
• IODOPHORS:
• An excellent cleansing agents,
(surfactant effect)
ALDEHYDE
• Glutaraldehyde : immersion disinfectant
• Cross-linking of microbial proteins
• Not affected by organic materials
• Skin irritation,asthma
• Limited to instruments that should be
sterilized but cannot withstand the high
heat
• Needs initial cleaning, proloned
immersion, terminal thorough rinse with
sterile water
 PHENOLS & RELATED
COMPOUNTS
• CRESOL: coal tar disinfectants
• Lysol: 50% mixture of cresol in
saponified vegetable oil
• EUGENOL guiaiacol : weak
antimicrobial actv; rapid analgesic
properties; component of sedative
pastes in dentistry & oil of cloves
• Declined use because of allergic
sensitization
 Bisphenols
• Handwash antiseptics
• Hexachlorophene, chlorhexidine gluconate,
parachlormetaxylenol
• Hexachlorophene: accumulate in the skin, most effective
vs gm positive org; impt comp in surgical soaps;
accumulate in scalp , neurotoxicity
• Chlorhexidine Gluconate: hand hygiene
• Disruption of membrane function
• HAVE AN ANTIVIRUS EFFECT
• Have SUBSTANTIVITY
• Oral rinses: reduce plaque formation & gingivitis
• May cause calculus formation, staining of teeth & alteration
taste perception
 Parachlormetaxylenol
(chloroxylenol)
• Handwash antiseptic
• Disruption of the antimicrobial cell wall & enzyme
inactivation
• Gm positive & antifungal effects
• Kill Pseudomonas sp
• TRICLOSAN: antimicrobial soaps , mouth rinses,
antiplaque agent
• Effective cytoplasmic membrane functions &
sysnthesis of RNA , fatty acids proteins by binding
to protein reductase
 ALCOHOLS
• Ethanol & Isopropanol: carriers &
antimicrobials
• Low cost, rapid evaporation & lack of
residue: disinfecting inanimate objects
• Detrimental effect of dental equipment
surfaces
• Topical antiseptics in addition to
disinfection
SURFACE ACTIVE AGENTS
• Detergent effect
• Ability to interact noncovalently with
membrane proteins & lipids
• Anionic agents: soaps &
dodecylsulfate detergents: cleansing
& emulsifying
• Cetylpyridium chloride, benzethonium
chloride: mouth rinses
 OXIDIZING COMPOUNDS
• Hydrogen peroxide: most common
• 3% effective against vegetative bacteria
• 6% sporicidal; also known as oxygenating
compounds
• Antiseptic & debridement agent
• w/ tuberculocidal activity
• Plus sodium bicarbonate: may be used against
the anaerobic bacteria prevalent in peridontal
disease
 HEAVY METALS
• MERCURY & SILVER COMPOUNDS
• Silver nitrate: treat oral ulcers but may
delay healing
• Still useful as eye drops for gonococcal
inf prophylaxis
• Stannous fluoride : flouride source in
dentifrices for gingival health
• Tin (stannous ion) effective
antimicrobial
 USES ON DENTISTRY
• Effective infection control protocols:
1. thorough hand washing techniques with
appropriate antiseptics
2. combined with appropriate barrier technique
(gloves, masks, eye protection, rubber dam)
3. disposable covers for surfaces
4. disinfection of non-sterilizable surfaces &
equipment
5. heat sterilization of all compatible equipment
 Textbook:
• Pharmacology & Therapeutics
in Dentistry

• Yagiela et al
 THANK YOU
VERY MUCH !!!
Cast your burden on the Lord.
And He shall sustain you
He shall never permit the
Righteous to be moved.
Psalm 55 : 22