洗牙或感染艾滋病 就诊应查看医疗器械包装
2010-08-06 00:01 来源：大河网-大河健康报
洗牙、补牙不当可能感染乙肝
口腔诊疗包括口腔修复、颌面外科及口腔内科等多种诊疗操作，特别是随着美容事业的发展，其服务范围更广，与之相应的是患者间的交叉感染问题也日趋严重。
由于口腔诊疗一般都会造成患者口腔黏膜和皮肤损伤，80%~90%的患者在洗牙或补牙时会出现牙龈出血等问题。这意味着，如果前一个洗牙、补牙患者患有乙肝等传染性疾病，而他治疗所用的机头、器具没有经过彻底的消毒处理，或使医生的手被污染了，那么乙肝病毒等就可能通过机头、器具、医生的手等传播给下一个患者。
特别是补牙所使用的高速涡轮机在操作完毕后会产生一种“回吸”力，将患者的血液、唾液吸进机头腔隙中。如果消毒不够严格，当高速涡轮机探头伸入下一个患者的嘴里时，腔隙中没被清除干净的唾液和血污就会直接喷入患者口中。我国辽宁省发现的第一例艾滋病患者就是在非洲工作期间接受口腔治疗时感染上了艾滋病病毒。
而乙肝病毒传染的可能性更大。乙肝病毒比较顽固，在30℃的血清中能存活6个月，在130℃以上的高温环境中10分钟才能杀灭它。此外，注射乙肝疫苗不等于和乙肝病毒“绝缘”。有相当一部分人不产生乙肝抗体，即使注射了乙肝疫苗，感染乙肝病毒的几率还有10%~20%。
当然，口腔感染的对象不仅仅是口腔科患者，对于长期从事口腔诊疗、面对面近距离操作的医务人员，由于经常与患者的血液、唾液密切接触，因而他们发生感染的机会也更多。
口腔科医务人员的感染途径主要是直接接触，其次是飞沫传播。口腔诊疗过程中，医务人员的手可能被诊疗的锐器刺伤，如果患者的血液、唾液中含有病原体，就可能经伤口感染医务人员。此外，在口腔诊疗过程中，医生和患者相距不到50厘米，双方口腔中喷出的含有病原体的飞沫可直接进入对方呼吸道，也会增加交叉感染的风险。
患者到牙科诊所就诊“四注意”
很多患者为了图方便或是图便宜，就在街上随便找个牙科诊所进行治疗，殊不知，这存在很大的健康隐患。几乎所有牙科诊所都存在患者间血液、唾液交叉感染等问题，如果不能做到“一人一机”、“一人一手套”、“一人一盘的高温消毒器械”等消毒措施，没有为患者配备干净的牙科材料，更没有在为一个患者治疗后对公共部位进行消毒处理等，那么患者之间交叉感染的风险将大幅度提升。
基于此，患者在进行口腔诊疗时，一定要对自己所处的环境、医生的资格、整个牙科诊所的消毒情况有一个全面的了解。
首先，看看自己所处牙科诊所或医院的诊疗环境是否干净，医疗废物等是否妥善处理。
其次，看清楚医生或护士为你拿出的准备使用的医疗器械等是否有完整的包装，包装上需要显示出化学指示卡。如果是经过高温消毒杀菌的医疗器械，包装上化学指示卡的颜色均为黑色。
第三，注意观察医护人员的行为和对手套的使用，比如他们是否戴着手套还到处乱摸，或是接诊完上一个患者后没有及时清洗双手和更换手套就直接为下一个患者诊治。
第四，观察诊疗室内是否放有空气消毒设施，因为病毒性疾病主要是通过悬浮微粒这一途径传播，而口腔诊疗过程中，车针或磨石高速运转时产生的含有细菌的悬浮微粒在大约一平方米的范围内活动。
通常，一次口腔诊疗完成后，治疗台、器具表面、座椅扶手等都可能受到了细菌污染，因而，医生在为下一个患者进行口腔诊疗前，必须对整个诊疗环境进行系统的消毒处理。
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Scaling or AIDS doctor should see medical device packaging
2010-08-06 00:01 Source: Big river - river health report
Scaling, filling of Hepatitis B infection inappropriate
Oral treatment of oral Xiu Fu Bao Kuo, maxillofacial surgery and oral medicine clinic operations such Duozhong, especially with the beauty business development with outreach to a wider, the attendant is the cross infection between patients is also increasing.
As usually caused by oral treatment of oral mucosa and skin lesions, 80% to 90% of patients in the dental cleaning or dental bleeding gums when problems occur. This means that if the previous scaling, filling in patients with hepatitis B and other infectious diseases, and he used the nose treatment, apparatus has not been thoroughly disinfected, or to a doctor's hands are contaminated, then the hepatitis B virus possible through the nose, equipment, doctors hands spread to the next patient.
In particular, the use of high-speed dental turbines will produce after the operation a "back suction" force, the patient's blood, saliva sucked into the cavities of the nose. If not strictly sterilized, when high-speed turbine probe inserted into the patient's mouth the next time, lacunar not been cleaned in the saliva and the bloodstained will be directly injected into the patients mouth. China's Liaoning province discovered the first cases of AIDS is working in Africa to undergo dental treatment infected with HIV.
The hepatitis B virus infection more likely. Stubborn hepatitis B virus, the serum at 30 ℃ can survive for 6 months, at temperatures above 130 ℃ environment can kill it in 10 minutes. In addition, the injection of hepatitis B vaccine and hepatitis B virus does not mean "insulation." A considerable number of people do not produce antibodies against hepatitis B, even if the injection of the hepatitis B vaccine and risk of hepatitis B virus infection and 10% to 20%.
Of course, oral infection is not only the dental patients in dental clinics for long-term, face to face close operation of medical staff, as often with the blood, saliva and close contact, Yiner them more chance of infection.
Dental health care workers infected mainly through its direct contacts, followed by the droplets. Oral treatment process, the medical staff's hand may be treatment of the sharp stab, if the patient's blood, saliva contains pathogens, wound infection may be by the medical staff. In addition, in the course of oral treatment, doctors and patients less than 50 cm apart, Shuangfang mouth disease-causing pathogens of droplets emitted directly to each other respiratory tract, will increase the risk of cross infection.
Patients to the dental clinic "four note"
Many patients to map or chart to facilitate inexpensive, easily find on the street dental clinic for treatment, they realize that there is significant health risks. Almost all dental clinics exist between patients with blood, saliva cross-infection and other issues, if they can not do the "one person, one machine", "one person, one glove," "one person one of the high-temperature sterilization equipment" and other disinfection measures, not for patients with clean dental materials, and no patients in a public area after the disinfection treatment, then the risk of cross infection between patients will be improved significantly.
Based on this, the patient during dental treatment, be sure to their surroundings, the doctor's qualifications, the disinfection of dental clinics have a comprehensive understanding of the situation.
First of all, look at their dental clinics or hospitals in which the environment is clean and clinics, medical waste is handled properly.
Second, look at doctors or nurses out of preparing for your use of medical devices have a complete package, the package needs to show a chemical indicator. If the high temperature disinfection and sterilization of medical devices, packaging, chemical indicator on the color of all black.
Third, observe the behavior of health care and the use of gloves, such as wearing gloves, they also went around to grope, or admissions after patients did not complete a wash their hands and change gloves in time directly to the next patient on the diagnosis and treatment.
Fourth, the observation of treatment room air disinfection facilities are placed, because of viral diseases is mainly transmitted by the suspended particles, while the oral treatment process, high speed bur or millstone generated when the suspended particles containing bacteria in about within the framework of one square meter.
Tong Chang, Hou completion of a dental clinic, treatment units, surface equipment, chair rails and so Keneng by bacterial contaminated and, Yi Shengzai for the next Huanzhe for oral treatment Qian, must be right Huan Jing Zheng Ge a systematic treatment of Xiaoduchuli.
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