|
|
 |
|
 |
|
To provide patient safety in dental care, Nitta Dental Clinic continuously
implements a variety of measures designed to improve or maintain quality
in both software and hardware used within the clinic. We aim for the highest
and most up-to-date quality levels possible and are making daily efforts
to raise the quality level, with primary emphasis on the areas of (1) prevention
of nosocomial infections, (2) radiation protection and (3) measures to
address emergency situations such as occurrence of accidental symptoms.
This section describes the safety measures implemented at Nitta Dental
Clinic. |
|
 |
|
 |
|
|
 |
|
 |
|
 |
|
| Nowadays there are many news reports about nosocomial infections. At Nitta
Dental Clinic, we pay close attention to prevention of nosocomial infections
and perform sterilization and disinfection of instruments and fixtures
individually. |
|
| Sterilization |
All microorganisms are destroyed and a germ-free condition is achieved. |
| Disinfection |
Microorganisms are destroyed until their pathogenicity is neutralized completely. |
|
|
| Instruments |
|
|
| Complete sterilization with an autoclave (at 132゜C for one hour) |
| Instruments are put in a sterilization pouch and sterilized. After that, they are kept in a storage cabinet equipped with a germicidal lamp (sterilization with ultraviolet radiation). |
| Autoclave |
|
UV germicidal lamp in the instrument storage cabinet |
 |
|
 |
|
|
 |
|
|
Instruments in the individual sterilization pouch
(for single patient use) |
|
| The sterilization pouch containing instruments is opened in front of the patient. |
|
| Dental chairs |
|
|
After each treatment, the chair is wiped with a cotton ball soaked with 70% isopropyl alcohol. If necessary, sterilization is done by wiping with a mixture of sodium hypochlorite, 3% hydrogen peroxide water and 70% isopropyl alcohol.
Sodium hypochlorite, which dissolves and removes harmful substances, is effective in destroying hepatitis virus, HIV virus and many pathogenic microorganisms. |
|
| Hands and fingers |
|
|
| Disposable latex gloves are used.⇒ Changed after use with each patient. |
|
 |
|
| Infection prevention through use of disposables |
|
|
| Paper cups, aprons, injection needles, scalpels, suture needles and thread. |
|
| Handling of hazardous waste |
|
|
| Used injection needles and scalpels and bloodstained gauze are stored in isolation as infectious medical waste and consigned to a disposal service company. |
 |
|
|
|
|
|
|
 |
|
 |
|
|
|
 |
 |
|
|
|
|
|
| Preface |
|
|
 |
| X-ray room |
There are surely many people who are concerned about what effect radiation, which is routinely used in medical treatment, has on the human body. So, we would like to explain the radiation exposure associated with dental x-ray examinations.
The amount of radiation the human body receives (exposure) is expressed
in a unit called a sievert (SV). Medical examination is not the only source
of radiation exposure. Actually, in our daily life we are constantly exposed
to naturally occurring radiation. For example, radiation sources include
cosmic rays coming from outer space, soil, rocks, and even ourselves.
According to data compiled by the United Nations Scientific Committee
on Effects of Atomic Radiation (UNSCEAR), the annual global average radiation
dose in humans is 2.4 mSv (1 mSv is equivalent to 1/1,000 of 1 Sv) from
natural sources and between 0.4 and 1 mSv from medical exposure. For Japanese
people, while the amount of natural radiation exposure, 1.4 mSv, is below
the worldwide average, medical radiation exposure stands at 2.4 mSv, exceeding
the global average. With the widespread use of CT scans, the medical radiation
dose is expected to continue rising in the future.
Incidentally, radiation exposure from a regular chest x-ray is 0.07 mSv,
and the dose of radiation from a round-trip flight between Tokyo and New
York is about 0.19 mSv. |
|
| X-ray examination at our clinic |
|
|
 |
| Standard dental x-ray |
 |
| Panoramic dental x-ray |
Two types of x-ray photography are used in dentistry: standard dental x-ray (x-ray of individual teeth) and panoramic dental x-ray (x-ray of the entire mouth). In standard dental x-ray, in particular, the irradiation tube has a diameter as small as 6 cm, so its effect on the human body is very small. The radiation dose from a single dental x-ray is some 0.016 mSv. In the case of a panoramic x-ray, the radiation dose is about 0.04 mSv.
The amount of radiation exposure from a single x-ray examination at a dental
office is estimated to be equivalent to 1/87-1/35 of the natural radiation
exposure.
Dental treatment sometimes involves taking x-rays several times. This,
however, poses little threat to patients’health because a dental x-ray
machine emits only small doses of radiation, which are well within the
range of regional variations in natural radiation exposure.
Nitta Dental Clinic uses the state-of-the-art digital radiographic technology,
which reduces the level of the radiation dose to about one-quarter of that
produced by regular x-ray machines. Additionally, by draping the patient
with a protective apron incorporating radiation-proof lead at the time
an x-ray is taken, we offer all possible protection measures for small
children and pregnant women during x-ray exposures. |
|
| X-ray room |
|
|
| Use of walls incorporating a lead plate, doors and lead glass prevents the escape of radiation. Our x-ray room has passed the required inspection by the local public health center. |
 |
|
 |
| Digital panoramic x-ray machine |
|
Wearing a protective apron during x-ray |
|
|
|
|
|
|
|
|
|
|
|
|
 |
|
|
|
|
|
| Major high-risk accidental symptoms that can occur during dental treatment are listed below: |
| 1 |
Pain shock (caused by hypertonicity; the principal symptom is anemia.) |
| 2 |
Hyperventilation syndrome (caused by a shortage of carbon dioxide as a result of hypertonicity-induced overbreathing) |
| 3 |
Anaphylactic shock (a severe allergic reaction, which leads to breathing difficulty) |
| 4 |
Hypoglycemic coma (a sharp drop in the blood glucose level, which causes loss of consciousness) |
| 5 |
Hypertensive encephalopathy (blood pressure rises too high, causing headache and gait disturbance) |
| 6 |
Postoperative abnormal bleeding (bleeding doesn’t stop easily after operation) |
| 7 |
Angina attack (caused by a decreased blood supply to the heart due to hardening of the nutrient vessel) |
| 8 |
Myocardial infarction (the nutrient vessel of the heart becomes occluded, causing necrosis of the heart muscle) |
| 9 |
Thyroid crisis (caused by hyperthyroidism) |
| 10 |
Cerebrovascular disorders (includes intracerebral hemorrhage and cerebral infarction) |
|
|
The most important protective measure is preventing these occurrences
from happening. This is why we put in place preventive measures and pay
meticulous attention to detail. These measures include: interviewing the
patient to get his or her medical history as well as current illness; analysis
of medication currently in use; analysis of test results in other clinical
departments; exchanging information and collaborating with the patient’s
family doctor; evaluation of the patient’s physical condition on the day
of the treatment; taking vital signs (blood pressure, pulse, oxygen partial
pressure, etc.); careful selection of medicines administered; supervision
of the patient condition’s during and after the treatment. At the same
time, patients get lavish attention at our clinic so that they can receive
dental treatment in a worry-free, relaxed state.
To be well prepared for an emergency situation if it should arise, dentists
of our clinic are required to receive annual emergency care training conducted
by the Department of Dental Anesthesiology of Osaka University Faculty
of Dentistry, the Department of Anesthesiology of Osaka Dental University,
the Dental Association in Toyonaka City and the Department of Dentistry
and Department of Oral Surgery of Toyonaka Municipal Hospital. Because
there were occasions when serious danger was indeed narrowly averted thanks
to the training, we fully understand the importance of such training.
In-house, we hold annual regular and special training sessions, participated
in by all staff, which provide emergency care training through simulation.
Also, a morning meeting is held daily, in which any physical problems of
a patient scheduled to visit the clinic that day are briefed so that the
staff may know how to cope with these problems. In our evening meeting,
we go over the activities of the day. If any problem or areas needing improvement
should be found, discussion is held to upgrade countermeasures as well
as to raise the skill levels of each of our staff.
In terms of facilities, we have necessary medicines and instruments ready
for use to address cases (1) to (7) of the above list. As for items (8)
to (10), which require promptly contacting or working together with specialized
medical institutions, we maintain close liaison with relevant institutions. |
|
|
|
|
|
|
|
|
|
|
|
|
