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Biomedical subjects

J J Crawford

Publications and source records attributed to J J Crawford.

At least 19 recordsLinked to original sources
PubMed1991

Current status of Occupational Safety and Health Administration infection control regulations.

In the wake of widespread hepatitis B, human immunodeficiency virus, and other bloodborne infections, organizations of health care employees have asked the Occupational Safety and Health Administration (OSHA) to address the reduction of infection risks encountered in the delivery of private and institutional health care. The task is much the same as reducing job related risks in industry. This article explains and reviews interim OSHA infection control regulations that apply to dentistry now, anticipating a final rule soon to be released by OSHA. Helpful forms, details, and information sources are provided.

Communicable Disease Control↗
PubMed1990

Evaluation of a dental unit designed to prevent retraction of oral fluids.

Most older units that drive high-speed dental handpieces include a retraction device designed to prevent dripping of fluids from the water-spray line after the unit has been turned off. Oral fluids and debris may be drawn, along with water, into the water line. Bacteria and debris, unless deliberately flushed out of the water line, may be transmitted to the next patient. Most new units now have mechanisms to prevent retraction. A new dental control unit, designed to eliminate mechanical aspiration of oral fluids, was tested. A kit to test the level of retraction in the water-spray line was also examined. The new unit was found to be effective in protecting the unit water from contamination by oral microorganisms, thereby protecting patients from cross-contamination. However, the control of retraction did not prevent the colonization of the water line by aquatic bacteria. Both internal and external sources of microorganisms must be controlled.

Cross Infection↗
PubMed1988

A psychometric study of positive and negative nominations and the pupil evaluation inventory.

Two peer evaluation measures, the Pupil Evaluation Inventory (PEI) and positive and negative nominations were compared in a sample of 260 children in grades 1 to 5. Stabilities of the measures were assessed over a 4-month period. In the total sample, PEI factors and negative nominations were more stable than positive nominations, and PEI Aggression and Withdrawal scores were more stable than negative nominations. PEI Aggression and Withdrawal scores were more stable in grades 3 and 5 than in grade 1, and the Likability factor was more stable in grades 2 to 5 than in grade 1. Negative nominations were most strongly correlated with the PEI Aggression factor, and positive nominations were more strongly correlated with Likability than with Aggression. Implications for the use of these nomination measures are discussed.

Aggression↗
PubMed1988

Bacteremia following intraoral suture removal.

Following dental extractions, prophylactic antibiotic protection of patients at high risk of cardiovalvular infection is usually discontinued before suture removal. To determine whether bacteremia is created upon removal of intraoral sutures, twenty healthy patients who required extractions of at least five erupted teeth and placement of several sutures were selected without regard to sex, age, or race. Blood samples were drawn preoperatively, immediately after the extractions, before suture removal, and immediately following removal of the intraoral silk sutures. The samples were cultured in prereduced and aerobic media suitable for quantitative colony counts. Fourteen of 16 patients yielded positive blood cultures following tooth extractions. One of 20 patients yielded a positive blood culture following suture removal. Even though the incidence of bacteremia following intraoral suture removal is relatively low (5%), this study suggests that intraoral suture removal is not a benign procedure for those persons who are considered high-risk cardiac patients.

Bacteria↗
PubMed1988

Analytical and physiological variability of salivary microbial counts.

Quantitation of mutans streptococci (MS) and Lactobacillus has been proposed as a method for the identification of patients at high risk for dental caries. The purpose of the present study was to investigate the analytical and physiological variability of this procedure. Variability due to specimen collection and processing was investigated by repeated sampling studies. Sample stability was investigated over storage periods of up to 72 hr at 5 degrees C, room temperature, and 37 degrees C. Physiological variability was investigated by performance of serial analyses on ten individuals, who collected six samples at intervals on a single day, and rising and noon samples on ten subsequent days. Sample collection, rather than sample processing, was found to be the major factor determining the imprecision of salivary microbial analysis in the majority of cases. However, individual subjects varied considerably in the consistency with which they provided saliva samples. Imprecision due to sample processing was relatively small, with coefficients of variations of 2.3% for MS counts and 2.1% for Lactobacillus counts. Samples were generally stable over a wide temperature range for at least 72 hours, although there was some loss of viability of lactobacilli on prolonged storage at room temperature or 37 degrees C in one experiment. Rising samples yielded higher counts than samples collected after breakfast and toothbrushing. Day-to-day variability was considerable, with 95% confidence limits exceeding 1 log in 28% of data sets for MS count and 39% of data sets for Lactobacillus.

Circadian Rhythm↗
PubMed1988

Control of cross-infection risks in the dental operatory: prevention of water retraction by bur cooling spray systems.

A new dental unit control system was found to overcome the possibility of mechanically retracting bacteria from the mouth into the water line used to provide a spray of water to cool high-speed burs during treatments. This was demonstrated by results obtained after clinical use and after use in simulated, worst case test conditions using a red tempera indicator solution and indicator bacteria.

Bacillus subtilis↗
PubMed1985

State-of-the-art: practical infection control in dentistry.

Practical infection control in the operatory is a multi-step process. Protocol should be updated to include good: identification of high-risk patient populations, barrier technique, aseptic technique, surface disinfection, instrument sterilization, and equipment disinfection and sterilization.

Antisepsis↗
PubMed1979

Office sterilization and asepsis procedures in endodontics.

Available evidence that there has been an epidemic of hepatitis B in the population since the 1960s and of the vulnerability of clinical dental and endodontic personnel has indicated a need to improve general asepsis procedures to guard against the spread of infection, and to improve screening for possible carriers. Specific improvements in personal protection, surface disinfectants and procedures, and control of bacterial populations in dental water units as well as broader use of instrument sterilization can provide safer conditions of treatment for patients and personnel alike. Monitoring of asepsis can increase awareness and guide improvements of skills in aseptic treatment, and improved methods of transporting samples can improve recovery of anaerobic pathogens for determinations of antibiotic susceptibility.

Antisepsis↗
PubMed1975

New light on the transmissibility of viral hepatitis in dental practice and its control.

Evidence of an increase in the nonparenteral spread of viral hepatitis is of much concern in dentistry and supports the need for sterilization of all instruments used in intraoral treatments. Methods for the rapid sterilization of all dental handpieces and air-water syringes are still inadequate for routine clinical use. It may be possible to improve surface disinfection of these items by more thorough, repeated cleansing with common disinfectants and by the use of stronger germicidal agents such as aldehydes. However, for handpieces and some other equipment, effective sterilization methods must be developed or the instruments must be modified so they can be safely and rapidly sterilized. Surface disinfectants that will destroy hepatitis viruses are needed for disinfection of the dental unit. The use of gloves is also an important consideration for the protection of both the dentist and his patient. The high attack rate of hepatitis among surgeons, as well as patient protection, make the wearing of gloves during surgery imperative. Evidence that aerosolborne viruses would be removed by filtered laminar air flow or by face masks is not available, but use of these devices reduces exposure of personnel to aerosols in general and appears to be highly desirable. Sterilization of all possible instruments is advocated for use in all institutions and dental offices. Careful monitoring of the effectiveness of sterilization also is advocated. These concepts and new information on which they are based should be incorporated into dental curriculums and continuing education courses for all dentists and auxiliary personnel.

Antigens, Viral↗
PubMed1974

Bacteremia after tooth extractions studied with the aid of prereduced anaerobically sterilized culture media.

Both prereduced molten agar and broth and aerobic molten agar and broth were inoculated with blood samples collected from patients with periodontitis, but in otherwise good health, both before and after extraction of two or more teeth. Postoperative blood samples from 23 of 25 patients sampled yielded anaerobic and facultative species. Colony counts from nine samples yielded from less than 1 to over 100 colonies per ml of blood. Organisms detected were species belonging to the genera Bacteroides, Fusobacterium, Peptostreptococcus, Leptotrichia, Propionibacterium, Peptococcus, Veillonella, plus Streptococcus mitis, S. salivarius, vibrio forms, and strains resembling S. mutans. The data indicate that prereduced anaerobically sterilized culture medium with polyanethol sulfonate is effective for detecting anaerobic species in bacteremia and that anaerobic species can be prevalent in bacteremias immediately after tooth extraction in patients with periodontitis.

Aerobiosis↗