Dental Tribune UK Edition, September 13-19, 2010, Vol. 4 No. 21

‘Prion diseases or transmissible spong- iform encephalopa- thies (TSEs) are a family of rare pro- gressive neurode- generative disorders that affect both hu- mans and animals. W hen British surgeon Joseph Lister first ex- perimented with the use of carbolic acid (phenol) dur- ing surgery to prevent infections, he was able to quickly reduce infection rates; this process was to be known as antisepsis. Since then, the adoption of further measures such as thorough hand washing and the wearing of dis- posable gloves has further helped to cut infection rates. Lawson Tait went from an- tisepsis to asepsis, introducing principles and practices that have remained valid to this day. Generally considered a precur- sor to minimising infection, asepsis is where procedures are carried out free from disease- causing contaminants, such as bacteria, viruses, fungi, and parasites. However, elimina- tion of infection is the goal of asepsis, not sterility. So in today’s modern age, why does this not seem enough? The answer: Prions. Prion diseases or transmis- sible spongiform encephalopa- thies (TSEs) are a family of rare progressive neurodegenerative disorders that affect both humans and animals. They are distin- guished by long incubation pe- riods, characteristic spongiform changes associated with neuro- nal loss, and a failure to induce inflammatory response. The problem they impart to dentistry is that they cannot be effectively removed with standard sterilisa- tion measures. Control guidelines In 1999, the World Health Or- ganisation (WHO) set control guidelines on TSE and in section 3.2 stated that, ‘Although epide- miological investigation has not revealed any evidence that dental procedures lead to increased risk of iatrogenic transmission of TSEs among humans, experimental studies have demonstrated that animals infected by intra-perito- neal inoculation develop a signifi- cant level of infectivity in gingival Are current methods of keeping infection at bay broken and in need of fixing? Neel Kothari finds out Hand washing is only part of infection control best practice page 14DTà So, when is good enough, enough? InfectIon control trIbune pages 15-16 Infection Control Tribune All the practical team is responsible for infection control says Richard Musgrave A team effort pages 17-18 Mhari Coxon looks at infection control issues from a solitary standpoint View from the hygienist Infection Control Tribune