Objective

To give prospective ADC Part 1 candidates a clear preview of our teaching approach and the structure of both the Crash Course and the Comprehensive Course. It demonstrates how we teach, what we cover, and how the two programs differ. The study materials below are taken from Day 1 of the Crash Course and Week 1 of the Comprehensive Course. The Comprehensive Course contains detailed, expanded content, while the Crash Course condenses the same topics into short, high-yield notes. The main additional difference is the number of mock tests included. Prospective candidates should review the study materials below to understand our teaching style and the quality of content before enrolling.

Review the lecture notes on Ethics and Mandatory Notifications, then review the Exam-Focused Revision Summary and the High-Yield Examination Points. After completing these, take Mock Test 554.

Next, review the notes on Acute Dental Emergencies and then take Mock Test 555.

Afterwards, do the same with Infection Prevention and Control and take Mock Test 556.

Lecture Notes: Ethics & Mandatory Notifications in Australian Dental Practice

1. Introduction

Ethical dental practice is a cornerstone of safe, competent, and lawful health care in Australia. For dentists, dental specialists, and dental practitioners, the ethical and legal obligations extend far beyond technical proficiency. The modern regulatory framework—particularly the Dental Board of Australia (DBA), the Australian Health Practitioner Regulation Agency (AHPRA), and mandatory reporting laws such as those concerning child protection—requires practitioners to uphold strict standards of conduct, transparency, and patient protection.

This lecture note covers the essential ethical and legal concepts related to:

Ethical foundations in dental practice

Requirements for valid consent: voluntary, informed, and documented

Exceptions to confidentiality and disclosure

Mandatory notifications under the Health Practitioner Regulation National Law (National Law)

Types of notifiable conduct: professional misconduct, impairment, intoxication, and practice placing public at risk

Mandatory reporting obligations for child safety across Australian jurisdictions

Application to real-world clinical dentistry scenarios

2. Ethical Principles in Australian Dentistry

Ethics in dentistry is grounded in a set of universal principles that guide every aspect of clinical judgment, professional behavior, and patient interaction. These principles form the ethical basis from which consent, confidentiality, mandatory notifications, and professional conduct standards are derived.

2.1 Key Ethical Principles

2.1.1 Autonomy

The principle of autonomy obliges the dentist to respect a patient’s right to make their own choices about treatment. This includes:

The right to accept or refuse treatment

The right to receive truthful and complete information

The right to be free from coercion or manipulation

This principle is directly tied to the ethical and legal requirements of voluntary, informed, and documented consent.

2.1.2 Beneficence

Practitioners must act in the best interests of the patient. This means prioritizing their health, safety, and wellbeing, and recommending treatments that genuinely benefit them.

2.1.3 Non-maleficence

The classic medical rule: "Do no harm."
Practitioners must avoid treatments or behaviors that can cause injury, suffering, or risk. This includes avoiding treatment while impaired or intoxicated.

2.1.4 Justice

Justice refers to fairness, equal treatment, and appropriate use of resources. Dentists must not discriminate, must manage waiting lists ethically, and must price treatments fairly.

2.1.5 Veracity

Truthfulness in communication is essential. Misleading claims, withholding information, falsifying records, or providing incomplete explanations violate ethical and legal standards.

2.1.6 Confidentiality

Patient information is private and must be protected unless an exception applies. Confidentiality supports trust in the dentist–patient relationship.

3. Consent in Dental Practice

Consent is a legal and ethical requirement. A practitioner who treats a patient without valid consent risks legal liability, civil litigation for battery or negligence, professional disciplinary action, and ethical violations.

3.1 The Three Core Elements of Valid Consent

3.1.1 Consent Must Be Voluntary

Voluntary consent means:

The patient decides freely

No coercion, pressure, manipulation, or deception

No misuse of authority or urgency

Practitioners cannot subtly force a patient into accepting a treatment plan, either by overwhelming them with jargon, overstating risks of refusal, or implying that decline of treatment will damage the professional relationship.

Populations needing special consideration for voluntariness:

Children and minors

People with cognitive impairments

Elderly patients dependent on carers

Individuals with limited English proficiency

Patients in pain or distress

3.1.2 Consent Must Be Informed

Informed consent requires the practitioner to give the patient material information so they can make a meaningful decision. Material information includes:

The nature and purpose of the proposed procedure

The benefits of treatment

The risks—especially those that are material or significant

Alternatives, including no treatment

Costs

Prognosis with and without treatment

Who will perform the procedure and what their qualifications are

Informed consent is a process, not a signature. The practitioner must ensure the patient understands what is explained. Tools such as diagrams, models, translated materials, and interpreters may be necessary.

3.1.3 Consent Must Be Documented

Documentation provides legal protection and demonstrates adherence to professional standards.

Accepted forms of documentation include:

Progress notes summarizing the consent discussion

Signed informed consent forms (especially for invasive procedures)

Written treatment plans

Digital records or scanned forms

Audio or video recordings where appropriate

Documentation should include:

Date and time of discussion

Information provided

Patient questions and responses

Confirmation of understanding

Patient’s voluntary agreement

4. Exceptions to Confidentiality and Consent

Australian law recognizes that confidentiality is not absolute. There are situations where dentists must or may disclose information without consent.

4.1 Disclosure Where There Is Risk of Serious Harm

A practitioner may disclose confidential information if:

The patient is at risk of causing serious harm to themselves

The patient intends to harm another person

Public safety is threatened

Disclosure must be limited to what is necessary and to appropriate authorities.

Examples:

A patient threatens to assault a partner

A mentally unstable patient expresses intent to self-harm

A patient with active communicable disease refuses to follow infection control precautions

4.2 Disclosure Required by Law

Certain laws override confidentiality. These include:

Mandatory notifications under AHPRA

Child protection reporting legislation

Court orders or subpoenas

Public health reporting requirements (infectious diseases, dangerous conditions)

Medicare or insurance audits when legally authorized

Dentists must comply with the law even if the patient objects.

4.3 Disclosure for Therapeutic Purposes

Information may be shared with:

Treating healthcare team members

Referring specialists

Laboratories when essential for treatment

These disclosures are allowed as long as they are consistent with patient care and privacy legislation.

5. Mandatory Notifications Under the National Law

Mandatory notification is a legal responsibility requiring certain practitioners to notify AHPRA if they reasonably believe another health practitioner has engaged in notifiable conduct.

This applies to:

Dentists

Dental specialists

Dental hygienists

Dental therapists

Dental prosthetists

Employers

Education providers

5.1 Purpose of Mandatory Notification

The purpose is patient safety, not punishment. It ensures early identification of risks and prevents harm.

Mandatory notifications are governed by the Health Practitioner Regulation National Law (as in force in each state and territory).

5.2 The Threshold: “Reasonable Belief”

A “reasonable belief” must be:

Based on observable facts

Supported by objective evidence

More than suspicion or rumor

A practitioner is not required to investigate beyond their professional relationship with the individual but cannot ignore clear evidence.

6. Categories of Notifiable Conduct

AHPRA defines four categories of notifiable conduct. These are essential knowledge for ADC examinations and Australian dental practice.

6.1 Impairment

Impairment is defined as a condition—physical or mental—that detrimentally affects a practitioner’s ability to perform their work safely.

Sources of impairment:

Mental illness (untreated depression, psychosis)

Physical impairments limiting procedural capability

Substance dependence

Neurological conditions

Cognitive impairment due to illness or aging

Not every diagnosis is an impairment. The key question is:
Does the condition pose a substantial risk to the public?

Examples requiring notification:

A dentist with severe depression who cannot concentrate during procedures

A therapist with tremors affecting hand skills

A practitioner with substance addiction practicing unsafely

Examples that do not necessarily require notification:

A practitioner receiving appropriate treatment and practicing safely

A practitioner taking leave due to illness and not treating patients until recovery

6.2 Intoxication While Practicing

Intoxication from alcohol or drugs while treating patients is an immediate and serious threat to safety.

Examples of notifiable situations:

Dentist performing extractions while smelling of alcohol

Practitioner administering anesthesia under the influence of cannabis

Staff observing impaired coordination or slurred speech in a treating dentist

The requirement applies not only to illicit drugs but also:

Prescription medications

Over-the-counter sedatives

Abuse of nitrous oxide

6.3 Significant Departure from Professional Standards

This includes conduct that:

Is substantially below accepted standards

Places the public at risk

Involves reckless disregard for safety

Examples:

Performing unnecessary or fraudulent procedures

Reusing single-use items

Failing to maintain infection control despite reminders

Practicing outside one’s scope without competence

Using unregistered or illegally imported materials

Non-examples (not mandatory notification):

Differences in clinical opinion

Minor practice variations

Genuine errors without risk to the public

6.4 Sexual Misconduct

Sexual misconduct in healthcare includes:

Inappropriate sexual contact

Grooming behavior

Sexualized comments

Exploiting the patient–practitioner relationship

Inappropriate physical examinations without chaperone or consent

This is a zero-tolerance area. Any reasonable belief of sexual misconduct requires mandatory notification.

7. Who Must Report and When

7.1 Registered Health Practitioners

Must report when:

They form a reasonable belief of notifiable conduct

The practitioner is a colleague or supervisor

The conduct occurred in the context of professional practice

7.2 Employers

Must notify if a registered practitioner’s conduct places the public at risk.

7.3 Education Providers

Must report impairments that may place students at risk when they are participating in clinical training.

8. Exceptions to Mandatory Notification

Some situations exempt the practitioner from mandatory notification.

8.1 Treating Practitioner Exception

Healthcare providers who are treating the practitioner (e.g., psychiatrist treating a dentist with depression) may be exempt unless there is a substantial risk of harm to the public.

8.2 Reasonable Steps Already Taken

If the risk has already been controlled, for example:

Practitioner has ceased practice

Practitioner has been removed from clinical duties

Employer has taken corrective action

9. Process of Notification

9.1 How to Notify

Notification is made to:

AHPRA (online or phone)

The Dental Board of Australia (through AHPRA)

9.2 Content of a Notification

Include:

Practitioner’s details

Description of conduct

Evidence or observations

Impact on patient safety

Dates and times

Notifications must be factual, objective, and free of personal judgments.

9.3 AHPRA Response

AHPRA may:

Assess and triage the notification

Request more information

Initiate an investigation

Impose interim restrictions

Refer to a performance or health panel

Take no further action if not substantiated

10. Child Safety and Mandatory Reporting

Child protection laws in Australia operate at the state and territory level. Dentists are mandatory reporters in every jurisdiction, either explicitly (named in legislation) or implicitly (as registered health practitioners).

10.1 When Must a Dental Practitioner Report?

A mandatory report must be made when a practitioner suspects on reasonable grounds that a child is:

Being abused

At risk of abuse

Neglected

Exposed to family violence

Suffering physical, emotional, or psychological harm

Sexually abused or exploited

And when the suspicion is formed in the course of their professional work.

10.2 Signs Relevant to Dental Practice

Dentistry is uniquely positioned to detect craniofacial injuries associated with abuse.
Common indicators:

Bruising or marks on head or face

Torn frenulum in infants

Jaw fractures inconsistent with history

Bite marks

Unexplained dental trauma

Delay in seeking treatment for serious facial injury

Repeated injuries over time

Behavioral signs:

Fearfulness around caregivers

Withdrawn or anxious behavior

Minimizing or contradicting explanations

10.3 Mandatory Reporting Pathways (State-by-State Overview)

New South Wales

Mandatory reporters include all health practitioners.

Reports submitted to the Department of Communities and Justice (DCJ).

Victoria

Registered health practitioners are mandatory reporters.

Reports made to Child Protection (DHHS).

Queensland

Registered health practitioners must report sexual abuse.

Broader concerns reported through Child Safety Services.

South Australia

All health practitioners are mandatory reporters.

Reports to the Child Abuse Report Line (CARL).

Western Australia

Mandatory reporting applies specifically to sexual abuse.

Other concerns reported voluntarily.

Tasmania

All registered health practitioners are mandatory reporters.

Northern Territory

Mandatory reporting applies to any adult who suspects a child is being harmed.

One of the strictest jurisdictions.

ACT

Health practitioners are mandatory reporters.

10.4 Legal Protections

Mandatory reporters are protected from civil or criminal liability.

Confidentiality of the reporter is maintained.

10.5 Failure to Report

Penalties include:

Fines

Disciplinary action

Criminal charges (in some jurisdictions)

11. Application to Clinical Dentistry

11.1 Case Example: Impairment

A dentist’s assistant notices the principal dentist is increasingly forgetful, dropping instruments, and unable to focus. Patients complain about incomplete procedures.

Action:
Mandatory notification for possible impairment.

11.2 Case Example: Intoxication

A dentist returns to work after lunch smelling of alcohol and appears unsteady.

Action:
Immediate mandatory notification.

11.3 Case Example: Failure to Meet Standards

A clinician routinely reuses single-use irrigation needles.

Action:
Mandatory notification for significant departure from accepted standards.

11.4 Case Example: Child Harm

A child patient presents with multiple bruises on the face. Caregiver provides inconsistent explanations.

Action:
Report to child protection agency.
Also document findings thoroughly.

11.5 Case Example: Consent

A practitioner places implants without explaining alternatives or risks.

Action:
This violates ethical and legal consent standards and may be a professional conduct issue.

12. Documentation Standards for Ethical and Legal Protection

Proper documentation is essential in all areas of consent, mandatory notifications, and patient care.

Should include:

History and examination

Consent process

Risks explained

Patient questions

Decisions made

Refusal of treatment

Notes on child safety concerns

Details of injuries

Steps taken to ensure patient safety

Records retained securely

Digital workflows must follow privacy laws and secure storage requirements.

13. Professional Boundaries and Ethical Conduct

Ethical obligations extend to relationships with:

Patients

Staff

Colleagues

Students

Vulnerable individuals

Boundaries prevent exploitation and ensure psychologically safe environments.

Forbidden conduct:

Sexualized comments

Dual relationships with conflicts of interest

Accepting inappropriate gifts

Humiliating staff

Bullying or harassment

These may constitute notifiable conduct if they risk public safety.

14. Interprofessional Responsibilities

Ethical dental practice includes working respectfully with:

GPs

Specialists

Nurses

Allied health practitioners

Sharing patient information is allowed only when it supports patient care and adheres to privacy requirements.

Collaboration helps ensure early detection of:

Impairments

Behavioral problems

Child abuse

Public safety risks

15. Summary of Key Points

Consent

Must be voluntary, informed, and documented.

Applies to all procedures.

Requires transparent communication.

Disclosure Exceptions

Risk of serious harm

Legal requirements

Therapeutic necessity

Mandatory Notifications

Required for:

Impairment

Intoxication

Significant departure from standards

Sexual misconduct

Child Safety

Mandatory reporting required in all states/territories

Dental practitioners are in a key position to identify facial injuries

Failure to report attracts penalties

Ethics

Autonomy, beneficence, non-maleficence, justice, veracity, confidentiality

Foundation of professional judgment and conduct

16. Conclusion

Ethics and mandatory notification responsibilities are not theoretical constructs—they are daily realities of Australian dental practice. Upholding these standards ensures patient safety, maintains public trust, supports the reputation of the profession, and protects practitioners from legal and regulatory consequences.

Dentists must be vigilant about consent, confidentiality, and legal obligations, especially in the areas of impaired colleagues, intoxication, misconduct, and child protection. Applying these obligations consistently and correctly is essential for compliant, safe, and ethical dentistry.

Exam-Focused Revision Summary: Ethics & Mandatory Notifications

Concise, high-yield, ADC-oriented revision notes.

1. Core Ethical Principles

These principles underpin all ethical and legal duties in Australian dentistry.
Autonomy

Respect patient’s right to choose or refuse treatment.

Requires voluntary, informed, documented consent.

Beneficence

Act in the patient’s best interest.

Non-maleficence

Do no harm; avoid risky practices (e.g., working while impaired).

Justice

Fair, non-discriminatory treatment.

Veracity

Truthfulness and honesty.

Confidentiality

Protect patient information except when required by law or serious risk.

2. Consent Requirements

Valid consent must be:

Voluntary

Free from pressure, coercion, manipulation, or intimidation.

Extra care with vulnerable persons (children, elderly, anxious, non-English speakers).

Informed

Patient must understand:

Nature and purpose of treatment

Risks and complications

Benefits

Alternatives (including no treatment)

Costs

Who is performing the procedure

Prognosis with and without treatment

Use interpreters when needed.

Documented

Documentation may include:

Detailed clinical notes

Signed forms for invasive procedures

Written treatment plan

Confirmation of patient questions and understanding

3. Exceptions to Confidentiality

Disclosure allowed or required when:

1. Risk of Serious Harm

Threats to self or others

Severe untreated communicable disease

Substantial danger to the public

2. Legal Requirement

Mandatory notifications to AHPRA

Child protection reporting

Court orders or subpoenas

Notifiable disease reporting

Medicare / insurance audits allowed under law

Only disclose minimum necessary information.

3. Therapeutic Necessity

Sharing information with treating team when essential for care.

4. Mandatory Notifications (AHPRA / National Law)

Dentists and all registered health practitioners MUST report when they have a reasonable belief that another practitioner has engaged in notifiable conduct.

Four Categories of Notifiable Conduct

1. Impairment

A physical or mental condition that places the public at risk of substantial harm.
Examples requiring notification:

Severe depression leading to unsafe performance

Cognitive decline affecting competence

Substance dependence interfering with work

Not every diagnosis = impairment.
Risk must be substantial.

2. Intoxication While Practising

Practising under the influence of alcohol, illicit drugs, or impairing medications.

Immediate risk → mandatory notification.

Examples:

Slurred speech, tremors, instability

Smell of alcohol while treating patients

Using nitrous oxide recreationally at work

3. Significant Departure From Professional Standards

Conduct substantially below accepted standards, placing the public at risk.
Examples:

Reusing single-use items

Gross infection control breaches

Fraudulent, unnecessary, or incompetent treatment

Practising outside scope without training

Not included: reasonable differences in clinical opinion.

4. Sexual Misconduct

Any sexual activity, grooming, comments, boundary violations with patients.
Zero tolerance.

5. Who Must Report?

Any registered health practitioner

Employers

Education providers (for students in clinical training)

Threshold: reasonable belief (more than suspicion; based on evidence or observation).

6. Reporting Exemptions

Treating practitioner exemption

Doctors/dentists treating an impaired practitioner may be exempt unless risk is imminent.

Risk already controlled

If the practitioner has already stopped practising or is removed from risk, mandatory reporting may not be required.

7. How to Report

Report directly to AHPRA / Dental Board of Australia.

Provide factual observations, dates, evidence.

Avoid accusations not supported by facts.

AHPRA may:

Investigate

Impose conditions

Suspend registration

Take no further action

8. Child Safety: Mandatory Reporting

Dentists are mandatory reporters in all Australian jurisdictions.

When to Report

Report when you reasonably suspect:

Physical abuse

Sexual abuse

Emotional/psychological harm

Neglect

Exposure to family violence

Particularly relevant in dentistry due to facial injury patterns.

Common Injuries Suggestive of Abuse

Torn upper labial frenum

Facial bruising inconsistent with history

Jaw fractures

Bite marks

Delayed presentation with facial trauma

Multiple injuries in different healing stages

Where to Report

To each state’s Child Protection authority, e.g.:

VIC: DHHS Child Protection

NSW: DCJ

SA: CARL

WA: Mandatory for sexual abuse

NT: Mandatory for all adults
(Varies by state, but all allow or require reporting.)

Legal Protections

Mandatory reporters are protected from civil/criminal liability when reporting in good faith.

Reporter identity is kept confidential.

Failure to Report

May result in:

Fines

Professional disciplinary action

Criminal penalties (in some states)

9. Practical Application in Clinical Dentistry

Consent

Document every discussion.

Avoid starting treatment if the patient is unsure or anxious without clear understanding.

Mandatory Notifications

Red flags include:

Impaired colleague making repeated errors

Dentist intoxicated during procedures

Gross infection control breaches

Inappropriate physical contact with patients

Unsupervised student performing restricted acts

Child Safety

Document injuries objectively

Do NOT confront caregiver aggressively

Do NOT delay reporting for “proof”

Do NOT attempt your own investigation

Prioritise child protection authority involvement

10. High-Yield Examination Points

✔ Consent = voluntary + informed + documented
✔ Lack of voluntariness invalidates consent even if paperwork exists
✔ Mandatory reporting requires reasonable belief, not proof
✔ Impairment must pose substantial risk to require reporting
✔ Intoxication while practising = automatic mandatory notification
✔ Sexual misconduct is always notifiable
✔ Reusing single-use items = significant departure from standards
✔ Child abuse reporting supersedes confidentiality
✔ Torn frenum in child = red flag
✔ Mandatory reporters are legally protected

Mock Test on Ethics & Mandatory Notifications in Australian Dental Practice

Mock Test 554

Dental Emergencies-Ludwig angina

Diagnostic Algorithm for Rapidly Progressive Submandibular Swelling

1. Initial Clinical Presentation

Symptoms: Rapidly increasing swelling, fever, dysphagia (difficulty swallowing saliva).

Signs: Firm induration extending to submandibular area, intraoral swelling, grossly carious molar.

Airway status: Patient can maintain airway but cannot tolerate oral fluids.

2. Key Decision Points

Airway assessment first:

Is airway compromised? (stridor, drooling, inability to lie flat, desaturation).

If yes → emergency airway management.

If no → proceed with infection evaluation.

Localization of swelling:

Right-sided, firm, indurated, extending to submandibular space.

Buccal vestibular swelling intraorally.

Uvula midline (no peritonsillar abscess).

3. Source Identification

Dental origin: Grossly carious lower right second molar.

Pathway: Infection spreads from molar roots → submandibular space → risk of bilateral spread (Ludwig’s angina).

4. Differential Diagnosis

Peritonsillar abscess (ruled out: uvula midline).

Parapharyngeal abscess (would cause medial bulging of pharyngeal wall).

Cellulitis vs abscess (firm induration suggests cellulitis stage).

5. Red Flag Features

Fever (systemic involvement).

Dysphagia (difficulty swallowing saliva).

Rapid progression.

Submandibular induration.

Dental source.

6. Diagnosis

Likely: Odontogenic infection spreading into submandibular space → early Ludwig’s angina.

Simplified Algorithm Flow

Patient presents with facial swelling + fever ↓

Check airway → compromised? → secure airway immediately ↓

Examine swelling → location, induration, intraoral findings ↓

Identify source → dental, tonsillar, salivary gland ↓

Rule out differentials (peritonsillar abscess, parapharyngeal abscess) ↓

Confirm odontogenic spread → submandibular space involvement ↓

Diagnosis: Ludwig’s angina (early stage)

Flowchart- style teaching diagram (algorithm + infection spread pathways)

Flowchart-style teaching diagram:

It combines the diagnostic algorithm with the infection spread pathways. It’s ready now.

This visual integrates:

📋 Algorithm boxes: Patient presentation → airway check → swelling exam → source identification → differential diagnosis → final diagnosis.

🦷 Infection pathway illustration: Carious lower molar spreading into the buccal vestibule, submandibular, and sublingual spaces.

🔴 Red shading: Highlights the infection spread zones.

➡️ Arrows and labels: Show logical progression and anatomical involvement.

Mock Test 555

Infection Prevention and Control

Revision Notes 5 Infection Prevention and Control

High-Yield Revision Note for ADC Part 1 Candidates

Infection Prevention and Control (IPC) is a core requirement for safe dental practice in Australia and a major topic in the ADC Part 1 examination. IPC protects patients, practitioners, staff, and the community from transmission of infectious diseases. ADC exam questions commonly test regulatory requirements, sterilisation processes, Standard Precautions, clinical judgement, and legal obligations related to IPC.

This note summarises essential knowledge for high-performance exam preparation.

1. Regulatory Framework for IPC in Australian Dentistry

IPC in dental practice is governed by the following documents and regulations:

1. Dental Board of Australia (DBA) – Guidelines for Infection Prevention and Control

Defines mandatory expectations for every registered dental practitioner.
All practitioners must be familiar with and strictly follow these guidelines.

2. NHMRC Australian Guidelines for the Prevention and Control of Infection in Healthcare

Sets national evidence-based standards for IPC across healthcare facilities.

3. AS/NZS 4815 or AS/NZS 4187

Standards for reprocessing reusable instruments, depending on practice complexity.

4. State/Territory Public Health Legislation

Covers reportable diseases, clinical waste, steriliser validation, radiation use, and practice audits.

5. Legal obligations

Failure in IPC can result in:

AHPRA notifications
Disciplinary action
Fines, suspension, or deregistration
Practice closure in severe breaches

2. Chain of Infection (High-Yield Concept)

The chain of infection involves:

Infectious agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host

IPC aims to break this chain through hygiene, sterilisation, environmental controls, PPE, and safe work practices.

This concept forms the theoretical basis for exam questions.

3. Standard Precautions (Core IPC Concept)

Standard Precautions apply to every patient, regardless of infection status.
They are the minimum infection control measures.

A. Hand Hygiene

Most effective IPC measure. Required:

Before/after contact with patient
After glove removal
After touching contaminated surfaces

Alcohol-based hand rub is preferred unless hands are visibly soiled.

B. Personal Protective Equipment (PPE)

Includes gloves, masks, protective eyewear, face shields, gowns/aprons.

Rules:

Gloves: single-use only (never wash or reuse)
Masks: discard when moist; do not reuse
Eye protection: clean between patients
Gowns: use when splash risk exists

C. Respiratory Hygiene & Cough Etiquette

Provide masks, tissues, and hand hygiene opportunities in waiting area.

D. Sharps Safety

Use single-hand scoop technique if recapping
Never pass sharps hands-to-hands
Dispose immediately into puncture-proof sharps container

E. Environmental Cleaning

Two categories:

Clinical contact surfaces (contaminated frequently)
→ Clean + disinfect between patients
Housekeeping surfaces
→ Routine cleaning

Use hospital-grade disinfectants listed on the ARTG (Therapeutic Goods Administration).

F. Aseptic Technique

Maintain asepsis during procedures involving:

Extractions
Surgery
Periodontal therapy
Endodontic canal entry

Minimise contamination by using sterile instruments, dry fields, and careful handling.

4. Transmission-Based Precautions

Applied in addition to Standard Precautions for certain infections.

A. Airborne Precautions

For TB, measles, chickenpox.
Measures:

N95/P2 respiratory protection
Minimise aerosol-generating procedures
Adequate room ventilation

B. Droplet Precautions

For influenza, pertussis, mumps.
Measures:

Surgical masks
Physical distancing
Patient separation in waiting room

C. Contact Precautions

For MRSA, VRE, C. difficile.
Measures:

Gloves + gown
Enhanced surface disinfection
Dedicated equipment

5. Instrument Reprocessing – High-Yield Exam Topic

Reusable dental instruments must undergo a validated sterilisation process.

A. Cleaning (critical step)

Removes organic matter. Methods:

Manual cleaning (least preferred)
Ultrasonic cleaning
Washer-disinfector

B. Inspection

Check for cleanliness, damage, rust, corrosion.

C. Packaging

Sterilisation pouches or wraps
Label with cycle number, date, operator initials
Include chemical indicators

D. Sterilisation (Steam Autoclave)

Requirements:

Correct temperature (121–134°C)
Correct cycle type and holding time
Mechanical monitoring
External + internal chemical indicators
Biological indicators (weekly or practice-specific requirement)

E. Cooling and Storage

Packs must be dry before removal
Store in clean, dust-free areas
Do not use compromised (wet/torn) packs

F. Traceability

Maintain steriliser logs including:

Cycle parameters
Results of tests (Helix/Bowie-Dick)
Load identification
Steriliser servicing schedules

Single-use items

Must never be reused, cleaned, or sterilised.
This is a frequent ADC exam trap.

6. Dental Unit Waterlines (DUWLs)

Biofilm can contaminate water lines.

Key points:

Flush lines at start of day and between patients
Maintain water quality <500 CFU/mL
Use sterile water for surgical irrigation

7. Airborne Risk Reduction During Clinical Care

Aerosol-generating procedures carry high transmission risk.

Risk reduction strategies:

High-volume evacuation
Rubber dam
Pre-procedural mouth rinses
HEPA filtration (optional)
Adequate room ventilation

AGPs require heightened PPE awareness.

8. Exposure Management (Sharps, Blood, Body Fluids)

If exposure occurs:

Steps:

Immediate washing with soap/water
Encourage bleeding from puncture (do NOT squeeze)
Rinse splashes to eyes with saline
Notify supervisor and document
Assess risk (pathogen + injury type)
Seek medical attention immediately
Initiate PEP (post-exposure prophylaxis) if required

Hepatitis B immunisation

Mandatory for all dental clinicians.
Must maintain documentation of seroconversion (anti-HBs titre).

9. Handling of Sterile and Clean Items

Sterile items

Must not be stored near sinks or contaminated zones
Must not be used if packaging compromised
Open package immediately before patient care

Clean items

Must be separated from contaminated items
Must not enter the dirty reprocessing area

Zoning (clean, dirty, sterile) is critical for compliance.

10. Environmental and Waste Management

Waste categories:

General waste → normal bin
Clinical/infectious waste → yellow bin
Sharps → dedicated sealed sharps container

Cleaning protocols

Develop written cleaning schedules
Use correct detergents and disinfectants

11. Outbreak Response and Transmission Risk

Practices must have protocols for:

Patient triage
Staff illness management
Isolation or deferral of symptomatic patients
Enhanced cleaning
Reporting communicable disease when required by law

12. Legal and Professional Accountability for IPC

IPC failures may result in:

AHPRA notification
Mandatory notification if conduct places public at substantial risk (e.g., reusing single-use items)
DBA audits
Conditions or suspension from practice
Practice closure (public health orders)

Common high-risk breaches:

Not reprocessing handpieces correctly
Reusing single-use items
Inadequate sterilisation documentation
Contaminated waterlines
Sharps mismanagement

13. High-Yield Exam Points for ADC Part 1

Memorise the following for rapid recall:

✔ Standard Precautions apply to ALL patients
✔ Hand hygiene is the most effective infection control measure
✔ Do NOT reuse single-use devices
✔ Handpieces must be heat-sterilised after every patient
✔ Autoclave validation must be documented
✔ Torn or wet sterilisation pouches = unsterile
✔ Sharps containers must be puncture-resistant and replaced when ¾ full
✔ Transmission-based precautions supplement Standard Precautions
✔ Use sterile water for surgical irrigation
✔ Report sharps injuries immediately and follow PEP protocol
✔ Hepatitis B immunity documentation required
✔ Reprocessing steps: cleaning → inspection → packaging → sterilisation → drying → storage
✔ Chain of infection forms the theoretical basis of IPC

Conclusion

Infection Prevention and Control is a legally enforceable, safety-critical component of dental practice in Australia. ADC Part 1 candidates must understand both the scientific principles and the regulatory expectations around sterilisation, Standard Precautions, transmission-based precautions, environmental controls, and post-exposure management. Mastery of IPC concepts strengthens clinical reasoning, protects patient safety, and prepares candidates thoroughly for regulatory-style exam questions.

Mock Test 556.

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