Study on measurement of infectious environmental contamination of dental office-Hygienic management with the use of Adenosine Tri-Phosphate as a contamination index-

建立了“拭子冲洗法”，利用ATP测量牙科诊所环境的污染。作为污染指标，用发光计（lumitester K-210）在样品液和ATP萃取剂（荧光素-荧光素酶）的溶液中发光测量ATP，溶液中加入ATP发光剂（荧光素-荧光素酶）。测量区域为仪器设备的尖端和手柄部分，操作者、助手和患者的面部和胸部表面，操作者和助手的左前臂和右前臂。ATP浓度（=污染程度）越低，发光测量值（RLU）越低。以消毒蒸馏水的参考值（小于10）测量受检区域的污染程度。结果，高速机头、HVE尖端和标度器记录的值大于10^4。手术者和患者的面部部分超过10 ^3。有些病例显示操作者和助手的前臂大于10^2。据报道，在食品制造加工业中，“砧板清洁度”是确定安全性的标准，该标准小于10^2，但在小于10^2的发光水平上几乎没有机会检测到微生物。另一方面，在牙科诊所产生的切割粉尘中，患者的血液和唾液中含有各种各样的细菌和病毒，很难通过培养来识别这些微生物。因此，认为有必要加强安全标准，防止继发感染的发生。

"Swab-rinse method" has been established with the use of ATP to measure the contamination of dental office environment. As a contamination index, ATP measurement was taken by luminescence with a luminometer (lumitester K-210) on the solution made of lOOmul of specimen liquid and lOOmul of ATP extract reagent with addition of ATP luminescent reagent (luciferin - luciferase) Areas measured were tip and handle portions of instruments and equipment, the face and chest surface of the operator, assistant and patient, and left and right forearms of the operator and assistant.The lower the ATP concentration ( = the degree of pollution) is, the lower the luminescent measurement value (RLU) is. The degree of contamination was measured in subject areas for inspection with a reference value of sterilized distilled water (less than 10) . As a result, values over 10^4 were recorded with the head of high-speed handpiece, HVE tip and scaler. Some of the faces of the operators and patients exceeded l0^3. Some cases showed over 10^2 in the forearms of the operator and assistant. In the food manufacturing and processing industry, " Cleanliness of cutting board" is reportedly the standard to determine the safety, which is less than 10^2, however, there is little chance for microbes to be detected at the luminescent level of less than 10^2. Cutting dust produced in the dental practice, on the other hand, contains various kinds and amounts of bacteria and viruses in blood and saliva from the mouths of patients, and it is quite difficult to identify these microbes by culturing. Therefore, it is considered to be necessary to tighten the safety standard to prevent from occurrence of secondary infection.