Dental Instruments & Infection Control

Certain dental instruments, devices, and equipment are reusable and undergo safe processing.  All methods of infection prevention and control, have common goals:

  • Preventing transmission of micro-organisms to staff and patients;
  • Minimizing damage to patient care items from foreign material or inappropriate handling;
  • Safe handling of chemical disinfectants.

 

Steps in cleaning, disinfection, and sterilization of instruments

  1. Instruments are manually cleaned (i.e. removal of debris, whether organic or inorganic) using a surfactant, detergent, and in some cases, an ultrasonic cleaner, then rinsed, and dried.
  2. Cleaned instruments are inspected and then packaged for sterilization. Pouches are labelled with the date and time of processing to aid in quality control.
  3. Packaged instruments are sterilized (see below) by being run through a cycle on a machine called a Statim. This machine is a steam flush pressure pulse sterilizer (SFPP). With the SFPP, air is actively removed from the chamber through pressurizations and flushes with steam.

Categorization of patient care items

Given the wide range of patient care items, depending on the potential risk for infection associated with their intended use, they are categorized as: critical, semi-critical, and non-critical.  This classification determines their processing requirements.

Critical Items

These patient care items penetrate soft tissue or contact bone (eg. all surgical instruments, periodontal scalers, etc.)

Critical items are manually cleaned, inspected, packaged, and run through a complete sterilization cycle in the Statim.

Semi-critical items

These items contact mucuous membranes or non-intact skin (eg. mouth mirrors, reuseable impression trays, handpieces, etc.). Semi-critical items are treated the same way as critical items; they are manually cleaned, inspected, packaged, and run through a complete sterilization cycle in the Statim.

Non-critical items

For those items that may contact intact skin, but not mucous membranes, or do not directly contact the patient (eg. x-ray head, blood pressure cuff, etc.) these non-critical items undergo cleaning followed by low-level disinfection (eg. Chlorine-based products, 0.5% accelerated hydrogen peroxide, 3% hydrogen peroxide, 60 – 95% alcohols, phenolics, etc.) – usually prepared wipes and sometimes sprayed solution & disposable paper towel.

Centralized processing of critical and semi-critical items

All critical and semi-critical items are processed in a central area of the office designed to facilitate quality control and ensure safety. This instrument processing area has clearly designated areas for:

  • Receiving, cleaning, and decontamination
  • Preparation and packaging
  • Sterilization
  • Storage

 

Sterilization

Cleaned instruments are packaged in sealed sterilization pouches equipped with mechanical indicators to ensure success of sterilization. Pouches also are labelled with the date and time of processing to aid in quality control.
The sterilization process includes the use of biological indicators and a dedicated incubator for conducting spore tests, in order to ensure efficacy. These methods directly assess the procedure’s effectiveness in killing the most resistant micro-organisms.

Our office uses a machine called a Statim, which is a steam flush pressure pulse sterilizer (SFPP).
With the SFPP, air is actively removed from the chamber through pressurizations and flushes with steam.
Sterilization times, temperatures, are employed as indicated by the equipment manufacturer.
Sterilization is monitored throughout the workday, ensuring consistent conditions and effectiveness.

In the event of a spore test failure, the sterilizer is removed from service for maintenance after which another spore test is performed. Once the equipment is shown to be successful again, it may be used for more sterilization cycles.

 

Storage

Sterile and single-use disposable items are stored in an enclosed space.
Sterilized instruments are stored in their sealed pouches that are not opened until immediately before use, in the room where the procedure is being performed.
Packages containing sterile instruments are inspected before use to verify integrity.

 

Core principles

Every step taken in the cleaning, sterilizing, and storing of equipment is in keeping with the core IPAC principles of:

  • Risk assessment;
  • Following routine practices;
  • Using barrier techniques to protect patients and providers;
  • Applying the principles of cleaning, disinfection, sterilization, and storage of all dental instruments.

GET IN TOUCH WITH US

Cliffcrest Dental

2995 Kingston Rd, Scarborough,
ON M1M 1P1, Canada