An efficient cross-infection control mechanism is paramount for any dental practice to ensure the safety of their patients as well as the dental staff. Dentists have to consider various factors before devising a comprehensive sterilization and disinfection program for their dental surgeries. A detailed discussion regarding disinfection and sterilization procedures has been given in a previous article. In this article, we will give a brief overview of key considerations and factors that make sterilization procedures effective and successful.
Things to Consider Before Sterilization and Disinfection of Dental Instruments
1. Separation of Contaminated Instruments
According to the Centers for Disease Control, a detailed mechanism should be devised for the separation of contaminated and sterilized instruments. The best way to do this is to secure the instruments in sterilization cassettes, which not only help in better organizing instruments before and during sterilization, but they also prevent exposure of the sterilized instruments with the contaminated ones.
2. Always Use a Protective Barrier
- Wearing Gloves – Contaminated instruments should never be handled with bare hands. Rather, the Centers for Disease Control (CDC) mandates that dental professionals tasked with the sterilization of dental instruments must wear gloves to protect themselves from accidental injury and cross-infection from dirty instruments.
- Wearing Masks and Glasses – both masks and glasses protect the dental professional from accidental infection from an aerosol that is generated during washing or cleaning of contaminated dental instruments.
Remember, safety of the dental team is as essential as that of the patients. For patients who are known to have any communicable disease such as Hepatitis or HIV, double protection must be used in the form of double gloves and masks. For sterilization of instruments used on high-risk patients, protective aprons must also be used.
3. Hand Washing
Dental professionals who come in contact with contaminated dental instruments must wash their hands after every contact, regardless of whether they wore gloves or not. Cleaning the hands with the help of soap, followed by using an antiseptic detergent, is sufficient to prevent cross-infection.
[1] http://www.dentaleconomics.com/articles/print/volume-106/issue-11/science-tech/instrument-processing-and-sterilization-key-considerations.html
4. Do not Disinfect When you Can Sterilize
Disinfection only destroys the microbes but not their spores. This means that organisms can regrow after some time and cause infections. Therefore, whenever possible, instruments should be sterilized rather than disinfected.
Things to Consider During Sterilization and Disinfection of Dental Instruments
5. Devise a Definite Route of Instrument Transportation
Dentists should allocate a space in their dental clinic, which serves as a centralized station for sterilization of dental instruments. All members of the dental team must be familiar with the places that are designated for cleaned and contaminated instruments. In this way, all contaminated dental instruments will be collected at a single place, and it would become much easier and time-efficient to sterilize them at one place. In addition, chances of cross-infection due to mingling of clean instruments with contaminated ones will also be reduced.
6. Safely Securing Sharp Instruments
Sharp instruments like scalpels, blades, scissors, etc., are frequently used in dental surgical procedures. After sterilization, they must be secured at designated places to prevent accidental contamination or injury. For this purpose, sterilization cassettes, which contain specified slots for each instrument type, can be used. These cassettes not only allow for efficient sterilization but they also prove to be quite useful in safe instrument storage.
7. Always Clean Instruments Before Sterilization or Disinfection
Prior to packaging contaminated instruments for sterilization, they must be thoroughly cleaned to remove visible debris, chemicals, or blood droplets. For instruments that are not affected by steam or water, the best method for cleaning is by washing them under running water. Alternatively, ultrasonic cleaning can also be employed. After washing, instruments should be thoroughly dried and visually inspected for cleanliness.
8. Safe Disposal of Non-reusable Instruments
Contaminated instruments that are only used once must be safely secured in containers that are clearly marked and designated for disposing of disposable dental instruments. Sharp instruments such as needles should be broken down before discarding to ensure that they are not accidentally reused.
Things to Consider After Sterilization of Dental Instruments
9. Ensuring Quality Control
It is the duty of the dentist and the dental office manager to ensure that the highest standards of instrument disinfection and sterilization are being maintained. In addition to frequent or surprise inspections, chemical or biological indicators can be placed in autoclaves during sterilization. These indicators change their color when sufficient sterilization has taken place. Details regarding various types of sterilization indicators are given in another article.
10. Packaging and Storage of Sterilized Instruments
Instruments required for a specific procedure are placed in special packages before placing them for sterilization. This will minimize the chances of their contamination during storage and transport after sterilization. Sterilization cassettes can also be used to sterilize together a set of instruments required for a specific procedure. These cassettes also allow easier arrangement of the instruments and minimize the risk of injury and damage during the cleaning, packaging, and storage phases.
Dental professionals who are involved in the sterilization of dental instruments must have detailed knowledge regarding the key considerations while disinfecting or sterilizing dental instruments. This is because they are not only responsible for the safety of their team members, but the health and well-being of the patients also depend upon them.