Pieces of critical equipment go into bone or soft tissue, come in contact with blood or touch tissues that are normally sanitary. Semi-critical equipment contacts mucous membranes or broken skin. Non-critical equipment is only used on unbroken skin. Critical instruments must be sterilized after each use. Semi-critical instruments must be sterilized or treated with a high-level disinfectant after each use. Non-critical instruments can be disinfected between uses with an intermediate or low-level hospital disinfectant.
The Centers for Disease Control have specific guidelines to follow when sterilizing dental equipment. It is critical to know the classification of the instrument so it will get the proper level of sterilization or disinfection. Sterilizing all appropriate instruments after each use helps ensure the safety of both your patients and staff.
Heat Sterilization for Critical and Semi-Critical Instruments
Heavy-duty gloves should be worn when touching instruments that have been used. The equipment needs to be put into water or a cleaning solution immediately after use, and fragments should be removed. Enzymatic solutions can be used to help remove blood and other proteins. Non-enzymatic solutions can help in removing other types of fragments. Mechanical cleaners can be used if you do not wish to directly handle used equipment. Rinse and dry instruments thoroughly and package them to help prevent contamination. A steam autoclave, chemical vapor sterilizer or dry heat sterilizer should be used to sterilize dental instruments that are heat stable.
Other Types of Sterilization
Flash or cold sterilization use should be limited. Flash sterilization can be used on unwrapped equipment to be used again right away. In this process, equipment is sterilized using less time and at an increased temperature. In cold sterilization, liquid chemical germicides registered as a sterilant or disinfectant with the Environmental Protection Agency are used on equipment.
Periodic spore tests should be performed on sterilizers to ensure they are working properly. This can be done with an in-office testing system or through a mail-in service. Some states require a mail-in service be used weekly or monthly to verify sterilization procedures. Check your state requirements to be sure you are in compliance. The Guidelines for Infection Control in Dental Health-Care Settings, published by the Centers for Disease Control, should be followed for sterilizing all dental equipment. Follow all EPA and Food and Drug Administration regulations concerning usage and labeling of disinfectants and sterilants.
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