W&H's Kate Scheer explores the importance of decontamination in the dental practice
Dental practices today face the challenges of maintaining patient and staff safety, thankfully industry advances developed safer processes and that also ensure greater workflow efficiency, especially decontamination and, in particular, sterilization of dental instruments. However, to establish a streamlined sterilization process one must consider several factors.
Every dental practice should have policies and procedures in place for containing, transporting, and handling dental instruments contaminated with blood or other bodily fluids.
It is important to take heed of manufacturer’s guidelines on how best to sterilize such tools. For example, dental handpieces and their attachments – including low-speed motors and reusable prophylaxis angles – should always be heat sterilized, as opposed to high-level or surface disinfected.
Dental instruments are divided into three categories: critical, semi-critical and non-critical items. Those used to penetrate soft tissues or bone are critical items, and must be sterilized before and after use.
Semi-critical items typically come into contact with mucous membranes, but are not used for penetrating soft tissues or bone. These instruments should be sterilized in the same way as critical items.
Non-critical instruments are only used on intact skin so an intermediate level of disinfection should be applied, even if there are no visible signs of blood or other potentially infectious materials.
Single-use items or those that cannot be satisfactorily sterilized must be safely disposed of after use.
According to HTM 01-05 guidelines, dental practices should have a nominated lead member of staff responsible for infection prevention and decontamination. They should be in charge of developing a standardised, written protocol for decontamination, according to evidence-based regulations and standards.
This helps the dental team achieve a reproducible system for consistently cleaning and sterilizing instruments. Infection prevention and control policies should be tailored to the unique needs and preferences of the practice, and reassessed regularly to ensure their effectiveness.
It is also important that the entire dental team – including new members of staff – are educated regarding decontamination, particularly in how to use and maintain the equipment on a day-to-day basis. This helps ensure any team members can clean and sterilize instruments when needed, if, for instance, the practice is operating under reduced staff levels.
It is the responsibility of the practice owner to support the on-going education of the dental team in terms of decontamination. In fact, HTM 01-05 guidelines recommend that, as part of verifiable ECPD, dental professionals should receive no less than five hours’ training on this subject over a period of five years.
There are plenty of online ECPD courses that cover decontamination, but clinicians can also take advantage of in-practice training through which they can refresh their knowledge through a combination of theoretical and hands-on exercises. This training is also available from some handpiece manufacturers.
Staff should know what kind of sterilizer is in the practice and what types of cycles the sterilizer supports. They need to be familiar with preparing instruments for sterilization – paying special attention to new instruments – loading configuration, lubrication, inspection, wrapping, labelling, and also storing the instruments after sterilization. A comprehensive understanding of record management is essential.
The sterilizer you choose will have a significant impact on your decontamination protocol. The preferred method of sterilizing instruments is through delivering saturated steam under pressure at the highest temperature and longest holding time compatible with the instrument.
For this reason, type B vacuum sterilizers are recommended, as they can also be used to sterilize hollow instruments and porous loads. At W&H we offer a full range of top-quality autoclaves, including the Lara type B vacuum sterilizer with Eco Dry technology, which can process a typical 2kg load cycle in 38 minutes.
Our next generation Lisa type B vacuum sterilizer (above left with Thermoklenz unit) also offers intuitive connectivity and comprehensive traceability down to the individual instrument or kit via the EliTrace system. The Lisa sterilizer’s Eco Dry+ technology also reduces the cycle time – with an S class cycle time of 13 minutes, and B class cycles from 28 minutes – thus optimising energy consumption for a more cost-effective sterilization process.
Dental photos by Jonathan Borba on Unsplash