At every dental office, patient safety has been and will always be the number one priority. Dental instrument cleaning used to be a problem back in the day without current technology, such as autoclave, as it can hurt productivity. However, nowadays, automated equipment such as an ultrasonic cleaner or washer-disinfector has helped dental offices to solve this problem. Practices can now have a safe sterilization process, all while maintaining productivity and efficiency.
Besides safety for you and your patients, a proper dental instrument cleaning process allows the equipment to last longer and function as intended. The ultimate goal of which is to help you save money in the long run.
In this article, we are going to summarize the necessary steps dental offices need to make when cleaning dental instruments. Our list is built based on guidelines provided by the Centers for Disease Control and Prevention (CDC).
Before the instrument cleaning process
1. Have a designated cleaning area
All dental practices should have a specific area designated to dental instrument cleaning, disinfecting, and sterilizing in order to have better-controlled quality and safety. In this area, offices should divide it into different sections:
- 1) One to store contaminated equipment
- 2) One to clean the instruments
- 3) One for packaging
- 4) One for sterilizing the equipment
- 5) One to store clean instruments
Having different areas in the cleaning area helps reduce cross-contamination between contaminated and clean equipment. If your practice cannot physically divide the cleaning area into different sections, you can instead use labels to identify different sections.
2. Have necessary personal protective equipment (PPE)
Personal protective equipment, such as facemask, eye protection or face shield, gown, and gloves, are required during the cleaning process to protect dental professionals from microbial contamination and prevent you from spreading infectious agents you may carry to the instruments. To avoid injury from sharp tools, dental personnel should wear utility gloves that are puncture and chemical resistant. You should also use forceps to move the instruments if possible to reduce the risk of injury.
How to clean dental instruments (8 steps)
Step 1: Transporting
After use, place instruments in a special container (sealed, leak-proof, biohazard symbol) before being transported to the cleaning area. Remember to use forceps and heavy-duty gloves whenever possible to reduce exposure to sharp objects that could lead to injury.
Step 2: Cleaning
Next, dental personnel can clean the instruments manually or by using automated equipment, such as an ultrasonic cleaner, instrument washer, or instrument washer/disinfector. Manual cleaning requires more time and carries a higher risk of sharp accidents. Therefore it is not as recommended as using automated equipment.
Manual cleaning: Use cleaning brushes and cleaning solutions (surfactant, detergent) to scrub away the debris. If you need to do manual cleaning, you need to pre-soak your instruments, so that debris (e.g., blood) doesn’t dry out and harden. Tools can be soaked with a detergent, a disinfectant/detergent, or an enzymatic cleaner. The CDC recommends using long-handled brushes to reduce the risk of injury from sharp objects.
Automated equipment: With these equipment operating in different conditions of time and exposure, practices don’t need to pre-soak or scrub the instruments, improving productivity and efficiency. The three common types of automated cleaning equipment are ultrasonic cleaning devices, instrument washers, and instrument washers/thermal disinfectors.
Step 3: Rinsing
After cleaning, rinse instruments with tap water to remove all residue debris and cleaner.
Step 4: Drying
Next, dry instruments thoroughly using air guns, paper towels, or cloth.
Step 5: Inspecting
After drying, inspect the instruments carefully to identify those that still have debris. If necessary, proceed to clean such instruments again. Additionally, this is an excellent opportunity to identify those that are damaged and need replacement or removal.
Step 6: Packaging
Next, package your instruments with instrument cassettes, wraps, or pouches. There are many ways that you can package your instruments. However, it really depends on your sterilization method. Most packaging is designed to allow penetration of heat, vapor, or steam.
Additionally, remember to add the following information on the package label: sterilizer used, cycle or load number, sterilized date, and expiration date (if applicable).
Step 7: Sterilizing
Each sterilization method and material requires different time, pressure, and temperature. To determine the setting for your sterilizer, refer to instruction from the manufacturer.
There are three types of sterilization methods:
- Steam autoclave: uses saturated steam under pressure.
- Dry heat: employs high temperatures for extended periods.
- Unsaturated chemical vapor: uses proprietary chemicals that contain formaldehyde, alcohol, and other inert ingredients to produce a vapor.
The CDC has provided a guideline on the correct packaging material choices for each method of sterilization:
- Packaging material requirements: should allow steam to penetrate.
- Acceptable materials: paper, plastic, cloth, paper/plastic peel packages.
- Packaging material requirements: should not insulate items from heat; should not be destroyed by temperature used
- Acceptable materials: paper bags, aluminum foil, polyfilm plastic tubing, wrapped perforated cassettes.
Unsaturated chemical vapor:
- Packaging material requirements: vapors should be allowed to precipitate on contents; vapors should not react with packaging materials; plastics should not contact sides of the sterilizer.
- Acceptable materials: wrapped perforated cassettes, paper, paper/plastic peel packages.
Step 8: Storing
Finally, store sterile instrument packages in closed and dry cabinets. Before using, remember to examine to see if the package is wet, torn, or punctured.
To recap how to clean dental instruments, there are 8 steps:
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