Effective and efficient infection control in the dental office is essential for the safety of patients and to ensure that productivity does not suffer. Care must be taken by the dental healthcare professional to ensure that all instruments are cleaned prior to sterilization, and that this is carried out in a safe manner to avoid injury and puncture wounds. Use of closed-system cassettes reduces the risk to dental healthcare professionals when executing infection control programs.

When using ultrasonic cleaners, washers and autoclave sterilizers, it is important to always follow the manufacturer’s instructions. It is also important to consult with the manufacturer of dental instruments and devices as needed to ensure complete sterilization and to avoid damage to these items. A cleaning and sterilization process that meets ADA and CDC guidelines is vital to an effective infection control program. Streamlining of this process requires an understanding of proper methods, materials, and devices.

Use of a complete system that encompasses and fulfills all elements that are critical maximizes efficiency and minimizes risks. Closed cassette systems provide a more efficient and safer way to process, sterilize and organize instruments in a dental office - these eliminate manual steps during instrument reprocessing such as hand scrubbing and time-consuming sorting of instruments, thereby improving safety and increasing efficiency.

In general, the timer is activated for three to six minutes for loose instruments and ten to twenty minutes for instrument cassettes, and the timing is adjusted as necessary. While the ultrasonic device is running, the lid or cover should be kept on to reduce the release of aerosol and spatter into the area from the ultrasonic cleaner. Routinely replacing the cleaning solution in the ultrasonic scaler is important, and is necessary at least once a day, more often with heavy usage.

Instrument washers use high-velocity hot water and a detergent to clean instruments. Widely used for decades in hospitals and large facilities as part of the central sterilization process, these devices have recently become available for the dental office. These devices require personnel to either place instruments in a basket or to use instrument cassettes during the cleaning and drying cycles. Instrument washers for dental offices come in two different designs. One is a counter-top model. This type does not require professional installation. The other type is built-in and resembles a kitchen dishwasher. It functions much the same as the counter-top model, but it has a larger capacity and requires professional installation. Some models have the ability to dry the instruments after washing, some do not.

Instrument washers and thermal disinfectors are approved medical devices that have been rigorously tested to meet Food and Drug Administration (FDA) requirements for safety and efficacy of medical devices; household dishwashers are not appropriate for use in a dental office.