Dental equipment used on known hepatitis patients do not require special reprocessing procedures. The same sterilization and other infection control precautions should be used regardless of a patient’s HIV, hepatitis, or other disease status.

Ideally, all items that enter the patient’s mouth and come into contact with oral tissues should be heat sterilized. If this is not feasible because the device or instrument cannot withstand the heat sterilization process, a high-level disinfectant should be used.

Maintain sterilized instruments in the pouches or wrapping in which they were sterilized. If the packaging becomes torn or wet, the items must be repackaged and heat sterilized. Avoid mingling non-sterile packages with sterile ones. There should be a visible indicator, such as chemical indicators or color-change autoclave tape on the outside of each package to allow staff to easily discern sterilized instrument packages from those that have not yet been heat-processed.

Dry heat autoclave sterilizers have been used effectively in dental office for many years. Just as with any other sterilization method, dry heat sterilization is highly dependent upon the operator following the manufacturer’s instructions for cycle time, temperature, instrument packaging, and loading technique. Because dry air is not as efficient a heat conductor as moist heat at the same temperature, a much higher temperature is required for a dry heat unit to accomplish sterilization.

There have been some recommendations that dry heat be used only in situations where moist heat is not desirable due to the material, such as oils, powders, sharp instruments and glassware. However, the same source points out that dry heat provides excellent penetration and prevents the corrosion of metals. Since forced-air dry heat systems have very short sterilization cycles and are kind to high carbon steel instruments, they are very often used in orthodontic practices to re-process pliers and cutters.
Keep in mind that the only way to assure that sterilization parameters are routinely met is to use spore tests/biological monitors. Weekly testing is recommended.

The FDA maintains a list of products that have received clearance as chemical sterilants. The list includes information regarding proper contact time, active ingredients and reuse or shelf life. Always read instructions carefully before using a chemical germicide.

The Centers for Disease Control and Prevention (CDC), the American Dental Association (ADA), OSAP, most state dental licensing boards, and dental handpiece manufacturers all recommend heat sterilization between patient uses. Virtually all handpieces currently in production are heat-tolerant, and those that are not can be retrofitted to allow heat-processing. Autoclaving and chemical vapor sterilization are considered accepted methods of heat sterilization. High-level disinfection via chemical germicides cannot be biologically monitored to assure sterility. Further, extended contact with chemical germicides may corrode handpiece components.