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The Importance of Dental Sterilizer

Today’s busy dental practices face a serious challenge: to maintain or increase productivity while ensuring that patient safety remains a top priority. At times, these may seem like incompatible goals. Advances in dental processing equipment, however, have empowered practices to develop safer processes while realizing efficiencies and ultimately, saving money.

Sterilizers are medical devices, requiring clearance by the Food and Drug Administration before manufacturers may offer them for sale. The FDA requires rigorous testing to ensure an adequate margin of safety in each cycle type described in the instructions. Failing to follow the instructions of the manufacturer is ill advised, since it may result in inadequate sterilization of the instruments or devices in the sterilizer. It is never appropriate to use a household device, such as a toaster oven, for sterilization of dental equipment.

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. Many methods of instrument reprocessing are available. 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.

Dry heat 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.

Packaging cleaned instruments prior to placing them in the autoclave sterilizer is a standard of care that protects instruments and maintains their sterility until they are ready for use on a patient. Unprotected instruments may be re-contaminated with dust and spatter or by coming into contact with any number of non-sterile surfaces during transport, storage, tray set-up, and operatory set-up.

Dental Autoclve

What You Need to Know about Sterilization

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.

Dental Autoclve

The Sterilization Information about Dental Autoclave Sterilizer

Today’s busy dental practices face a serious challenge: to maintain or increase productivity while ensuring that patient safety remains a top priority. At times, these may seem like incompatible goals. Advances in dental processing equipment, however, have empowered practices to develop safer processes while realizing efficiencies and ultimately, saving money.

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. Many methods of instrument reprocessing are available. 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.

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 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. Assurance of sterility of instruments and devices can be obtained through the use of one of several tests, and these tests must be performed regularly to ensure that the sterilizer is sterilizing all instruments and devices and that these are safe for use on patients.

Parameters such as time, pressure and temperature vary according to the type of autoclave sterilizer, materials being sterilized and individual models within sterilizer brands. The first step in determining the settings for the sterilizer is to refer to the manufacturer’s instructions. Sterilizers are medical devices, requiring clearance by the Food and Drug Administration before manufacturers may offer them for sale. The FDA requires rigorous testing to ensure an adequate margin of safety in each cycle type described in the instructions. Failing to follow the instructions of the manufacturer is ill advised, since it may result in inadequate sterilization of the instruments or devices in the sterilizer. It is never appropriate to use a household device, such as a toaster oven, for sterilization of dental equipment.

Dental Autoclve

What are the Effects of Dental Autoclave

A Packaging cleaned instruments prior to placing them in the sterilizer is a standard of care that protects instruments and maintains their sterility until they are ready for use on a patient. Unprotected instruments may be re-contaminated with dust and spatter or by coming into contact with any number of non-sterile surfaces during transport, storage, tray set-up, and operatory set-up.

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 dental 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 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.

Dental autoclaves are machines that are commonly used during sterilization in dentistry. These machines are usually made from large metal cylinders, and they are similar to pressure cookers. Once the dental equipment are placed in the autoclave, they are sprayed with high-pressure steam. The high pressure inside this machine helps raise the steam to very high temperatures that are necessary for killing disease-causing micro-organisms.

Any tools that can not be subjected to moisture or intense heat must be sterilized with other methods. Chemicals are often used during sterilization in dentistry as well. Some of the chemicals used to kill germs and sterilize dental tools are typically iodine or alcohol based, since both of these chemicals are very effective at killing germs.

dental equipment

The Way to Replace Parts of Dental Sterilizer

Autoclave sterilizers have been known to play a significant role in the daily functioning of dental operatories and are recently becoming even more advanced and efficient due to advances in technology. Development of a new generation of autoclaves within the last two decades has added a new dimension to this heat sterilization modality. These autoclaves are classified as “Class B” sterilizers or “pre- and post-vacuum” steam sterilizers. The equipment is fitted with a pump that creates an initial vacuum in the chamber to ensure air is removed from the sterilizing chamber before steam enters.

The latest innovations allow for fast and easy use for efficient instrument processing, reliability and effectiveness for infection control assurance, automatic opening door for efficient instrument drying, and maximum space utilization and a complimentary design for your sterilization area. Although these sterilizers can be a somewhat costly addition to a dental operatory, the time and money that they save dentists down the road is substantial. Taking a few pointers into consideration and performing routine checks and replacing old parts on your unit can help maximize the life and functioning of your model.

Door Gasket: To replace the door gasket, begin by simply removing the old door gasket. Clean the gasket groove in the door, and chamber face. For easy installation of the new gasket, use the “South-East-West-North” method (i.e. begin installing the gasket at the bottom of the door, then install the left and right sides and finishing at the top by squeezing in any of the excess making sure that the gasket fits flush).

Dam Gasket: Use CAUTION when removing or installing the dam gasket –the door studs can be sharp. To install the door dam, align and place the dam gasket on and over the door studs. The dam must lie flat against the door (refer to the Installation Instructions included with the MIG035 dam gasket).

Chamber & Vent Filters (mesh style filter): If the machine has both a Chamber and a Vent Filter – Remove all trays and the rack from the chamber. Clean the chamber, then remove the chamber filter. Install the new filter. You must also replace the Vent Filter that serves as a filter for the steam trap/bellows and is located in the vent line to the tee fitting. Reinstall rack and trays.

Sterilizer: After replacing the PM parts, check the reservoir and clean if dirt or debris are present (Note: Debris is the number one reason for Steam Trap/Bellows failure). Refill reservoir with distilled water only. Conduct a temperature check using a Max Register Thermometer. Conduct a pressure check to identify any leaks that may need to be addressed. If calibration is necessary, use the RPI Pressure Gauge and the RPI Trim Pot Tool.

dental health

Guideline for Disinfection and Sterilization in Healthcare Facilities

Autoclave Sterilizer

Sterilization

Most medical and surgical devices used in healthcare facilities are made of materials that are heat stable and therefore undergo heat, primarily steam, sterilization. However, since 1950, there has been an increase in medical devices and instruments made of materials (e.g., plastics) that require low-temperature sterilization. Ethylene oxide gas has been used since the 1950s for heat- and moisture-sensitive medical devices. Within the past 15 years, a number of new, low-temperature sterilization systems (e.g., hydrogen peroxide gas plasma, peracetic acid immersion, ozone) have been developed and are being used to sterilize medical devices. This section reviews sterilization technologies used in healthcare and makes recommendations for their optimum performance in the processing of medical devices 1, 18, 811-820.

Sterilization destroys all microorganisms on the surface of an article or in a fluid to prevent disease transmission associated with the use of that item. While the use of inadequately sterilized critical items represents a high risk of transmitting pathogens, documented transmission of pathogens associated with an inadequately sterilized critical item is exceedingly rare 821, 822. This is likely due to the wide margin of safety associated with the sterilization processes used in healthcare facilities. The concept of what constitutes “sterile” is measured as a probability of sterility for each item to be sterilized. This probability is commonly referred to as the sterility assurance level (Autoclave Sterilizer) of the product and is defined as the probability of a single viable microorganism occurring on a product after sterilization. SAL is normally expressed a 10-n. For example, if the probability of a spore surviving were one in one million, the SAL would be 10-6 823, 824. In short, a SAL is an estimate of lethality of the entire sterilization process and is a conservative calculation. Dual SALs (e.g., 10-3 SAL for blood culture tubes, drainage bags; 10-6 SAL for scalpels, implants) have been used in the United States for many years and the choice of a 10-6 SAL was strictly arbitrary and not associated with any adverse outcomes (e.g., patient infections) 823.

Medical devices that have contact with sterile body tissues or fluids are considered critical items. These items should be sterile when used because any microbial contamination could result in disease transmission. Such items include surgical instruments, biopsy forceps, and implanted medical devices. If these items are heat resistant, the recommended sterilization process is steam sterilization, because it has the largest margin of safety due to its reliability, consistency, and lethality. However, reprocessing heat- and moisture-sensitive items requires use of a low-temperature sterilization technology (e.g., ethylene oxide, hydrogen peroxide gas plasma, peracetic acid) 825.

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