Instrument Sterilization in a Dental Practice

Dentistry is by default an invasive medical procedure of varying levels. The dentist has to probe or work inside the mouth of the patient. Proper instrument sterilization is vital. Infections carried by unsterilized instruments can even lead to fatalities.

It can be extremely serious

Dr. Crystal Baxter, DMD, MDS is a prosthodontic practitioner. She enlists 242 cases of dental malpractice cases that she attended for reviewing in her career of twelve years. Of these, eleven cases were due to dental infections, and comprised of four fatalities. It is unfortunate to know that even experienced dental surgeons are sometimes negligent of basic instrument sterilization. As a patient, you should not hesitate to confirm whether the clinic follows the proper procedures.

Types of dental instruments

Instruments are categorized into Noncritical, Semi-critical, and Critical.

  • The pulse oximeter, blood pressure cuff, facebow, and the radiograph cone are noncritical things as they only contact the intact skin.
  • Dental hand pieces, reusable impression trays, amalgam condenser, and the dental mouth mirrors are semi-critical types as they contact non-intact skin but do not penetrate into it.
  • Finally, the surgical instruments, scalpel blades, surgical dental burs, and periodontal scalers are in the critical classification. Adequate sterilization must be administered to all categories.

Steps of de-infecting instruments

The patient needs to verify whether the clinic has a central sterilization area. It should be isolated so that the germs do not spread from there. It must have separate sections for receiving the instruments, cleaning them, decontamination, proper packaging, sterilization, and storage. Also, it must be ensured that the staff are attending to the contaminated instruments in Proper Protection Equipment (PPE) to nullify the chances of cross-infection.

  • Cleaning: This can be done manually or via automatic systems such as the ultrasonic cleaners, or automatic washers. However, all good clinics still prefer manual cleansing even when they have the automatic systems. Persistent debris can be stuck in places where the automated systems prove insufficient. For hand washing, the instruments are soaked in lukewarm water or in an enzyme solution followed by brushing and wiping. The instruments are then checked for their functionalities. The cleaning process must not damage the piece.
  • Sterilization: Steam sterilization is the usual process. Other procedures include ozone sterilization, vaporized Hydrogen Peroxide, ethylene oxide, dry heat, and chemical vapor.

Once cleaned, inspected, and sterilized, the instruments must be stored adequately. Special pouches, wraps, and rigid containers are used for this purpose. The wrapped instruments are further secured by a sterilization tape. Also, you should not stack up the wrapped dental appliances as it can compromise sterility.