Dental Sterilisation – How The Process Protects Efficiently

dental sterilisation critical dental australia

While it’s fair to say that sound dental sterilisation procedures help to promote best hygiene practices, it isn’t simply just ‘good’ policy.  According to Science Direct, data suggests that over 83,000 patients per year suffer from Healthcare-associated infections (HAI’s) here in Australia. Other sources suggest that this figure could be closer to 160,000 cases per year. This includes blood-borne diseases such as Hepatitis, vCJD (Variant Creutzfeldt-Jakob disease) and HIV. For this reason, infection control through dental sterilisation is vital in ensuring that both patients and dental professionals remain protected.

 

The aim of dental sterilisation

While microorganisms can be inhaled, ingested, or splashed directly onto the skin, one of the biggest problems is the passing of infectious bacteria via contaminated instruments and equipment. The human mouth contains anywhere between 500-1000 different types of bacteria, with anywhere up to 1 billion of them living on a single tooth surface at any one time. As a result, the potential for the spread of health-associated infections (HAI’s) is incredibly high.

The aim, therefore, of proper dental sterilisation is to break the chain of cross-contamination by killing any microorganisms and spores found on dentist tools and equipment, which could otherwise be responsible for the spread of a wide range of air borne and blood-borne diseases.

For this reason, the Australian Dental Association has laid down strict guidelines for the sterilisation of dentist tools.

Here are some of the steps needed to ensure the best outcomes for dental sterilisation.

 

Protection

Before any equipment or tooling is cleaned, it’s important for the dental professional to wear some form of protection. This includes smocks, chemical and puncture-resistant gloves, and face masks. Wearing quality Personal Protection Equipment (PPE) not only prevents the risk of injury when handling sharp tools, but also prevents any equipment-to-person contamination before any sterilisation and cleaning commences.

Pre-soak

One of the key steps in tool and equipment sterilisation in a dental practice is pre-soaking. A bit like dirty dishes, when substances (in this case biological debris) are left to dry out and harden, they can be difficult to remove. When it isn’t always achievable to immediately clean instruments directly after use – particularly in busy practices – it is recommended that any soiled tools and instruments be pre-soaked. This can be achieved using an enzymatic spray gel. Just like soaking your pots and pans, it keeps any organic build-up moist and therefore when the time comes to properly clean any instruments, any debris is far more likely to be removed.

dentist tools dental sterilisation critical dental australiaCleaning before steaming

Autoclaves use a process of superheated steam to effectively kill any lingering microbes. However, any remaining debris left on the instrument before being placed in the autoclave can cause a barrier to form. This, in turn, can stop the steam from penetrating the recesses of an instrument where micro-bacteria are likely to harbour. For this reason, it is required that any excess visible material be removed before sterilisation begins. There are several ways to achieve this, including:

Ultrasonic cleaning

This method utilises soundwaves which are passed through a solution to shake any debris free. Ultrasonic solutions should also be specially formulated to ensure that any mineral build-up, spotting, or corrosion is prevented.

Automated instrument washers

Similar to a dishwasher, instrument washers are intendedly designed to eliminate the need to manually wash and dry any dentist tools. They are capable of operating many cycles per day so that instruments are quickly and safely re-purposed.

Manual scrubbing

This should only ever be used as a fall-back system or last resort and isn’t recommended by the ADA. It not only demands the most time but also carries the highest risk of accidents with sharp objects.

 

Drying dental instruments prior to sterilisation

As a general rule of thumb, steam sterilisers will only ever remove the amount of moisture that they introduce and therefore if a dental instrument is placed into a steriliser wet, they will emerge wet. As a result, any packaging will also become wet. Moist packaging can easily become a breeding ground for bacteria which may, in turn, increase the prospect of instrument contamination contained within. While they can be manually dried, this isn’t recommended for obvious reasons and the best solution is to place any dental tools and instruments into a hot-air dryer.

 

Packaging dental instruments

The final step before placing any dental instruments in a steriliser is to package them using either pouches or wraps. A good autoclave wrap allows any sterilisation agent to penetrate while being able to withstand the high temperatures and harsh conditions contained within. Indicator strips should also be used on both the outside and inside to ensure that

  • The correct temperature is met
  • The steriliser has been running for the correct length of time and,
  • The steam is correctly penetrating all packaging.

So now you know what dental sterilisation is and why it’s important, how do you know that your dentist is practising good sterilisation in your dental practice?

sterilisation in dental practice dental-sterilisation-critical-dental-australia

Well, you could of course ask. You could say that as a new patient seeking treatment you are a little concerned about the prospect of cross-contamination and see what they have to say. Any dentist should be committed and dedicated to protecting your health and therefore, should be more than happy to explain the sterilisation process to you. If they aren’t or they get defensive, then this may be a red flag.

You might also ask to see their autoclave validation report. This is a certificate from a third-party company who send out sterilising envelopes complete with difficult to eradicate bacteria.

The envelopes complete with bacteria are then placed in the sterilisation machine or autoclave. The results are then sent back to the third party who analyse them. The dentist will then get back a report to say just how well the steriliser is functioning. Technically, this is known as biological monitoring.

What if you aren’t comfortable asking about a particular dentist’s sterilisation habits. Is there anything you can look out for?

There are signs that just might indicate whether good sterilisation processes are taking place. They include:

 

Gloves

Any gloves the dentist puts on should always come out of a glove dispenser and not off an unsterilised countertop. Also, watch what they touch. They should only ever touch sterile dental tools and your mouth. If they touch anything else, then they should be putting on a new pair of gloves.

Check out the dental practice

Is the clinic clean and uncluttered or is there lots of junk on countertops? Do you see things like soap dispensers, special containers for the disposal of needles and sharp implements? Do you see signs that say, ‘sterilisation room’? There should be a dedicated room – or at the very least – a dedicated space in the clinic for sterilising dental equipment and instruments.

Dental instruments

Before use, the dentist should be unwrapping previously sealed instruments in front of you – remember, a sealed bag indicates that the dental tools in question have been properly sterilised.

The bottom line is that a good dentist will be only too proud to talk to you about their sterilisation methods and the emphasis they place upon it. So do go ahead and ask.

 

Here at Critical Dental, we have a stock a wide range of dental sterilisation equipment including indicators, wraps and even autoclaves. Why not download our latest catalogue and take a closer look for yourself or give us a call at (02) 8883 0674 to further assist you in such inquiries.

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