Disinfection and sterilization are two crucial decontamination processes that are performed in medical and dental offices. Any good dental practice will have robust protocols for carrying out these processes, the purpose of which is to ensure that any medical and surgical instruments being used do not transmit infectious pathogens to patients.
Disinfection is the process of eliminating or reducing harmful microorganisms from inanimate objects and surfaces.
Sterilization is the process of killing all microorganisms.
Blood and saliva are two of the most common bodily fluids found in dentistry. Unfortunately, they are also particularly adept at carrying and spreading infectious diseases to anyone that comes into contact with them, directly or indirectly. For example, if you were to touch something containing the saliva of a person with an infectious disease, and then touch your own lips or mouth, you could be infected yourself and become a carrier. It is also important to note that the tissues of the other elements of the respiratory tract (the nose and throat), are very similar to those of the mouth and therefore, infectious microorganisms that are found in the saliva can often be found in the nose and throat. This increases the risk of infection to surrounding people. Blood-borne diseases can also cause infection in someone if they come into contact with their saliva, and vice versa.
Some of the most common infectious diseases transmitted through saliva include:
- Rhinoviruses (common colds)
- Flu virus
- Epstein-Barr virus (better known as mono)
- Type 1 herpes
- Strep bacteria
- Hepatitis B
- Hepatitis C
There are many different types of infectious diseases which can be transmitted through contact with an infected patient’s blood including:
- Hepatitis B
- Hepatitis C
- Human Immunodeficiency Virus (HIV)
By undertaking comprehensive disinfection and sterilization processes, your dental practice can ensure that there is minimal risk to both patients being treated, and the staff carrying out the procedures.
While there are far more comprehensive guides available that relate to the correct methods of disinfection and sterilization of dental equipment, here is the basic information that you need to be aware of to ensure that you are offering patients and staff the maximum protection possible.
If you are handling any piece of equipment that has been potentially contaminated with bodily fluids, you should ensure that you are wearing the correct PPR. This includes well-fitting gloves, safety eyewear, face masks, and impermeable smocks/overalls. This will protect you from infection as you clean and organize the instruments and prevent you from passing any infectious agents that you yourself may be unknowingly harboring and passing them onto clean instruments.
If you are dealing with back to back patients, you may not have the time to properly clean and disinfect each instrument right away. Unfortunately, this can give bodily fluids like blood time to dry out and harden, which makes it harder to remove. We recommend that you pre-soak your dirty instruments by spraying them with a solution designed to keep any organic matter on them moist until you are able to perform the total disinfection and sterilization process.
It can be tempting to think that sterilization alone will be sufficient. However, steam sterilization may not be effective if it can’t come into contact with the full surfaces of each instrument – for example, if there is some bio-debris stuck to them. Guidelines from the Centers for Disease Control (CDC) recommend that all instruments are fully cleaned before they are sterilized. You can do this by hand if you don’t have access to an automated instrument washer or ultrasonic cleaning device. The point is that they need to be completely clean before they go in to be sterilized.
Once clean, your dental instruments also need to be dried thoroughly before being sterilized. This is because sterilizers will only remove the amount of moisture that they introduce as part of the sterilization process, meaning that if you place wet instruments into it, they will still be wet at the end of the process. This makes it harder to package and increases the risk of contamination.
Finally, your instruments will need to be packaged before they enter the sterilizer, with each package sealed to prevent exposure to the air when they are removed. There are some types of packaging that are better able to maintain their integrity during the sterilization process so be sure to choose carefully.
Think of your sterilizer as a conventional dishwasher. If you put too many items in, there is a risk that they won’t all emerge fully clean. This is because they take longer to reach the optimal temperature for cleaning and the water and cleaning solution can’t circulate as easily. Overloaded sterilizers have the same problem.
The only way to know just how effective your sterilization process is is to monitor it – something which is also recommended by the CDC. This can be done using chemical indicators on the packaging which show that the correct temperatures are being reached and that the steam is penetrating the packaging. You can also obtain biological indicators that show if your sterilizer is actually killing microorganisms. These tests should be carried out on a regular basis to ensure the efficiency of your process.
For more advice on the best way to disinfect and sterilize, please don’t hesitate to get in contact with our dental office.