2. Outlines
1. Sterilization & disinfection of instruments .
2. Processing area of instruments .
3. Cleaning & Disinfection of Environmental Surfaces
4. Waste management
5. Contaminated sharp management .
3. Sterilization & disinfection
• Sterilization: killing all bacteria and spores.
• Disinfection: killing of infectious agents outside the
body by direct exposure to agents.
• high-level disinfection may be kill all microorganism
with numbers of bacterial spores.
4. • Dental instruments are classified into three categories
( critical, semi-critical, or noncritical ) depending on their
risk of transmitting infection and on the need to sterilize
them between uses.
5. Critical instruments
• Surgical and other instruments that touch bone or
penetrate soft tissue are classified as critical and should
be sterilized after each use.
EXAMPLES :
• surgical instruments
• Periodontal scalers
• Scalpel blades
• Forceps
• burs
6. Semi-critical instruments
• Instruments that touch mucous membranes, but do not
touch bone or penetrate tissue .
• If sterilization is not feasible because the instrument will
be damaged by heat, use high-level disinfection.
EXAMPLES :
• Mirrors.
• Amalgam condensers.
• Dental handpieces .
7. Non-critical instruments
• Contact intact skin and use intermediate-level or low-
level disinfection for them.
EXAMPLES :
• x-ray heads.
• Face-bows
• Blood pressure cuff.
9. 1 Receiving
• After collected the instruments that used in treatment in
disinfection solution tray, send them to the clean and
sterilization room receive them and clean up.
10. 2 Cleaning
A) Manual cleaning.
1. Wear mask & gown.
2. Wear heavy-duty gloves to avoid risk of hand injuries.
3. Clean one by one.
4. Use a long handled brush.
11. Cont…
B) Ultrasonic cleaner.
1. More effective in cleaning than manual.
2. Reduce spatter in environment
3. Reduce chances of hand injury
12. Cont…
C) Automated cleaning.
• It`s a combination of very hot water with a detergent to
remove the organic material & kills most microorganism
at level of heat.
13. 3 Preparation and packaging
• Before sterilization the instrument must be packaged to
protect them from contaminated after sterilization.
Place chemical indictors inside the pack
• Types of packaging & sealing:
Heat sealing tape sealing Auto sealing
14. 4 Sterilization
1. Steam autoclave
2. Flush sterilization
3. Dry heat
4. Chemical sterilization
5. Hand pieces Sterilization
6. Types of indicators of
monitoring sterilization
15. Steam autoclave
• Suitable for sterilization of most reusable items and
instruments, including dental hand pieces.
• 121 °C (30min) under 15 psi
16. Flush sterilization
• Involves sterilizing unpackaged instruments using short
exposure times.
• Flush sterilization should be used only for instruments
that are to be used quickly.
17. Dry heat
• Dry heat indicated for carbon steel & stainless steel
dental instruments.
• Heat to 160 -170 ° C for 2 hours
• is not recommended for most dental hand pieces
18. Chemical sterilization
• Chemical vapor sterilization is very similar to autoclaving
,except a combination of chemical and water.
CHEMCLAV
19. Hand pieces Sterilization
• High speed , straight and contra angle hand pieces
should be cleaned and sterilized at the end of each
treatment session.
• Hand pieces Sterilization can sterilized by autoclave
or special hand pieces device sterilization.
20. Monitoring sterilization
Types of indicators
• Biological Monitoring
• Chemical Monitoring
• Mechanical Monitoring
21. 5 Storage
Storage the clean items in shelves or
drawers must be:
Dry
Clean
Close
25. Regulated waste
A. Contaminated waste: waste that contacts blood or
other body fluids like, barriers ,patient napkins and PPE.
B. Hazardous waste: it poses a risk to human ,the
environment. Like, amalgam fixer solution and tooth
with amalgam and lead foil from x-ray film pockets.
C. Biohazard waste: contaminated waste that transmitting
infectious disease. Like, sharp tools, extracted tooth
and tissue with blood.
27. Unregulated waste
General waste include :
Disposable paper towels
Paper mixing pads
Used patintbibs
Surface barriers
28. • Contaminated sharps are classify as infectious waste.
• Contaminated needles and other disposable
sharps, such as scalpel blades orthodontic wires and
broken glass must be placed into a sharps container and
must be puncture resistant , closable & color coded with
biohazard symbol.
29. Thank
you
Reference :
Office Safety & Asepsis Procedures (OSAP).
Infection control in dentistry guidelines.
Annapolis, MD, USA:OSAP Research