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Amin Abusallamah
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1. Sterilization & disinfection of instruments .

2. Processing area of instruments .

3. Cleaning & Disinfection of Environmental Surfaces

4. Waste management

5. Contaminated sharp management .
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.
• 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.
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
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 .
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.
Receiving


                           1

Storage            5               2         Cleaning

                       4       3

                                       Preparation
   Sterilization                           &
                                       Packaging
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.
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.
Cont…

B) Ultrasonic cleaner.
1. More effective in cleaning than manual.
2. Reduce spatter in environment
3. Reduce chances of hand injury
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.
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
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
Steam autoclave

• Suitable for sterilization of most reusable items and
  instruments, including dental hand pieces.
• 121 °C (30min) under 15 psi
Flush sterilization

• Involves sterilizing unpackaged instruments using short
  exposure times.

• Flush sterilization should be used only for instruments
  that are to be used quickly.
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
Chemical sterilization

• Chemical vapor sterilization is very similar to autoclaving
  ,except a combination of chemical and water.



                     CHEMCLAV
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.
Monitoring sterilization
            Types of indicators
• Biological Monitoring

• Chemical Monitoring

• Mechanical Monitoring
5                Storage

    Storage the clean items in shelves or
              drawers must be:
                   Dry
                  Clean
                  Close
Clinical contact   Housekeeping
    surfaces         surfaces
Clinical contact surfaces
Housekeeping surfaces
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.
Dental infection control post treatment last
Unregulated waste

General waste include :
 Disposable paper towels
 Paper mixing pads
 Used patintbibs
 Surface barriers
• 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.
Thank
                                              you
Reference :

Office Safety & Asepsis Procedures (OSAP).
Infection control in dentistry guidelines.
Annapolis, MD, USA:OSAP Research

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Dental infection control post treatment last

  • 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.
  • 8. Receiving 1 Storage 5 2 Cleaning 4 3 Preparation Sterilization & Packaging
  • 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
  • 22. Clinical contact Housekeeping surfaces surfaces
  • 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