Outlines1. Sterilization & disinfection of instruments .2. Processing area of instruments .3. Cleaning & Disinfection of Environmental Surfaces4. Waste management5. 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.
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 CleaningA) 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 environment3. 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 Sterilization1. Steam autoclave2. Flush sterilization3. Dry heat4. Chemical sterilization5. Hand pieces Sterilization6. 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
Regulated wasteA. 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.
Unregulated wasteGeneral 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 youReference :Office Safety & Asepsis Procedures (OSAP).Infection control in dentistry guidelines.Annapolis, MD, USA:OSAP Research