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Reprocessing Instruments in the Dental Surgery

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Reprocessing in the dental surgery is not a simple matter of sterilising instruments, it's and entire "reprocessing protocol" to protect patients and staff from potential infections from blood, saliva or aerosol-borne infections.

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Reprocessing Instruments in the Dental Surgery

  1. 1. 12 auxiliary September/October 2016 R eprocessing in the dental surgery is not simply a matter of sterilizing instru- ments, it’s an entire “reprocessing protocol” to protect patients and staff from potential infections from blood, saliva or aerosol-borne infections. The Dental Board of Australia guide- lines on infection control state dental practitioners must practise in a way that maintains and enhances public health and safety by ensuring that the risk of the spread of infectious diseases is prevented or minimised.1 To support the dental profession, Chris Jobson from European dental hand- piece and steam sterilizer manufacturer, W&H, conducted a series of free CPD educational presentations for guidance on “Decontamination and Sterilization in the Dental Setting” at ADX16 Sydney and in other state capitals during 2016. Mr Jobson says one of the most critical areas is the proper cleaning and reprocessing of hollow reusable medical devices (RMDs) such as handpieces, using an effective, reproducible and verifiable process. Automated handpiece units “It has been recognised by both Australian Standards and the ADA Infection Control Guidelines that automated handpiece lubricating units are recommended over manual lubri- cation of dental instruments to avoid over-lubrication, which may inhibit the penetration of steam into the handpiece during sterilization,” Mr Jobson said. “Over-lubrication can also lead to the build-up of grit and contaminants which may assist biofilm build-up as well as cause the handpiece to wear prematurely, greatly reducing its service life.” Mr Jobson noted that the Australian Standard states it is the responsibility of each practice owner and the steri room staff to employ a verified process of cleaning instruments using a detergent that will effectively remove contaminants prior to sterilisation. Australian Standards and ADA Infection Control Guidelines both specifically note that cleaning is a process of washing with water and detergent. Ultrasonic cleaners use detergent to clean hand instruments and similarly, a suitable detergent should always be used to clean dental handpieces. Therefore, further investigation for some evidence of effectiveness is warranted for automated handpiece cleaning and lubricating units that claim a cleaning functionality, yet do not use detergent. The W&H Assistina 3x3 does pro- vide an independently verified process2 for both internal and external cleaning as well as the automated lubrication of handpieces. The compact bench-top unit is capable of internally cleaning (drive mechanism), externally cleaning and lubricating up to three handpieces in just 6.5 minutes ready for sterilising, making it ideal for all dental practices. Reprocessing in the dental surgery By David Petrikas infection | CONTROL Figure 1 and 2. W&H provides a complete infection control solution that includes the Lisa Class B steriliser and innovative Assistina 3x3 handpiece maintenance unit.
  2. 2. 14 auxiliary September/October 2016 The W&H ActiveFluid™ detergent used to clean the handpieces in the Assis- tina is a gentle, slightly alkaline (pH 7.6) water-based cleaning agent containing an anionic surfactant - ideal for cleaning and neutralising acidic organic contaminants such as blood and saliva whilst inhibiting the growth of viruses and bacteria within the Assistina process chamber. Choose the right sterilizer “With some RMDs being more chal- lenging to reprocess than others, any mistake has direct implications for the safety of the dental team and patients. This is especially confusing as not all steam steriliser cycles are capable of ster- ilising every type of RMD such as hollow and wrapped loads,” Mr Jobson said. Always use correct sterilization cycle Mr Jobson pointed out that only a “B Type”’ cycle is capable of steri- lising all load types and should always be used when handling mixed loads to ensure effective sterilisation of all instru- ments including Hollow A, Hollow B and wrapped loads - even in the case of smaller loads. W&H was the first benchtop steam steriliser manufacturer to design a steri- lizer with exclusive “B Type” cycles only to ensure each and every load is properly sterilised, relieving the reprocessing staff from the responsibility of selecting the appropriate cycle for the type of load cre- ated. This is an important foundation and safeguard for reliable infection control. The W&H “Lisa” steriliser comes with more automated functions, including auto load sensing to reduce the cycle time, an in-built air detector ensuring full exposure of instruments to saturated steam (even with hollow loads) and inbuilt cycle-data logging with user identification including password for load release to ensure proper oversight of the sterilisation process. Instrument tracking The W&H Lisa supports automated instrument tracking (or batch control identification) using a dedicated W&H LisaSafe bar code label printer which will only produce a label for those sterilisation cycles where the parameters for time, temperature and pressure have been met. Batch control identification is now widely used in both private and public practices to automate and streamline instrument tracking for those critical instruments (mandatory according to the Australian Standard) and provide a link between the instruments used on a patient and a verified sterilisation cycle. The W&H Lisa also automatically stores each cycle’s parameters on a downloadable memory card and Lisa can be permanently attached to a PC to auto- matically log all cycle batch data to the practice PC to be included with the daily back-up of data. For assistance on setting up and equip- ping a reprocessing area to meet the required infection control standards, contact your local A-dec Territory Man- ager or A-dec equipment dealer. For more information, call A-dec Australia on 1800-225-010 or see www.wh.com. 1. DBA Guidelines 2. As verified by Robert Koch Institute and Swissmedic. Figure 3 and 4. The new W&H Assistina 3x3 now accommodates up to 3 instruments including turbines, straight and contra-angle handpieces, air motors and air-driven scalers; An innovative cleaning ring travels along the instruments, spraying a cleaning solution at very high pressure through 6 spray nozzles. This patented system avoids heating both the cleaning solution and the instruments. By eliminating brushing and scrubbing, micro-scratches on the instruments which can harbor future debris are also avoided.

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