The high turnover of patients in a dental clinic increases the microbial load in its space. In addition, the use of rotating devices leads to the scattering of organic matter (dentin, saliva, blood) possibly contaminated with pathogenic germs.
In the dental office we will meet two major categories of instruments and materials for the dentist to perform dental care and dental treatments. The first category consists of all the disposable instruments that are used in one single operation and then collected as waste and sent for recycling or destruction. The other type of instrument is the reusable, which will participate in numerous dental work. For an instrument to be reused in the dental clinic, it must undergo a rigorous sterilization step. Sterilization is the main means of controlling the infection by destroying all microorganisms (bacteria, viruses and spores) responsible for the transmission of serious infections and diseases.
How to decontaminate?
To prevent this risk, the exposed areas are decontaminated, thus reducing the number of germs to zero. For this purpose, the latest generation chemicals are used, the spectrum of which is very wide, while taking care to observe the exposure time of the decontaminant.
Special disinfectants are used for medical staff before and after the use of examination gloves.
Sterilization of dental instruments involves a complex of processes that completely destroy the microbial flora (the vegetative and sporulated form of bacteria, viruses, fungi) on the materials subject to the process.
The certainty of sterilization depends on the following stages:
– presterilization – preparation of tools for sterilization;
– methods of sterilization.
Presterilization involves immersing the instruments in a disinfectant bath. Prior to this step, normal prewash and cleaning is performed. After the optimum action time of the disinfectant has passed, the instruments are thoroughly washed with the appropriate brushes, insisting on the wrists, needles and frets, to remove all forms of organic matter. Extraction pliers as well as other surgical instruments are subjected to the same stages of presterilization, but in separate containers, then dry and clean again if necessary.
After drying and checking, the instruments are packed in tight sealed sheets that provide sterilization markers that turn (change color) to control the exposure of materials to the optimal temperature and allow for sterilization checking. Also, on metal boxes where other instruments are grouped, strips with such sterilization markers are placed both inside and outside the boxes. On these markers or individual sheets, the date, day and time are marked so that we can control the sterilization of the instruments up to 24 hours before use. This can be verified by daily mentioning in a sterilization booklet of the instruments undergoing this process, the type of sterilization, the apparatus parameters, and by that date the addition of the sterilization marker inside the apparatus.
Methods of sterilization
Devices used for sterilization are periodically inspected and monitored by state institutions certified for this purpose by tests that check the parameters of each appliance.
Referring to these devices, we talk about different methods of sterilization. Thus, sterilization of dental instruments is done by physical and chemical methods. Physical conditions involve dry heat (sterilization by hot air in the oven – PUPINEL – at 180 degrees for one hour a day) and humid heat (steam sterilization under pressure – autoclaving).
Chemical decontamination methods are performed with disinfectant and antiseptic solutions for disinfection of surfaces and hands.
About the autoclave
This is a fully automated, hermetically sealed enclosure that sterilize instrumentation using pressure vapors and at high enough temperatures to remove any pathogen.
In our clinic we have a new and performant model (Tuttnauer brand, model Elara 11). The operating temperature reaches 134 ° C and the vapor pressure at 328 KPa, the duration of a complete cycle being 50 minutes.