Disinfection and sterilisation guarantee patient health and, as such, are fundamental processes in a dental clinic. They are designed to destroy all microscopic life forms, preventing the transmission of infections through reusable tools. The two concepts are sometimes confused, but they are not the same thing, so we're going to tell you how disinfection and sterilisation differ from one another and how they are carried out. Ready? Let's get started!
What is cleaning, disinfection and sterilisation and what are the differences between them?
Cleaning, which is done with soap and water, is simply the destruction of dirt and organic material. It eliminates a large proportion of microorganisms, but not all of them. The method that does achieve this is disinfection, thanks to chemical or physical procedures. However, disinfection processes do not remove fungal spores. This requires sterilisation, which prevents microorganisms from surviving, reproducing or causing infections.
Not all dental instruments carry the same risk of infection. Dr. E. H. Spaulding's classification makes this more clear:
- Critical. This group includes sharp surgical instruments or those that are inserted into tissues. For example, surgical, periodontal or endodontic instruments. They must always be sterilised after use.
- Semi-critical. This includes devices that are exposed to fluids such as blood or saliva, even if they do not penetrate mucous membranes. They must also be sterilised after use.
- Non-critical. Light-curing lamps, chair buttons, computers, intra-oral X-ray equipment etc. All these items that come into continuous contact with the patient or aerosols are considered non-critical and should be disinfected between patients.
Levels of disinfection
The healthcare sector has three levels of disinfection: low, intermediate and high. The low level, which is used for non-critical equipment, kills fungi and some bacteria, but does not kill fresh spores or viruses. Intermediate kills bacteria, fungi and viruses, but not resistant spores. For these resistant spores, a more comprehensive procedure is required: high-level disinfection.
How do I choose a method of sterilisation or disinfection?
We've made a summary shown in this table:
Sterilisation methods for dental instruments
Sterilisation methods can be physical or chemical. The most well-known include ionising radiation and gas sterilisation (ethylene oxide). There is also the dry heat technique, which achieves the oxidation of cell constituents, and sterilisation in an autoclave (a hermetic and rigid chamber in which objects are placed) with humid heat through saturated pressurised steam. These last two are the most commonly used and recommended in a dental clinic. Let's take a closer look at autoclaves.
The effectiveness of autoclaves
There are different types: class S, class N and class B. The latter are recommended for a dental clinic. They remove the air from inside the chamber through a vacuum pump. This creates a negative pressure that allows steam to be released into the chamber. They are also capable of sterilising textile goods or porous elements with weep holes. Excellent operational control is essential to avoid errors or anomalies in the procedure.
In the correct sterilisation process, placing the material into the autoclave would follow immersion of the material in a vat of disinfectant, washing with soft brushes, rinsing, drying and packaging. The last step is storage, which requires ensuring that there are no traces of moisture.
At Dentaltix, we have a wide variety of high efficiency autoclaves, so you can choose the one which best suits your clinic's needs.
Recommended Disinfectant Products
For optimal disinfection of instruments and surfaces, Cattani Eco-Jet 1 Surface Disinfectant Wipes, effective against viruses, bacteria and fungi, are recommended. And there are also other formats, such as aerosols, which have a high antimicrobial efficacy, capable of evaporating quickly without leaving residues. A great example is the Medicaline surface disinfection spray, an environmentally friendly product that is active against coronavirus, adenovirus, rotavirus or vaccinia virus.
The Dental instrument disinfectant by Medicaline, which is suitable for ultrasonic baths, also acts against bacteria, enveloped viruses and fungi. In addition, if you want to clean your dental instruments such as burs, rotary instruments or trays, there are several products for this purpose and you can find them in our Dental Instrument Cleaning category. Alternatively, there are other products for disinfection in a dental clinic in other formats such as powder or sachets.
How can we protect our dental practice against COVID-19?
Surface cleaning, as well as wearing latex or nitrile gloves, keeping fingernails trimmed, surgical masks and goggles are universal protective measures for dentists. But these general recommendations from the health authority have become stricter with the emergence of COVID-19 in every aspect. Let's focus on the issue at hand: cleaning, disinfection and sterilisation.
With the rise of the pandemic, hydroalcoholic gel usage has become mandatory for patient's hands upon entry into the clinic. We also remind you that the patient must wait in a adequately ventilated room (ventilated for a minimum of five minutes).
Dentists, dental assistants and other healthcare personnel should wash their hands for at least 60 seconds and then apply a 60% hydroalcoholic solution before putting on gloves.
To avoid cross-contamination, dentists must also pay attention to specific elements such as impressions. For example, alginate impressions should be disinfected by spraying them with 1% hypochlorite and elastomers, such as silicones, should be immersed in glutaraldehyde, hypochlorite, povidone-iodine or persulfate.
It is very important to always remember to disinfect and sterilise rotary instruments after each patient and to disinfect goggles and screens with 70% isopropyl alcohol. Furthermore, you must not forget that some treatments generate a large amount of aerosols; in these cases, it is advisable to have a forced aspiration system and to utilise the double aspiration of the equipment. It is also a good idea to carry out absolute isolation. If you'd like to know more about innovations in the dental industry to reduce contagion-generating factors, don't miss our Blog The most innovative technologies for your rotators to prevent cross-contamination.
In summary, these are the keys to sterilisation in a dental practice across the board and applied to the pandemic era. Dental practices that follow these guidelines are bio-safe spaces where the patient will feel both cared for and protected.
Our goal is to provide you with information that benefits your dental practice. We hope we have achieved just that! If you have any questions please contact us, we'd love to answer them.
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