Effective and efficient infection control in the dental office is essential for the safety of patients and to ensure that productivity does not suffer. Infection control programs all include the cleaning and sterilization of reusable dental instruments and devices. Care must be taken by the dental healthcare professional to ensure that all instruments are cleaned prior to sterilization, and that this is carried out in a safe manner to avoid injury and puncture wounds. Use of closed-system cassettes reduces the risk to dental healthcare professionals when executing infection control programs. When using ultrasonic cleaners, washers and sterilizers, it is important to always follow the manufacturer’s instructions. It is also important to consult with the manufacturer of dental instruments and devices as needed to ensure complete sterilization and to avoid damage to these items.
Endo Instrument Sterilization
Files must be sterilized before use. ANSI/ADA Specification 28 recommends:
• Scrub the instruments with soap and warm water.
• Rinse thoroughly with distilled or deionized water.
• Allow to air dry.
• Place the instruments, unwrapped, in the autoclave tray.
• Use fresh distilled or deionized water.
• Steam Autoclave at 136° C (plus or minus 2° C) for 20 minutes.
• Recommended File Disposal: Place used files in a Biohazard Sharps container.
ULTRASONIC TIPS STERILIZATION
Maintain a temperature of at least 136°C (277°F) for a minimum of 20 minutes per USP recommendations.
Clean the exterior of the console by wiping with a soft cloth moistened with a mild detergent or disinfecting solution. The system is designed to allow for a disposable sanitary plastic barrier to be utilized over control console and/or handpiece.
Wipe off the handpiece with a soft cloth moistened with mild detergent or disinfecting solution. NOTE: When wiping down the handpiece cable, gently wipe from the middle of the cable out toward the handpiece and console. Avoid gripping the cable tightly. DO NOT SUBMERGE the handpiece in any fluid or spray any fluid directly on the handpiece.
Handpiece Cartridge Nut Steam autoclave for 10 minutes at 132°C. Handpiece Delivery Plunger Annually: Without a cartridge inserted, press the activation cuff until the guttapercha indicator moves all the way forward. Then, push the Return button and allow the indicator to completely retract.
Handpiece Cartridge Heater:If gutta-percha gets into the cartridge heater section of the handpiece, turn on the unit and press the Return button on the console to fully retract the plunger. Allow the heater section to reach operation temperature (180°C). Turn off unit. Insert the included handpiece cleaning brush into the heating chamber. Rotate the brush several times to remove the gutta-percha from the chamber. Cartridge Store cartridges at room temperature.
Cartridges are intended for single patient use. Dispose of used cartridges in a biohazard container. Do not immerse the cartridges in any liquid.
The three types of sterilizers most commonly used in dental offices are
Steam sterilization (autoclave)
Dry heat sterilization
Unsaturated chemical vapor sterilizers
Autoclaves use steam and are either gravity displacement or pre-vacuum-type sterilizers. Temperatures reach approximately 250 degrees F to 273 degrees F. Sterilization times range from four to 30 minutes depending on temperature, whether instruments are wrapped or unwrapped, and manufacturer’s instructions. The drying cycle may be 25 to 40 minutes.
Dry heat sterilizers are either static air or forced air. The high heat and extended time are major factors in achieving sterilization. Temperatures reach approximately 300 degrees F to 375 degrees F. Sterilization times vary from 12 to 150 minutes depending on temperature and manufacturer’s instructions.
Unsaturated chemical vapor sterilizers use a combination of alcohol, formaldehyde, ketone, acetone, and water to create a vapor for sterilizing. The combination of pressure, temperature, and time are the major factors in achieving sterilization. Pressure should measure 20 psi, temperatures should reach 270 degrees F, and sterilization time is approximately 20 to 40 minutes.
Instruments must be medical sterilization equipment that has been cleared by the FDA. Always follow the manufacturer’s instructions for sterilization times, temperatures, and other operating parameters, as well as instructions for correct use of containers, wraps, and chemical or biological indicators. Toaster ovens or glass bead sterilizers are not considered acceptable devices for sterilizing dental instruments and could jeopardize patient safety.
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