Dentist's Hygiene and sterilisation?

How do dentist's steralise there instruments and clean the drill etc, between patients, years ago i remember that they always use to have an Autoclave boiling all the instrumensts, i have seen them recently wiping the drill clean with a cloth,i am sure that whatever they do is adequate but how do they ensure there is no cross contamination??

Cross contamination is exactly the point! The autoclave is still the preferred method of complete sterilization. To remove any material left behind on "instruments" they are NEVER SCRUBBED due to OSHA regulations but they are put in a solution which is a "DISINFECTANT ONLY"and placed in the "ultrasonic machine," this vibrates the material or debris loose, and then they are rinsed, bagged and placed in the autoclave for the "sterilization process." The hand pieces or "drill" is sprayed and "wiped clean" to replace the ultrasonic process, bagged and then autoclaved along with other instruments but bagged separately due to oil used in some of them, most of these can't be submerged into a liquid other than the amount found in the mouth. Now there are some drills that can't be put through the autoclave due to damage the moist heat causes, these should be placed in a heat clave for sterilization process. Anything that is contaminated by saliva, blood, or possible spray or touch should be sterilized again for the safety of the patient, dentist, assistant and the rest of the staff and any others who come in contact with them. So if the drill is being "wiped down" when your being seated, it may be getting contaminated by a wipe which is an inadequate (which is a disinfectant wipe not sterilization method) means of sterilization. Ask for a "new bagged instrument" to be used or one from the heat clave. You should be able to trust your dentist and his staff, although the staff is or should be using what ever method the dentist chose for the office. I expect more than just "adequate" when it comes to the health of my patients. I have a philosophy that "I won't use it on a patient, if I wouldn't use it on my self." It's a shame that some dentist still don't use proper techniques for sterilization. I know most patients are afraid of the aids virus and hepatitis, but you should understand it's the patients with the lowered immune system that need the utmost of consideration due to their lowered immune system. They are more susceptible of contracting a small germ that could place them in a life and death situation, that could have been easily avoided just by sterilizing correctly and disinfecting the room correctly. I would hate to think that I might have been responsible for placing someone in this type of situation, just because I didn鈥檛 do my job correctly.

I hope I鈥檝e been of some help with this and that next time you will ask for a new hand piece. Ask your dentist to see what method of sterilization is used in the office. Good luck!

After all instruments are cleaned with a scrub brush and soap, they are placed in a cold sterile like Banicide. This liquid kills bacteria. The water is usually in machine call an Ultrasonic. This jiggles very very fast and gets rid of any elements left after the scrub down. After the jigglier, metal instruments are washed under tap water and bagged. Plastic instruments are washed under tap water and placed in another cold sterile liquid. Metal instruments are then placed in a autoclave. This will "cook" and kill any bacteria left. It does not boil.. it is like a steam oven.
Hand pieces are very delicate. They are wiped clean with an antiseptic wipe and bagged. They are also placed in the autoclave.

The dentist does not clean his instruments my friend, his wonderful assistant does all the dirty work.

In between patients i remove all traces of the previous patient, scrub all the instruments with a long handled brush and place them in an Ultrasonic bath, this is filled up with water and a special cleaning solution that kills all bacteria,ie HIV, TB! the ultrasonic bath vibrates so it removes any debris from the instruments, once the cycle has finished i then run the instruments under cold water to remove any hidden debris and place them into the Autoclave, All hand pieces are oiled and placed into sterile bags, these do not go into the ultarsonic bath as they have a tendancy to seize up but do go into the autoclave,this cycle runs for 3 minutes at 134 degrees, to make sure the autoclave is running at the correct temp i always put a test strip inside, this strip changes colour and lets me know that the machine is working properly!
Once the programme is finished i take the instruments back to my surgery and place them back in their correct places.
All my surfaces are then wiped down with Medical wipes, these wipes kill off the same bacterias as the ultrasonic solution.
Cross infection is highly important in a dental surgery and i would be some what worried if i thought my dentist or any dentist for that matter was just wiping hand pieces in between patients!

The current standard is to autoclave all air-driven handpieces.

If there is no air turbine to "suck in" particles, some advocate high level surface disinfection. Did you know that the entire 5 foot snake used in colonoscopies are "only" cleaned to a "high level disinfection" between patients? They are not autoclaved.

In my office, anything that can not be thrown away goes through the autoclave with the exception of a few plastic things that don't really touch the patient that would melt in the autoclave. They are treated in Cidex-Plus - the same stuff they use to treat the colonoscopy equipment - to high level disinfection.

Those plastic things include a little dish that the bonding chemical sits in during a procedure or the plastic handle that holds the disposable brush tip used in the bonding procedure. Stuff like that.

Sinec