How Are Dental Instruments Sterilized?

In today’s world, the need for infection control and proper sterilization is essential and patients are more concerned about the transmission of infection more than ever before. Not only is controlling bacterial contamination important to keep dentists, hygienists and other staff safe, but it is also vital to patient safety.

So what happens when the instruments leave your mouth and are taken away by the dental assistant or hygienist? First, the hygienist will wear thick nitrile gloves to transport the instruments from the chair to the sterilization room. In the sterilization room there are two areas, the red and blue side known as the contaminated area and sterile area respectively. The instruments that have not yet been sterilized are put in a red zone so that other staff members know to not touch them.

When a staff member has time to start the process of sterilization, they go to the red zone and put the cassettes of instruments into a Miele dental machine. The Miele is a programmable washer, similar to a dishwasher. This machine will wash away any large debris that is left on the instruments such as blood or calculus (tartar).

After the Miele washes the instruments, they are wrapped in an autoclave sterilization wrap. The cassette is wrapped like a present and the edges are taped down with a special tape. If the sterilization wrap is not used, some offices prefer to use autoclave bags which are plastic. After the cassette of instruments has been wrapped, they are put into an autoclave.

An autoclave is a device that is used to sterilize instruments by subjecting them to high pressure saturated steam at 121 degrees C for 15 to 20 minutes depending on the load of instruments in the autoclave. The pressurized steam will destroy microorganisms and autoclaves often have an additional drying cycle.

After the autoclave has run its course, it is imperative to know that the contents were sterilized. A way to check for complete sterilization is to check the tape or bags the instruments were sterilized in. Autoclave bags and tapes are imprinted with a dye that changes color when the correct temperature inside the autoclave had been reached.

Another way to check that the autoclave is indeed sterilizing its contents is to use a biological indicator monthly. The biological indicator confirms that the autoclave is working properly. The biological indicator works by using two vials. They both have bacteria in them and you put one in an autoclave and the other in an incubator. The vial that is put in the autoclave is run and then taken out and also put in the incubator along with the other vial. After incubation for 24 hours, you remove both of the vials and check the colors of both. The one that was not run in the autoclave should be yellow which means there are bacteria growing and it is unsterile. The other vial should have been sterilized in the autoclave and should be blue/purple in color. If the vial that was run in the autoclave has turned yellow, that means the autoclave did not kill the bacteria and the vial is not sterile. In this case, the instruments should not be used.

The sterilization process, although time consuming is effective and has many protocols to make sure instruments and other materials are truly being sterilized. If you have questions about your dentist office’s procedures on sterilization be sure to call or ask.

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