Bumedinst 6600.10 Dental Infection Control Program (Chapter 4)

Front 1

Sterilization Methods
-Steam Heat Sterilization-

Back 1

Under pressure steam is the most effective means of sterilization for most dentistry items. Items must be under pressure for an appropriate length of time.

Front 2

Sterilization Methods
-Dry Heat Sterilization-

Back 2

The use of dry heat at temperatures of 320 degrees through the means of conduction, radiation, or convection to achieve sterilization.

Front 3

Sterilization Methods
-Chemical Vapor Sterilization-

Back 3

A mixture of alcohols, formaldehyde, water, and other chemicals heated under pressure forms a gas to achieve sterilization at 270 degrees.

Front 4

Sterilization Methods
-Ethylene Oxide Sterilization-

Back 4

Sterilization at the low temperature of 120 degrees with the use of ethylene oxide gas.

Front 5

Sterilization Methods
-Liquid Chemical Sterilization-

Back 5

Usage of EPA classified chemical disinfectants used as sterilants.

Front 6

Sterilization Methods
-Bead Sterilizers-

Back 6

Using bead sterilizers for intra-appointment sterilization to clean metallic instruments between patients.

Front 7

Critical Items Requiring Sterilization
-Surgical Instruments-

Back 7

Instruments used to perform surgeries.

Front 8

Critical Items Requiring Sterilization
-Hand Pieces-

Back 8

Low-speed motor attachments, sonic scalers, and tips.

Front 9

Critical Items Requiring Sterilization
-Burs and Diamonds-

Back 9

Clean with ultrasonic cleaner and dry before sterilization. Dry heat sterilization imparts least damage to cutting surfaces and is preferred.

Front 10

Critical Items Requiring Sterilization
-Endodontic Files and Gates-Glidden Burs-

Back 10

Arrange in gauze packs and seal in peel packs before autoclaving. If additional files or burs needed sterilize in bead sterilizer.

Front 11

Critical Items Requiring Sterilization
-Rubber Products-

Back 11

Sterilize non-heat rubber products with ethylene oxide or chemical sterilizer. For Heat rubber products use steam or dry heat.

Front 12

Sterilization Monitoring

Back 12

Regular monitoring of sterilization methods is necessary to detect inadequate process conditions.

Front 13

Types of Sterilization Monitoring
-Biological Monitors-

Back 13

Detects if sterilization actually occurred.

Front 14

Types of Sterilization Monitoring
-Dosage Indicators-

Back 14

Chemical dyes that change when exposed to steam, dry heat, or chemical vapors when placed in instrument packs.

Front 15

Types of Sterilization Monitoring
-Process Indicators-

Back 15

Chemical dyes that change color when exposed to sterilizing conditions printed on packaging materials in tape form.

Front 16

Guidelines of Biological Monitoring
-Frequency-

Back 16

Performed at a minimum weekly.

Front 17

Guidelines of Biological Monitoring
-Test Procedures-

Back 17

1. Ensure system compatibility with sterilization process.
2. Place biological and chemical monitors in a test instrument packs during processing.
3. Use an unprocessed monitor for each test.
4. Follow manufacturer's instructions for test pack placement or place in center of the load for sterilization.

Front 18

Guidelines of Biological Monitoring
-Evaluation Criteria-

Back 18

Verify test pack after sterilization. If a pass, distribute sterile goods. If a fail, notify ICO and record results. Use another sterilizer if available and secure the prior. If another sterilizer is not available notify repair personnel and resterilize prior negatives.

Front 19

Guidelines for Dosage and Process Indicators

Back 19

1. Use internal and external indicators on each instrument pack.
2. If test pack fails resterilize with chemical and biological monitors.
3. Closely observe sterilization process.
4. If another fail, notify ICO, repair personnel, log results, and secure sterilizer.
5. Indicators don't replace biological monitors.
6. Liquid chemical sterilants or disinfectants cannot be biologically monitored.

Front 20

Sterilization Methods
-Ethylene Oxide Sterilization-

Back 20

Sterilization at the low temperature of 120 degrees with the use of ethylene oxide gas.

Front 21

Sterilization Methods
-Liquid Chemical Sterilization-

Back 21

Usage of EPA classified chemical disinfectants used as sterilants.

Front 22

Sterilization Methods
-Bead Sterilizers-

Back 22

Use of bead sterilizers is only intra-appointment sterilization of metallic instruments between patients.

Front 23

Critical Items Requiring Sterilization
-Surgical Instruments-

Back 23

Instruments used in surgeries.

Front 24

Critical Items Requiring Sterilization
-Hand Pieces-

Back 24

Low-speed motor attachments, sonic scalers, and tips.

Front 25

Critical Items Requiring Sterilization
-Burs and Diamonds-

Back 25

Clean with ultrasonic cleaner and dry before sterilizing. Dry heat is preferred as it imparts the least damage to cutting surfaces. Wrap in aluminum foil and sterilize at 320 to 345 degrees.

Front 26

Critical Items Requiring Sterilization
-Endodontic Files and Gates-Glidden Burs-

Back 26

Arrange in gauze packs and seal in peel packs prior to autoclaving. If additional files and burs are needed take from a new package and bead sterilize them before use.

Front 27

Critical Items Requiring Sterilization
-Rubber Products-

Back 27

Non-heat rubber products sterilize with ethylene oxide or chemical sterilization. Heatable rubber products use steam or dry heat.

Front 28

Critical Items Requiring Sterilization
-Sterilization Monitoring-

Back 28

Regular monitoring is necessary to detect an inadequate process or equipment malfunction.

Front 29

Sterilization Monitors
-Biological Monitors-

Back 29

Designed to detect if sterilization occurred.

Front 30

Sterilization Monitors
-Dosage Indicators-

Back 30

Chemical dyes that change color when exposed to steam, dry heat, or chemical vapors. Placed in instrument packs to detect sterilization.

Front 31

Sterilization Monitors
-Process Indicators-

Back 31

Chemical dyes that change color when exposed to sterilizing conditions. Printed on packaging material or provided as a tape to distinguish packages.

Front 32

Guidelines of Biological Monitoring
-Frequency-

Back 32

Performed at a minimum weekly.

Front 33

Guidelines of Biological Monitoring
-Test Procedures-

Back 33

1. Ensure sterilization method is compatible with system.
2. Place biological and chemical monitors in test instrument packs for processing.
3. Use unused monitors per process.
4. Follow manufacturer's instructions or place test pack in the center of load.

Front 34

Guidelines of Biological Monitoring
-Evaluation Procedures-

Back 34

1. After processing open test pack to verify if pass or fail.
2. If a pass, distribute items and continue bio-test procedure.
3. If a fail, notify ICO and record results.
4. If another sterilizer is available resterilize all items from last test and secure prior sterilizer.
5. If another sterilizer is not available notify repair personnel and use biological and chemical monitors on items.
6. If a second failure occurs secure sterilizer, notify ICO, and repair personnel.

Front 35

Guidelines of Dosage and Process Indicators

Back 35

1. Use internal and external indicators on each instrument pack.
2. If a pack fails resterilize with biological and chemical monitors.
3. Closely monitor sterilization process.
4. If a second failure record results, notify ICO, repair personnel, and secure sterilizer.
5. Dosage and process indicators don't replace biological monitoring.
6. Liquid chemical disinfectants and sterilants cannot be biologically monitored.