Cleaning of Reusable Dental Instruments

Importance of Cleaning

• Cleaning is crucial for infection control before heat sterilization.
• Proper cleaning removes biological contamination and prevents interference with sterilization efficacy.
• Inadequate cleaning can leave bioburden that affects sterilization.

Cleaning Procedures

• Perform cleaning as soon as possible in a designated area.
• Use appropriate personal protective equipment (PPE).
• Follow manufacturer's instructions regarding:
  • Detergent type and dilution
  • Water quality
  • Temperature
• Avoid household products; they may damage instruments or reduce cleaning effectiveness.

Pre-Soaking

• If immediate cleaning is not possible, pre-soak in a neutral pH detergent or enzymatic cleaner.
• Pre-soaking prevents the drying of bioburden, making cleaning easier.

Cleaning Methods

• Manual Cleaning:
  • Use heavy-duty utility gloves.
  • Use a long-handled brush to prevent sharps injury.
  • Scrub single instruments submerged in water to reduce spatter.
• Automated Cleaning:
  • Increases productivity and cleaning effectiveness.
  • Reduces worker exposure to blood and bodily fluids.
  • No need to pre-soak or scrub instruments.

Ultrasonic Cleaning

• Common in dental offices.
• Uses sound waves to create bubbles that implode, cleaning the surface.
• Critical to follow manufacturer's instructions.
• Use enzymatic or detergent solutions designed for ultrasonic cleaning.
• Solutions must be replaced daily, do not top off the tank.
• Place a maximum of two layers of instruments, fully covered by solution.
• Close the lid before activating the unit to prevent splatters.
• Test function periodically with the aluminum foil test.
• Rinse thoroughly under running water post-cleaning to prevent spotting and staining.

Instrument Washers

• More common in large practices and clinics.
• Provide efficient pre-sterilization cleaning.
• Clean, rinse, and dry instruments automatically.
• Approved as FDA-cleared medical devices.
• Domestic dishwashers are not acceptable for processing instruments.

Post-Cleaning Inspection

• Inspect instruments for debris and good working condition.
• Set aside instruments needing repair.
• Check functionality and lubricate as needed.
• Avoid using color-coded tapes or silicone rubber rings for identification, as these can hinder sterilization.

Summary

• Proper cleaning and handling of dental instruments are crucial for effective sterilization and infection control.
• Follow all recommended procedures and manufacturer's instructions to ensure safety and efficacy.