Cleaning of Reusable Dental Instruments

Importance

• Essential pre-heat sterilization step in infection control.
• Ensures removal of biological contamination (bioburden) which could interfere with sterilization.

Cleaning Process

• Timing & Location:
  • Clean instruments as soon as possible.
  • Designated area should be used, with appropriate personal protective equipment.
• Instructions & Detergents:
  • Follow manufacturer's instructions for cleaning.
  • Pay attention to detergent type, dilution, water quality, and temperature.
  • Approved cleaning solutions must be used.
  • Household products not intended for instruments can damage or reduce cleaning effectiveness.

Pre-Soaking

• Use neutral pH detergent or enzymatic cleaner to prevent bioburden drying if immediate cleaning is not possible.

Cleaning Methods

• Manual Cleaning:
  • Use heavy-duty utility gloves and long-handled brush.
  • Submerge single instruments in water to reduce spatter.
• Automated Cleaning:
  • Increases productivity and effectiveness; decreases worker exposure.
  • Instruments do not need pre-soaking or scrubbing.

Ultrasonic Cleaning

• Commonly used in dental offices.
• Requires sound waves to create cavitation on instrument surfaces.
• Follow manufacturer's instructions carefully.
• Proper solutions (enzymatic/detergent) must be used; water is not suitable.
• Solutions should be replaced daily, not topped up.
• No more than two layers of instruments in the basket.
• Rinse thoroughly after cleaning to prevent spotting or damage.
• Periodic testing for proper function is recommended.

Instrument Washers

• More common in larger practices.
• More efficient than ultrasonic/manual cleaning.
• FDA-cleared medical devices.
• Do not use domestic dishwashers for cleaning.

Post-Cleaning

• Inspect instruments for debris and functionality.
• Repair or lubricate as needed per manufacturer's instructions.
• Avoid using color-coded tapes or silicone rubber rings for identification as they may hinder sterilization.