Sterilization and Disinfection of Dental Instruments

Sterilization and Disinfection of Dental Instruments
According to the Centers for Disease Control,
1, 2
dental instruments are classified into three
categories depending on the risk of transmitting infection. The clas
sifications of critical,
semicritical and noncritical are based on the following criteria:
1)
Critical
instruments are those used to penetrate soft tissue or bone, or enter into
or contact the bloodstream or other normally sterile tissue. They should be
st
erilized after each use. Sterilization is achieved by steam under pressure
(autoclaving), dry heat, or heat/chemical vapor. Critical instruments include
forceps, scalpels, bone chisels, scalers and surgical burs.
2)
Semi
critical
instruments are those that
do not penetrate soft tissues or bone but
contact mucous membranes or non
-
intact skin, such as mirrors, reusable
impression trays and amalgam condensers. These devices also should be
sterilized after each use. In some cases, however, sterilization is not
feasible
and, therefore, high
-
level disinfection is appropriate. A high
-
level disinfectant is
registered with the U.S. Environmental Protection Agency (EPA) as a
"sterilant/disinfectant" and must be labeled as such.
3)
Non
critical
instruments are those th
at come into contact only with intact skin
such as external components of x
-
ray heads, blood pressure cuffs and pulse
oximeters. Such devices have a relatively low risk of transmitting infection; and,
therefore, may be reprocessed between patients by inter
mediate
-
level or low
-
level disinfection. An intermediate
-
level disinfectant is EPA
-
registered as a
"hospital disinfectant" and will be labeled for "tuberculocidal" activity (e.g.,
phenolics, iodophors, and chlorine
-
containing compounds). A low
-
level
disinf
ectant is EPA
-
registered as a "hospital disinfectant" but is not labeled for
"tuberculocidal" activity (e.g., quaternary ammonium compounds). The
tuberculocidal claim is used as a benchmark to measure germicidal potency.
Germicides labeled as "hospital dis
infectant" without a tuberculocidal claim pass
potency tests for activity against three representative microorganisms:
Pseudomonas aeruginosa
,
Staphylococcus aureus
, and
Salmonella
choleraesuis
.

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