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Sterilization and Disinfection of Dental Instruments

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  • 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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