An infection control newsletter of the University of Colorado School of Dentistry Sterilization Monitoring Service

We are again offering our new program to help encourage our present subscribers to get their friends and colleagues to subscribe to our service. If one of our current subscribers refers a new subscriber to our program, we will give the referring office six (6) months FREE sterilization monitoring. If you refer one of our colleagues to our office, please call Pamela Colosacco at (303)-315-5225 to arrange your complimentary six (6) months of monitoring service.

We want to take this opportunity to remind you to fill out the spore strip packet COMPLETELY. This helps to ensure that we have the appropriate information about your office and sterilizers in order to run the tests properly and record the results accurately.

Please follow the directions that are printed on the packets when you run your test strips. DO NOT put the packet into the sterilizer. You must remove only the test strip from the packet, (not the control strip) but do not remove the spore strip from the blue protective wrapper.

Many people experience undue anxiety about visiting the dentist. In recent years, the remote possibility of being exposed to AIDS or other infections in the dental office has heightened that anxiety. But dentists take a host of precautions throughout the day to protect their patients. You may not be aware that sterilization and other infection control precautions take place, because many of these procedures occur out of your view.

Universal precautions (the safety procedures established by the Centers for Disease Control and Prevention and the American Dental Association,) are used for each and every patient to help prevent the transmission of the AIDS virus and other infectious diseases. These precautions require all dental staff involved in patient care to use appropriate protective garb such as gloves, and sometimes masks and eyewear. After each patient visit, the gloves are discarded, hands are washed and a new pair of gloves is used for the next patient.

Virtually all dentists sterilize their handpiece (the dental drill) between patients. This precision instrument and the majority of the other dental instruments are cleaned and sterilized at very high temperatures after each use on a patient. Recommended sterilization methods include sterilization in: an autoclave (steam under pressure), a dry heat oven, or chemical vapor (commonly called a chemiclave). Dental offices are following the above specific heat sterilization procedures which are outlined by the Centers for Disease Control and Prevention and the American Dental Association. Disposable items, such as needles and saliva ejectors, cannot be sterilized and are discarded in special containers. The sterilization equipment usually is not in the treatment room, but if you'd like to see how and where it's done, ask the dental Staff to show you.

Before you, the patient, enter the examining room, all surfaces, such as the dental chair, dental light, drawer handles and countertops have been cleaned and decontaminated. Some offices may cover this equipment with protective covers, which are replaced after each patient. Sharp items and anything contaminated with blood or saliva are disposed of in special containers.

Also, OSHA, the federal Occupational Safety and Health Administration, has specific regulations that protect employees from injury and illness in the work place. Although these "safe workplace" regulations pertain to occupational settings, including dental offices, and the primary purpose of the regulations is to safeguard employees, these procedures also directly protect you, the patient. Don't let uncertainty about safety keep you away from the dentist's office, or cause anxiety while you're there, when a few minutes of conversation with your dentist can set your mind at ease. Your dental health is too important to neglect.

Things to Look For

AAMI released on 6 April 1998 an updated standard that provides guidance to alternative health care facilities on proper sterilization techniques. The goal of the document is to help ambulatory care clinics and office-based medical facilities in setting up and conducting a sterilization program in order to reduce the risk of equipment-related infections.

The revised standard, entitled Steam sterilization and sterility assurance using table-top sterilizers in office-based, ambulatory care medical, surgical, and dental facilities, 2nd ed. (ANSI/AAMI ST42—1998), addresses sterilization by saturated steam under pressure. This is the most commonly used sterilization method in alternative health care sites such as ambulatory care clinics, office-based surgical practices, and dental offices. Topics that are addressed in the standard include functional and physical design criteria for work areas; staff qualifications, education, and other personnel issues; sterilization processing procedures; installation, care, and maintenance of table-top steam sterilizers; quality control; and continuous quality improvement.

Changes from the previous edition are the addition of a new section on "Product and process improvements" that addresses continuous quality improvement, and changes in the recommended temperature and humidity ranges for work areas consistent with Guidelines for design and construction of hospital and health care facilities (American Institute of Architects, 1996). In addition, a number of the recommendations were edited for clarity.