Common Methods of Sterilization in Dentistry

Sterilization in dentistry is very important, and dentists and dental assistants typically clean and disinfect most surfaces in a their offices and treatment rooms to help prevent the spread of germs. Infection control programs all include the cleaning and sterilization of reusable dentist supplies. Care must be taken by the dental healthcare professional to ensure that all instruments are cleaned prior to sterilization, and that this is carried out in a safe manner to avoid injury and puncture wounds.

When using dental ultrasonic scalers, washers and sterilizers, it is important to always follow the manufacturer’s instructions. It is also important to consult with the manufacturer of dental instruments and devices as needed to ensure complete sterilization and to avoid damage to these items. Assurance of sterility of instruments and devices can be obtained through the use of one of several tests, and these tests must be performed regularly to ensure that the sterilizer is sterilizing all instruments and devices and that these are safe for use on patients.

Since many germs can be transferred simply by touching contaminated surfaces, dentists and dental assistants are typically very fastidious about disinfecting the surfaces in their offices and treatment rooms. Solid surfaces, such as counters and sinks, are generally wiped down with antibacterial spray. Dental chairs are also usually covered with disposable paper covers that are discarded after each patient. Dentists and their assistants also usually wear protective barriers, such as gloves and face masks, to help prevent spreading germs to their patients.

Tools that can't be thrown away, such as dental drills, are generally put through a very intensive dental sterilization process. First they are usually vigorously scrubbed by hand. This is usually done with hot water and detergent, and it helps remove any large particles, such as plaque. They may also be placed in a vibrating tray filled with cleaning solution, which can help remove very small particles.

Sterilization in dentistry also involves killing the invisible germs on tools. Dental autoclaves are machines that are commonly used during sterilization in dentistry. These machines are usually made from large metal cylinders, and they are similar to pressure cookers. Once the tools are placed in the autoclave, they are sprayed with high-pressure steam. The high pressure inside this machine helps raise the steam to very high temperatures that are necessary for killing disease-causing micro-organisms.

Tools that are not disposable are generally scrubbed by hand and placed in a machine known as an autoclave. This machine then disinfects the tools by spraying them with very high-pressure steam, which kills most micro-organisms. Any tools that can not be subjected to high heat or moisture are usually disinfected with chemicals.

The Advancements of Dental Air Polisher

First introduced in the 1940s, dental air polisher has changed noticeably since its inception, thanks mainly to advances in materials science. Compared to polishing with a prophy cup and paste, air polishing eliminates the need for direct tooth contact or pressure against the tooth, along with any discomfort from potential heat generated with prophy cups. This technique also offers more efficient biofilm removal, easier access into pits and fissures, and a less abrasive nature than pumice or prophy pastes.

Many hygienists and dentists will be most familiar with sodium bicarbonate powder, one of the first materials introduced for use with early air polishing systems. In my experience, sodium bicarbonate has been an excellent tool for heavy stain removal, but patients react poorly to the salty taste and abrasive feel. Sodium bicarbonate powders generally have a particle size up to 250 μm, and while damage to enamel has not been reported, researchers and manufacturers warn against prolonged use on cementum, dentin, and certain restorative materials such as composites.

Recent developments have brought new options to the market, including glycine, erythritol, calcium sodium phosphosilicate, calcium carbonate, and aluminum trihydroxide (to name a few). It's not necessary to review each in detail, but it's important that hygienists are generally educated on the many options now available for use.

In addition to being less restrictive when it comes to pre-existing patient conditions, two powders can now be used safely in subgingival air polishing: erythritol and glycine. Air polishing has traditionally been thought of as a technique for supragingival plaque and stain removal only; but these new options open the door for effective removal of subgingival plaque and biofilm, even in deep periodontal pockets.

Erythritol, while not currently available in the United States, is a sugar alcohol that has been shown to offer less discomfort, decreased treatment times, and reduced bleeding on probing when compared to scaling and root planing. Glycine is a naturally occurring amino acid that is water soluble, with a non-salty taste that patients often describe as a little bit sweet. This powder offers similar benefits to erythritol, and offers an option that's less abrasive with a particle size approximately four times smaller than sodium bicarbonate.This smaller particle size means that it's safe for all the same supragingival applications as sodium bicarbonate powders, but also offers the option to treat patients with periodontal infections, peri-implantitis, patients on a sodium-restricted diet, and those who have cosmetic or other restorative work.

How to Replace the Dental Sterilizers' Parts

Dental autoclave sterilizers play a significant role in the daily functioning of dental operatories. And recently sterilizers becoming even more advanced and efficient due to advances in technology. 

Automatic Sterilizer now provide an intuitive display and simple prompts that help you easily select the cycle you need…whether it is for unwrapped items, pouches, packs or dental handpieces. Once the sterilization process is complete, the door conveniently opens automatically and quietly to dissipate the steam and provide fast and efficient drying of your instruments.

Sterilizers can be a somewhat costly addition to a dental operatory, the time and money that they save dentists down the road is substantial. Taking a few pointers into consideration and performing routine checks and replacing old parts on your unit can help maximize the life and functioning of your model.

There are a few part replacement tips that can help you get the best results from your sterilizer:

Door Gasket: To replace the door gasket, begin by simply removing the old door gasket. Clean the gasket groove in the door, and chamber face. For easy installation of the new gasket, use the “South-East-West-North” method (i.e. begin installing the gasket at the bottom of the door, then install the left and right sides and finishing at the top by squeezing in any of the excess making sure that the gasket fits flush).

Chamber Filter (sintered bronze style filter): If the machine has only a Chamber Filter – Remove all trays and the rack from the chamber. Clean chamber then remove the old chamber filter. Install a new filter. Reinstall rack and trays.

Chamber & Vent Filters (mesh style filter): If the machine has both a Chamber and a Vent Filter – Remove all trays and the rack from the chamber. Clean the chamber, then remove the chamber filter. Install the new filter. You must also replace the Vent Filter that serves as a filter for the steam trap/bellows and is located in the vent line to the tee fitting. Reinstall rack and trays.

 Sterilizer: After replacing the PM parts, check the reservoir and clean if dirt or debris are present (Note: Debris is the number one reason for Steam Trap/Bellows failure). Refill reservoir with distilled water only. Conduct a temperature check using a Max Register Thermometer. Conduct a pressure check to identify any leaks that may need to be addressed. If calibration is necessary, use the RPI Pressure Gauge and the RPI Trim Pot Tool.