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Cleaning methods for dental instruments

Abstract

It is essential to ensure that reusable dental instruments are scrupulously clean as a first step in the decontamination process. Any residual soil on the surface of equipment creates a risk that will prevent steam, generated during sterilisation, from condensing on the surface of the instrument and raising the temperature to that required to ensure sterilisation. Further, most microorganisms will struggle to attach to the surface of a clean instrument. Adherence of microorganisms to the surface of an instrument that is contaminated with organic soil or the irregular surface of residual dental materials is likely to be greatly enhanced. It is therefore important to ensure that residual dental materials are removed from the surface of instruments, at the point of use, before they are allowed to set.

It is also important to ensure that the methods used to clean dental equipment do not damage the instrument. Any method that has the potential to scratch the surface of an instrument and therefore make it more difficult to clean should be avoided. Aggressive cleaning can lead to removal of the passivation layer, the chromium-rich layer that prevents corrosion occurring, formed on the surface of instruments made from stainless steel. If corrosion forms on the surface of an instrument, the surface becomes roughened and possibly stained. Surface staining can then be difficult to differentiate from other stains or marks caused by retained biological soil. Corrosion on the surface of an instrument will make the effective cleaning of the surface more difficult and therefore corroded or stained instruments should be discarded.

Key points

  • Describes the principles of instrument cleaning.

  • Emphasises the importance that operators carrying out manual cleaning are adequately protected.

  • Confirms that ultrasonic cleaning can be an effective method for cleaning instruments provided the equipment has been validated and an appropriate cleaning solution is used.

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References

  1. ISO. BS EN ISO 15883-1: 2006: Washer-disinfectors - Part 1: General requirements, terms and definitions and tests. 2006.

  2. ISO. BS EN ISO 15883-2: 2006: Washer-disinfectors - Part 2: Requirements and tests for washer-disinfectors employing thermal disinfection for surgical instruments, anaesthetic equipment, bowls, dishes, receivers, utensils, glassware, etc. 2006.

  3. Agilio iLearn. HTM 01-05 Ultrasonic Activity Test Using Aluminium Foil. 2014. Available at https: //youtu.be/8M8ve3k6Lls (accessed June 2023).

  4. Obituary. Martin Roger Fulford. Br Dent J 2020; 229: 586.

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Acknowledgements

This chapter was first originally published in M. R. Fulford and N. R. Stankiewicz (eds), Infection Control in Primary Dental Care, BDJ Clinician's Guides, https://doi.org/10.1007/978-3-030-16307-5_8 © Springer Nature Switzerland AG 2020. Further reading is included in the references list.1,2,3

The BDJ Editorial Team would like to thank the corresponding author of this chapter for granting us permission to republish this chapter within our journal. We would like to take this opportunity to reiterate our condolences for the passing of Martin. R. Fulford, and express our gratitude for all his contributions and services to dentistry during his lifetime. An obituary for Martin was published in the BDJ in 2020 and can be found here: https://www.nature.com/articles/s41415-020-2342-8.4

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Correspondence to Nikolai R. Stankiewicz.

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Fulford, M., Stankiewicz, N. Cleaning methods for dental instruments. Br Dent J 235, 105–111 (2023). https://doi.org/10.1038/s41415-023-6061-9

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  • DOI: https://doi.org/10.1038/s41415-023-6061-9

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