Week 7 Reprocessing Instruments

Question 1

Instrument
Processing

Answer 1

Question 2

Sterilization and Disinfection

Answer 2

Sterilization
> process intended to kill all microorganisms
• highest level of microbial kill that can be achieved
> The bacterial endospore is selected as standard…Why?
What is Sporicidal?
Disinfection
• less lethal process than sterilization
> intended to kill disease-producing microorganisms but not bacterial endospores

Question 3

Lower resistance

Answer 3

Question 4

HIGHER RESISTANCE

Answer 4

Question 5

Three Types of Sterilization used in dentistry

Answer 5

Question 6

Categories of Patient Care Items as per CDC:

Answer 6

1. Critical- items to be cleaned and sterilized by heat
2. Semicritical- items to be cleaned and sterilized by heat or if heat sensitive must use a high-level disinfectant.
3. Noncritical- treated with low-level disinfectant if no blood is visible.
   • Blood visible- intermediate disinfectant
   **The classification is based on the potential risk of infection during use of the items.

Question 7

Critical

Answer 7

Critical
•
Penetrates Soft tissue, bone, or enters bloodstream
•
Example: Surgical instruments, scalers, blades, surgical dental burs

Question 8

Semi critical

Answer 8

SemiCritical:
• Contacts mucous membranes but wont penetrate soft tissue, contact bone, nor enter into/contact the
bloodstream.
• Example: dental mirror, reusable dental impression trays, dental handpieces.

Question 9

Non-critical

Answer 9

NonCritical:
• contacts intact skin
• Example: BP cuff, stethoscope, lead apron, pulse oximeter

Question 10

BioBurden means?
Cleaning and inspection

Answer 10

Essential step before any sterilization or disinfecting procedure
BIOBURDEN: presence of microorganisms on g surface or item, prior to sterilization ( blood, saliva. fissue fluids, dental materials, etc)
Two basic types of dental instrument cleaning systers ( FDA)
vat are safe and effective:
Ultrasonic cleaners
Instrument washers/ washer- disinfectors
Cleaned instruments need to be visually inspected for

Question 11

Corrosion Control, Drying and
Lubrication

Answer 11

Carbon steel will rust during STEAM STERILIZATION
. Sterilize using dry heat or unsaturated
chemical vapor
• Can dip in a rust inhibitor (ex: sodium nitrite)
• Use stainless steel type instruments

Question 12

Steam Autoclave

Answer 12

Standard cycles
20-30 minutes at 121 C( 250 F) OR 3.5- 10 minutes at 132
C (270 F)
Drying cycle occurs at the end (make sure items are dry to reduce wicking or tearing
Immediate -use cycles: 3-10 minutes at 134 C (273 F)
Don’t stack packages flat. Place items on their edge,
separated
How to NOT place packages in sterilizer-

Question 13

Unsaturated Chemical Vapor Sterilization

Answer 13

Unsaturated Chemical Vapor Sterilization
• involves heating a special chemical solution in a closed
-chamber, producing hot chemical vapors that kill
microorganisms(formaldehyde, ethanol)
• Proper ventilation is needed
• Be careful not to breathe in vapors
• AKA Chemiclave
• Advantages:
1. reduces or eliminates corrosion of carbon steel instruments (instruments must be dry prior)
2. 20 mins cycles at 132.2 C( 270 F)

Question 14

Dry Heat Sterilization

Answer 14

• Higher temperatures required to heat air
• Carbon steel items do not corrode
1. Static air type(oven type) of dry heat sterilizer:
• heating coils (1-2 hrs) at 160 C(320 F)
• Cannot open until cycle is complete,
• use of proper packaging materials.
2. Forced air(rapid heat transfer) type:
• heated air circles chamber at high velocity (6-12min
• 12 min at 190.6 C ( 375 C)- wrapped
• 6 min at 190 at 190.6 C -Unwrapped

Question 15

Logging the Sterilization Process ( CDHO IPAC)

Answer 15

СОПО
IPAC)
A log book must be maintained for each load sterilized. This is a key component of the recall protocol as it allows for identification of clients who may have been exposed to non-sterile instruments or equipment.
Ihe log book needs to include:
o
1. Date
• 2. Load number
3. Time cycle started
4. Cycle parameters (total time of cycle, pressure and temperature
reached)
5. Load contents
6. Internal and external chemical indicator results (pass or fail)
7. Biological and chemical indicator results via BI and CI PCDs (pass or fail)

Question 16

Sterilization Monitoring
Three common types of monitoring used in dental offices:

Answer 16

Biological monitoring (spore testing):
uses live spores
Chemical monitoring-Uses heat-sensitive chemicals
Mechanical monitoring-observation of gauges and displays on the sterilizer (temperature, pressure, exposure time)

Question 17

Chemical Monitoring

Answer 17

Chemical Monitoring
• Involves use of heat-sensitive chemicals to asses the physical conditions during sterilization
• use of indicators that change color or physical form when exposed to high temperatures or to certain combinations of time, temperature, and the presence of steam.
Two locations for chemical indicators:
1. EXTERNAL:
ㅇ
Indicators that change color after a certain temperature has been reached
2. INTERNAL:
ㅇ
Integrated indicators that change color or form slowly,
ㅇ
respond to a combination of time and temperature toronio College

Question 18

Six classes of Cl’s

Answer 18

Class 1: external- shows the package has been exposed to the sterilization
process
Class 2- for specific test procedures, such as Bowie-Dick test; does not test
sterilization but air removal in vacuum steam sterizers
Class 3- internal: react to a single critical variable ( temp. 121C reached)
Class 4 - multivariable, internal two or more variables- temp., time,
pressure)
Class 5- integrating internal- react to all critical variables
Class 6 - emulating internal react to all critical variables

Question 19

Mechanical Monitoring

Answer 19

• Involves observation of gauges and displays on sterilizer and
• recording of sterilizing temperature, pressure, and exposure time.
Note: correct readings do not guarantee sterilization, incorrect readings can give first indication that a problem likely has occurred.

Question 20

Mechanical Monitoring

Answer 20

Mechanical Monitoring
• Sterilizer gauges and displays indicate conditions in sterilizer chamber rather than conditions within packs, pouches, or cassettes being processed.
• May not detect problems resulting from overloading, improper packaging material, or use of closed containers.
D
• Mechanical monitoring alone will not detect all potential problems that may cause sterilization failure.

Question 21

Sterilization monitoring

Answer 21

Sterilization Monitoring
o Remove items from sterilizer, wait until after dry cycle with steam sterilizers.
o Observe external chemical indicators for proper reaction; o Retrieve biological indicators for analysis; observe internal chemical indicators ostore or distribute packages to chairside o Maintain sterility assurance records:
> date and conditions of sterilization
> results of mechanical, biological, and chemical indicators. o Sterilize reusable heat-labile items (e.g., some plastic items) in a liquid sterilant, rinse, and package in clean packaging materials College