and between patients and staff. Use the following
information when breaking down your DTR and
setting up for your next patient.
DENTAL INSTRUMENTS.You must never
lay contaminated instruments directly on countertops
or work surfaces. Rewrap cassettes, packs, or trays in
the original wrap and place individually packaged
instruments in a leakproof covered container to
transport to the CSR.
LIQUID REGULATED WASTE.Place all
regulated liquid wastes in designated leakproof
containers identified either by the color red or by a
biohazard label. Pour liquid regulated wastes into the
sanitary sewer system through clinical sinks (not
handwashing sinks) or unit cuspidors unless local or
state regulations prohibit this practice.
THREE-WAY SYRINGE TIPS.Disposable
syringe tips are preferred. Sterilizable syringe tips may
also be used if disposable syringe tips are not available.
disposable sharps, such as needles, scalpel blades,
carpules, disposable syringes, used burs, and broken
instruments as regulated waste. Handle these items
with extreme care to prevent any unintentional injury
and the possible spread of bloodborne diseases. Place
used disposable sharps in puncture resistant containers
specifically designed for needles and other sharp
items. The universal symbol for biohazard must
appear on these containers. Do not recap, bend, break,
or otherwise manipulate needles by hand. In the dental
setting, because a patient may require a second
injection of local anesthetic, and most syringes are not
disposable, recapping is sometimes necessary. Use the
following guidelines when recapping:
Never recap a needle using a two-handed
Use one of the commercially available sheath
holders, or use the scoop technique.
If using the scoop technique, the cap is scooped
up from the tray with the needle tip using only
Never allow uncovered needles to remain on the
DENTAL HANDPIECES.Many dental clinics
with CSRs will have you remove the contaminated
handpieces you have used to complete a procedure and
turn them into the CSRs along with your instruments.
The CSR technician will handle, disinfect, lubricate,
and sterilize the dental handpieces. This saves the
dental assistant valuable time and avoids any excess
aerosols that occur during the disinfection and
If your command requires you to perform
handpiece maintenance in the DTR, you should
remove handpieces after each patient, then lubricate
and run them for 30 seconds. (This will also serve to
purge the tubing as stated previously.) This procedure
removes any potentially infectious material from
retraction of coolant water during previous treatment.
Many manufacturers require lubrication of
handpieces before and after sterilization. To prevent
cross-contamination, follow these procedures:
Use two separate containers of lubricant-one
marked for lubrication before sterilization and
another marked for after sterilization.
Lubricate handpieces with one end in a headrest
cover to capture the aerosol contaminants or use
one of the many commercial products for
cleaning and lubricating handpieces.
For disinfecting nonautoclavable handpieces
while wearing gloves, use the following procedures:
Submerge two gauze sponges per handpiece in a
high level, EPA registered disinfectant. Squeeze
out any excess.
Use one sponge to wipe the handpiece and
Wrap the second sponge around the handpiece
and return it to the holder for the period of time
specified by the manufacturer.
Before reuse, wipe the handpiece thoroughly
with potable water to remove residual disin-
If the handpiece is autoclavable, perform the
Remove the handpiece from the couplings,
clean, and lubricate following the manu-
Barrier Clean Up
After you complete the previously mentioned
procedures, remove and discard the disposable
coverings or barriers contacted during patient
treatment while you are still gloved. It is important to
remove the surface covers carefully to prevent
contamination of the covered areas.
accomplished by turning the soiled outer side toward
the inside, or inside-out.