completion of the sterilization cycle, open the test pack
and evaluate the dosage indicator to see if it passes or
fails the cycle. If it passes, you can distribute the sterile
goods and continue the biological test procedure. If it
fails, follow the procedures under guidelines for
internal and external indicators.
biological monitoring occurs, you must follow these
Notify the ICO and record the test results in the
If another sterilizer is available, perform the
Retrieve and resterilize all items sterilized
since the last negative test of that sterilizer
Process a test pack with both a chemical and
biological monitor and secure the sterilizer
from further use until the results of the
biological and chemical tests are read.
If the results of the biological and chemical
tests indicate negative growth or pass the
sterilization test, the sterilizer can be placed
If the results from the test still indicate
positive growth or failure of sterilization,
the sterilizer must be secured and dental
repair personnel notified.
If another sterilizer is not available, perform the
Notify dental repair personnel.
Retrieve and resterilize all items processed
since the last negative test. Use a test pack
with a biological and chemical monitor in
each load when resterilizing all items that
came up positive from the last test.
If a chemical monitor in the test pack
indicates a pass of the sterilization test, these
loads can be distributed if necessary. The
ideal situation is to have adequate
instruments and equipment to be able to hold
these items for 48 hours after a negative
biological test and then distribute.
If the biological test again fails, secure the
sterilizer and notify dental repair personnel,
and the ICO.
Make a narrative entry in the log of each action
taken and the results as they occur.
Retest the sterilizer using biological monitors.
Confirm exposure of the biological monitor to
Review the sterilization log for recent repairs or
GUIDELINES FOR INTERNAL AND
indicators inside and external indicators on the
outside of each instrument pack. When using glass
test tubes during dry heat sterilization, ensure an
internal indicator is in each test tube before the screw
top is secured. When any indicator of a load test pack
fails, resterilize it with a new test pack containing
both chemical and biological monitors. Be sure to
closely monitor the temperature, pressure, and
sterilizing time of the load. Watch the timer to be sure
it does not start before the correct temperature is
reached. Watch for steam leaks from the sterilizer
during the sterilization cycle. If the indicator again
fails, notify the ICO and dental repair personnel. Log
in the results from the failure, and secure the sterilizer
from use until the results of the biological monitor can
Follow the manufacturers instructions when
reading the indicators. Please be aware that internal
and external indicators are not replacements for
biological monitoring. Only biological monitoring
can tell you whether or not sterilization has actually
sterilants cannot be biologically monitored, their use
is discouraged. In using these agents, the key is the
time that instruments and equipment are in contact
with the sterilizing agents. Test strips for
concentration levels must be used according to
Disinfection is a less lethal process than
sterilization, which kills disease causing micro-
organisms. This does not include the destruction of
resistant bacterial spores. Disinfection is achieved by
either chemical or heat means.
appropriate chemical germicide or heat disinfection
method depends on what requirements need to be met