sterilizers. Monitor and record at least weekly the temperature in the sterilizer well.
If using salt in place of beads in the sterilizer, line the well with aluminum foil to prevent corrosion.
All critical category items require sterilization. Table 10-3 lists a variety of different dental instruments and materials and shows what type of sterilization or disinfection is effective and preferred for each particular item. It also lists methods that are effective and acceptable, effective but risk damage, and ineffective with risk of damage to materials. Sterilize critical category items before turning them in for service or repair.
Following BUMEDINST 6600.10, sterilize critical category items as follows:
Surgical instruments - Effective and preferred methods of sterilization are the steam autoclave, dry heat oven, chemical vapor, or ethylene oxide.
Handpieces - Handpieces include: low-speed motor attachments, sonic scaler, and tips. Follow manufacturer's instructions. See table 10-3, for recommended method of sterilization. Follow manufacturer's instructions for the cleaning of the fiber optic bundle.
Burs and diamonds - Clean burs and diamonds and dry before sterilizing. Many burs and diamonds are used only for single patient use. One accepted method of sterilization for burs and diamonds are to place them in a screw cap glass test tube (fig. 10-13) or an aluminum foil wrapped bur block and dry heat sterilize for 90 minutes at 320-345°F. Place a chemical indicator in each tube or wrapped bur block. At least weekly, place a biological monitor in one tube or foil wrapped block during the first load of the day,. retrieve and send for culture testing following the manufacturer's recommendations.
Endodontic files and Gates-Glidden burs - Arrange sets in file blocks and seal in peel packs before autoclaving. When additional files or burs are necessary, take them from a new package or from a file storage box and sterilize them in a bead or salt sterilizer before use. Use endodontic broaches once and discard into a sharps container. Dental Technician, Volume 2, NAVEDTRA 12573, chapter 7, illustrates and explains endodontic broaches.
Any number of factors can reduce the effectiveness of sterilizers. Overloading and improper wrapping can prevent adequate penetration into the instrument surface. Improper timing, temperature variations, worn gaskets and seals, and sterilizer malfunctions can prevent sterilization. Heat sterilization methods are generally reliable and effective. Nevertheless, regular monitoring of sterilization cycles is necessary to detect inadequate process conditions caused by human error or equipment malfunction.
Commands should base selection of sterilization monitors on reliability, appropriateness to the process, safety, and cost effectiveness. Many types of monitors are available. The three most commonly used sterilization monitors in the Navy DTFs are biological monitors, internal indicators, and external indicators.
BIOLOGICAL MONITORS. - Biological monitors are designed to assess whether sterilization actually occurred. These systems consist of bacterial endospores impregnated in paper strips or sealed in glass ampules or plastic vials.
INTERNAL INDICATORS - Internal indicators are chemical dyes that change color when exposed to steam, dry heat, or chemical vapor for a specified period of time. When placed inside an instrument pack, they determine whether the conditions necessary for sterilization have been met.
EXTERNAL INDICATORS - External indicators are chemical dyes that change color upon short exposure to sterilizing conditions. They are generally printed on packaging materials or supplied in tape form and are necessary to distinguish processed packages from those that have not been cycled. External indicators are not sensitive enough to be processed as an internal indicator and should not be used.
After endospore tests are processed through a sterilization cycle, they must be incubated according to the manufacturer's instructions. A pH indicator in the medium changes color when the ampule of endospores germinate and produce acids. This visually identifies a failure in the sterilization process. As a minimum,Continue Reading