Sterilization

Sterilization in Dental Practice
Sterilization is a critical process in dental practice, ensuring that all
forms of life, including the most resistant bacterial spores, are eliminated
from instruments that come into contact with mucosa or penetrate oral tissues.
This guide outlines the accepted methods of sterilization, their requirements,
and the importance of biological monitoring to ensure effectiveness.

Sterilization: The process of killing all forms of
life, including bacterial spores, to ensure that instruments are free from
any viable microorganisms. This is essential for preventing infections and
maintaining patient safety.

Accepted Methods of Sterilization
There are four primary methods of sterilization commonly used in dental
practices:
A. Steam Pressure Sterilization (Autoclave)

Description: Utilizes steam under pressure to achieve
high temperatures that kill microorganisms.
Requirements:
Temperature: Typically operates at 121-134°C
(250-273°F).
Time: Sterilization cycles usually last from 15 to
30 minutes, depending on the load.
Packaging: Instruments must be properly packaged to
allow steam penetration.



B. Chemical Vapor Pressure Sterilization (Chemiclave)

Description: Involves the use of chemical vapors (such
as formaldehyde) under pressure to sterilize instruments.
Requirements:
Temperature: Operates at approximately 132°C
(270°F).
Time: Sterilization cycles typically last about 20
minutes.
Packaging: Instruments should be packaged to allow
vapor penetration.



C. Dry Heat Sterilization (Dryclave)

Description: Uses hot air to sterilize instruments,
effectively killing microorganisms through prolonged exposure to high
temperatures.
Requirements:
Temperature: Commonly operates at 160-180°C
(320-356°F).
Time: Sterilization cycles can last from 1 to 2
hours, depending on the temperature.
Packaging: Instruments must be packaged to prevent
contamination after sterilization.



D. Ethylene Oxide (EtO) Sterilization

Description: Utilizes ethylene oxide gas to sterilize
heat-sensitive instruments and materials.
Requirements:
Temperature: Typically operates at low temperatures
(around 37-63°C or 98.6-145°F).
Time: Sterilization cycles can take several hours,
including aeration time.
Packaging: Instruments must be packaged in
materials that allow gas penetration.




Considerations for Choosing Sterilization Equipment
When selecting sterilization equipment, dental practices must consider
several factors:

Patient Load: The number of patients treated daily will
influence the size and capacity of the sterilizer.
Turnaround Time: The time required for instrument reuse
should align with the sterilization cycle time.
Instrument Inventory: The variety and quantity of
instruments will determine the type and size of sterilizer needed.
Instrument Quality: The materials and construction of
instruments may affect their compatibility with certain sterilization
methods.


Biological Monitoring
A. Importance of Biological Monitoring

Biological Monitoring Strips: These strips contain
spores calibrated to be killed when sterilization conditions are met. They
serve as a reliable weekly monitor of sterilization effectiveness.

B. Process

Testing: After sterilization, the strips are sent to a
licensed reference laboratory for testing.
Documentation: Dentists receive independent
documentation of monitoring frequency and sterilization effectiveness.
Failure Response: In the event of a sterilization
failure, laboratory personnel provide immediate expert consultation to help
resolve the issue.