1. Clean? Disinfect? Sterilize? What does it all mean??
DA 116 Infection Control

2. Instruments, supplies, equipment, surfaces
After each patient treatment procedure is completed

3. it cannot be disinfected**
Clean? (“pre-clean”)
_________________________________
Reduce the number of microbes and remove bioburden
Prevent debris from harboring microorganisms during sterilization process
**if a surface is not
CLEAN
it cannot be disinfected**
Remove all disposables and contaminated items from operatory first
Use soap and water OR an EPA-registered product that cleans and disinfects

4. __________________ the operatory
_________________________

5. Pre-Cleaning Instruments preferred method: mechanical cleaning
______________________
______________________

6. _____________? _______________________________
NOT the same as sterilization
Kills most disease-causing microorganisms, but not spores
Non-pathogenic microorganisms may remain on an object after disinfection
Use an EPA-registered hospital disinfectant with tuberculocidal, HIV, and HBV claims
Note: Hydrogen Peroxide is NOT an acceptable disinfectant

8. Levels of Disinfection:
____________________: (actually cleaning)
Least effective. Does not kill spores or Tuberculosis
_____________________ level disinfection:
Kills TB, which is the most difficult to kill as spores
If you use a process that kills TB spores, you will also be able to kill other organisms that are easier to kill (HBV and HIV)
__________________________disinfection:
Kills some, but not all bacterial spores, including TB as well as other bacteria, fungi and viruses
Almost as effective as true sterilization but not as thorough

9. Disinfectant Comparisons note: hydrogen peroxide and rubbing alcohol are NOT OSHA approved disinfectant
Disinfectant
Level
Advantages
Disadvantages
Required times
Glutaraldehyde
High
disinfect impressions
Corrosive
Eye irritation
10-90 min.
Iodophor
Intermediate
Fast acting
Residual activity
Cleans and disinfects
discoloration
10 min on surface
Complex (synthetic) Phenolics
Clean and disinfect
Skin/mucous irritation
No use on plastics
10 min
Chlorines
economical
Corrosive, skin irritation, must prepare daily
2-10 min

10. __________________ How to Use:
For surface disinfection – use the 2 step method.
• Clean by wiping surfaces thoroughly with disinfectant and paper towels or 4 x 4 gauze to remove all soils.
• Disinfect by reapplying disinfectant, keeping surfaces wet for 10 minutes. Wipe off excess solution after contact time is completed. Place barriers.

11. ________________________
How to Use:
For surface disinfection – use the 2 step method.
• To clean, remove one or more wipe towelettes and wipe surfaces
thoroughly to remove all soils. Discard used wipe towelettes.
• Remove one or more additional fresh wipe towelettes. Reapply
disinfectant to previously cleaned surfaces for a 10 minute contact time.

12. Additional Disinfecting Concerns:
_____________________
____________________
Film holders and positioners for digital radiographs should be heat sterilized between patients, UNLESS they are disposable items.
Sensors for digital radiographs cannot be sterilized and should be covered with a new barrier sleeve for each patient.
All items used in the mouth should be cleaned and soaked in a high level disinfectant before sending to the laboratory for processing.

13. __________?
_______________________________ _______________________________
destroys all living microorganisms, including bacterial spores and viruses. Kills good and bad microorganisms, all life
After proper sterilization, no microorganisms will be alive
Heat or Liquid Chemical

14. Steam under pressure
_____________________
______________________

15. Autoclave: Uses moist heat to sterilize
Steam under pressure is considered the sterilizing agent
_____________________________
For ______________for wrapped instruments
30 minutes for porous materials
Avoid overloading or wrapping instruments too tightly
Steam must circulate to all surfaces

16. Rapid Heat Sterilization
AKA ‘Statim’
Works like a convection oven, high temperature plus circulating steam
_____________________for wrapped items
___________________for unwrapped items

17. _________________________

18. Chemical Vapor Sterilization:
Combination of heat and _______________________(produces hot vapors of alcohol and formaldehyde that act as sterilizing agent)
Chemicals used: alcohol, acetone, ketone, formaldehyde and distilled water
Advantage:
No corrosion or dulling of instruments
Instruments are dry at end of cycle
All instruments which can be autoclaved, can be chemiclaved
Disadvantage: needs well ventilated area due to odor
__________________________________________
Clean, rinse and dry instruments well before sterilizing; wrap loosely

19. _________________________

20. Dry Heat Sterilization:
“Baking” – high temperature is sterilizing agent
_______________________________________
Advantage: no rust or corrosion or dulling sharp edges
Disadvantage: some plastics, gauze, impression trays cannot tolerate high temperatures, can cause damage
Instruments must be clean and dry prior to sterilization
Usually requires special metal instrument trays used during sterilization

21. _____________________
______________________

22. Glass Bead Sterilizer:
__________________
Previously used chairside during endodontic procedures to sterilize files between canals – used on the same patient
Consists of glass beads, metal beads and salt
450 degrees F, for seconds
The set of files are then autoclaved between patients

23. Ethylene Oxide Sterilizer
This is another chemical sterilization method
Considered a poisonous gas
Runs on a hour cycle
Used in hospitals but not in dental settings

24. Liquid Sterilant (cold sterilant or high-level disinfectant)
________________ product

25. Liquid Sterilants: AKA “Cold Sterilants”
Destroys all microorganisms IF exposed long enough to the sterilant
Disadvantage:
Time consuming (10 – 16 hours)
No bacterial spore test available; May use a color monitor dip stick to test the strength
Whenever new item is added, time is reset to ten hours
Toxic chemicals: glutaraldehyde;
_______________________________________
Advantage:
No packaging; will not harm heat sensitive items
Clean and dry everything before immersion; any water will dilute solution and lower effectiveness
After cycle, must rinse with sterile water; dry with clean towels, and wrap in clean packaging

26. Sterilization Monitoring
Biological monitoring with spore tests:
Liquid Disinfectant Monitoring: color monitor dip stick
(not a spore test)
Process indicators