1. Cleaning, Packaging & Sterilization of Dental Instruments

2. Presented by SPSmedical
Largest sterilizer testing Lab in North America with over 50 sterilizers
Develop and market sterility assurance products that offer advanced technologies
Provide full day sterilization Seminars and Facility audits for compliance with standards and recommended practices
Corporate member: CSA and AAMI, serving on numerous sterilization committees

3. Continuing Education Program
Following established protocols
for instrument processing is an
important aspect of modern dental
care as it helps to minimize the
patient’s risk for infection.
This program is intended to provide
an “overview” of current recommended
CDC guidelines and is approved for 1.0 credit (category
4) by DANB (Dental Assisting National Board).

4. INSTRUMENT PROCESSING
There are 6 recommended
steps for Instrument
Processing:
Cleaning
Inspection
Packaging
Sterilization
Storage & Delivery
6. Quality Assurance

5. CLEANING Cleaning is the first and most important step which should be
performed in a designated area,
ASAP wearing PPE.
Quick cleaning removes blood
much easier, and can minimize
instrument staining, corrosion
and/or pitting.

6. CLEANING Mechanical cleaning is a safer practice for staff and is much
more effective over manual
cleaning.
Therefore, whenever possible,
mechanically clean instruments,
using warm water and a neutral
pH detergent.

7. CLEANING After cleaning, thoroughly rinse
instruments with tap water and
ensure all debris and detergent
residue is removed.
If the tap water is of poor quality,
consider using treated water as a
final rinse to avoid instrument
staining.

8. INSPECTION Each instrument should be critically inspected after
each cleaning for residual
debris or damage.
Replace instruments as
needed and never sterilize
a “dirty” instrument.

9. INSPECTION In addition, check each instrument for proper
function and lubricate as
required by the instrument
manufacturer.
Hinged instruments with
stiff joints may be a sign
of inadequate cleaning..

10. PACKAGING Instrument packaging should be done in a clean and low
contamination area, using
FDA approved products:
Sterilization pouches
Sterilization wrappers
Sterilization containers

11. PACKAGING Sterilization pouches are for packaging single instruments
and small, light weight items.
Paper/plastic pouches allow
you to see the contents and
come with a build in adhesive
strip for seal sealing. It is important to remove all
excess air, prior to sealing the sterilization pouch.

12. PACKAGING For quality assurance, be sure
to include a chemical indicator
or integrator inside each pouch.
Per CDC guidelines, this will
verify sterilization parameters
were met inside as well as
outside the pouch (time,
temperature, and sterilant
contact).
Indicator
Integrator

13. PACKAGING
To assist sterilization and aid drying, place pouches facing each other and on edge using a divider.
Pouch dividers are part of the SPSmedical product line.

14. PACKAGING Sterilization wrap is ideal for packaging dental cassettes.
For sterility maintenance, be sure to use two layers of
wrap per industry
standards, and the
wrap mfg’s FDA
clearance.

15. PACKAGING For quality assurance, use indicator tape to seal and be
sure to include a chemical
indicator or integrator inside,
to verify sterilization
parameters were met.
For staff and patient safety,
consider using a latex free
indicator tape.

16. STERILIZATION Heavier wraps should be placed on the lower shelf of
the sterilizer and pouches
(being lighter) on the top,
on edge.
This enables condensate to
drain out without wetting
other items in the load.
To maintain sterility, packages should be visibly dry before transporting to a sterile storage area

17. STERILIZATION Sterilizers are Class 2 medical
devices requiring FDA clearance.
They are available in a variety of
sizes with the following processes
most common to dental:
Steam
Chemical vapor
Dry heat / Rapid heat transfer

18. Chamberland autoclave built in 1880
STERILIZATION
Saturated steam under pressure
is one of the oldest methods
used to sterilize dental
instruments.
The CDC recommends steam
sterilization as the process of
choice, because it is efficient,
fast, and inexpensive.
Chamberland autoclave built in 1880

19. STERILIZATION By heating distilled water under
pressure, moist heat is created
and rapidly kills microorganisms.
Some common steam sterilizer
cycle parameters are:
250°F/121°C for 30 minutes
270°F/132°C for 10 minutes
273°F/135°C for 4 minutes
Dry times are additional and can be from 20 to 40 minutes, depending on load.

20. STERILIZATION Chemical vapor sterilizers are available with a pre-set
cycle of 270°F/132°C for
20 minutes exposure.
This proprietary process
uses a chemical solution,
instead of distilled water,
that rapidly kills micro-
organisms.
OSHA requires a Material Safety Data Sheet on the chemical solution used for this proprietary sterilization process

21. STERILIZATION Dry heat sterilizers are common
in dentistry for instruments and
materials that can withstand
very high temperatures.
Static air dry heat sterilizers
are similar to an oven, as they
utilize heating coils to transfer
heat to the instruments over
long exposure times.
Static air dry heat sterilizers typically operate at 320°F/160°C for 1 to hours exposure time

22. STERILIZATION Forced air dry heat sterilizers are
also called “rapid heat transfer”
sterilizers and they circulate hot
air during the cycle reducing the
time needed for sterilization.
This type of dry heat sterilizer is
capable of sterilizing unwrapped
instruments in as little as 6 mins.
Forced air dry heat sterilizers operate at a range of 375°F to 420°F depending on the manufacturer

23. Storage & Delivery Sterile items should be stored
in a manner that reduces the
potential for contamination.
The shelf-life of sterile items
is event related and depends
on the quality of the packaging
material, storage conditions and
amount of handling.

24. ____________ Storage & Delivery Sterile packages should always
be handled with care. Avoid
dragging, crushing, bending,
compressing or puncturing, as
this can compromise sterility.
Be sure to inspect sterile
packages before distributing.
Do not use any package that is
damaged, wet or opened.
Sterilant
Microbes
____________

25. Storage & Delivery Special Note: Opening sterile packages
at point of use, increases
patients’ confidence.

26. Quality Assurance
Sterility assurance of processed instruments should be
routinely verified using three (3) types of indicators:
1) Physical
2) Chemical
3) Biological

27. Quality Assurance Physical indicators are the
time, temperature and pressure
gauges built into sterilizers.
These readings should be
recorded for every cycle and verified prior to unloading
the sterilizer. Hospital sterilizers are required to have a
chart or printout, whereas this is optional for sterilizers
located in private offices or clinics.

28. Quality Assurance 2) Chemical indicators should
be on the outside and inside of
all packages to visibly show
they have been processed.
Class 5 chemical indicators FDA cleared as equal in performance to
a BI are called “integrators”. Use of steam integrators is common in hospitals an growing in dentistry.

29. Quality Assurance 3) Biological indicators provide
users the highest level of sterility
assurance and contain bacterial
spores available in plastic vial or
paper strip format.
The CDC recommends all sterilizers be spore tested at
least weekly, and every load that contains an implant.

30. Quality Assurance
Biological indicators are processed along with a normal
load. After processing, self-contained spore vials are
activated by crushing the side of the plastic vial and
then incubated.
Sterilizer failure is noted if the
spores in the vial grow during
incubation. Growth is observed
by a color change in the media
from purple to yellow.

31. Quality Assurance Biological indicators can also
be sent to an outside Lab for
3rd party verification.
After processing the BI strip
along with a normal load, the
processed strip along with an unprocessed strip are sent
to an independent lab for incubation. Test results are
returned via mail or fax, with some services offering
electronic record keeping.

32. Quality Assurance Mail-in spore testing of sterilizers
is very popular with private
offices.
For user convenience, SPSmedical
test reports are also posted online* at

33. Quality Assurance While sterilizers can and do
mechanically fail, operator
error is the leading cause of
sterilizer failure, e.g.
Cold start
Wrong cycle
Overloading
Improper packaging
Sterilizers that fail the spore test, should not be used until a passed test is recorded

34. SPSmedical thanks you for taking the time to review…
The six 6 recommended
steps for Instrument
Processing:
Cleaning
Inspection
Packaging
Sterilization
Storage & Delivery
6. Quality Assurance

35. Cleaning, Packaging and Sterilization of Dental Instruments
THANK YOU!
SPSmedical Supply Corp.
Sterilization Products & Services
6789 W. Henrietta Road
Rush, NY USA
Fax: (585)
Ph: (800)
Website:
© , SPSmedical Supply Corp.
Cleaning, Packaging and Sterilization of Dental Instruments
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