INTRODUCTION
The handling of instruments and equipment in a dental office to avoid cross contamination, is vital if we consider that this depends on the patient's health to the point of jeopardizing his own life.When we speak of asepsis is necessary to make a detailed review of all objects that are susceptible to contamination during procedures that take place so we can design a protocol covering all aspects to be taken into account.
These objects can be distinguished into 5 groups as follows:
1. Disposable material
2. Instrumental sterilizable
3. Teams
4. Surfaces
5. Water pipes unit
WASTE MATERIAL
This group includes the application of anesthesia needles, bibs or fields for patients, and physical barriers (plastic liners). One can not imagine a dentist that does not use disposable needles, in fact currently only get needles for this kind of needles.
The bibs or fields used for each patient must be absorbent paper and plastic as possible below so that fluids do not damage the clothes. They are not recommended plastic bibs that no absorption of fluids. Neither the cloth, unless you have an autoclave for sterilization and use one per patient.
Physical barriers are necessary for all equipment and supplies that can not be sterilized, among which include the dental chair, the handle of the lamp, the instrument trays, connector’s handpieces with their hoses, hose Snuffer saliva, and the phone.
For complete dental chair is difficult to get a plastic cover, but you can line the seat, armrests and the back area which are the points of splash contamination during procedures.
Connectors for handpieces and suction hose for saliva, can be used long thin bags as those used to make ice, and the handle of the lamp in the chair you can buy the balloons and pumps used for children's parties or halved depending on the form this takes.
The way syringe (water-air), may also lined with a bag long making a hole through which the tip. For this it is free and is contaminated with the patient's mouth, and are manufactured in Colombia a triple syringe plastic shields that are perfectly well adjusted and changed with each patient. This produces Quirudent ® and is available in dental deposits.
Sterile instruments
This group includes all the instruments that can be sterilized in either dry heat oven, autoclave or in solution. It is necessary to consider several aspects such as temperature and time of sterilization.
For dry heat oven temperature should be 160 º C -170 º C for a minimum of 1 hour. To the autoclave, the temperature should be 121 º C - 135 º C at a predetermined constant pressure on each apparatus during 35 - 40 minutes.
For sterilization solutions are completely reliable only benzalkonium chloride and glutaraldehyde, the latter being less corrosive to the instruments. After cleaning the instruments to be sterilized, fully immersed in the solution. Disinfection is accomplished in 1 hour and sterilization in 8 hours. These solutions once prepared in this activity for 20 days, after which they are no longer reliable and should be replaced.
EQUIPMENT
These handpieces have high and low speed, and the curing lamp. Almost all current handpieces are autoclavable, with a maximum temperature of 135 º c. The dry heat oven BEARINGS damages. In the absence of an autoclave, immersed in cleaning solution after 8 hours. Once removed from the solution, it is necessary to fully wash and oils to minimize corrosion at BEARINGS.
An office should have minimum 3 high-speed parts. The micro motor that receives the counter-angle and straight piece can be lined with one of these bags I've been talking and there is no risk of contamination. This way you can have a single micro and two or three against angles (low-speed part).
The lamp light cured lining it is not recommended that you must have excellent ventilation to prolong the life of the bulb. This can be disinfected with gauze soaked in a product called Lysol ® disinfectant spray. This product has as active ingredients 79% ethanol and dimethyl benzyl ammonium 0.1%. According to research is the only one that can eliminate 100% of pathogens contaminating the equipment without damaging them?
It is necessary to disinfect the equipment to 10 minutes and dry with the environment. Here in Colombia is achieved only at Fedco stores at an approximate cost of $ 17,000 º, about 8.50 Dollars. In the U.S., costs half. It is a great advantage to purchasing this product with a good use eliminates the problem of computers that can not be sterilized.
SURFACES
The surfaces of the furniture that is contaminated and in general everything that can be moistened to be disinfected with Lysol ® can be treated following the manufacturer's instructions.
DISINFECTION OF WATER PIPES
In a recent study, the CRA or Clinical Research Associates, determined that the contamination in the pipes through which water exits the handpiece high speed and the syringe can be detrimental to the health of patients. This study tested various disinfecting solutions that are available in the U.S. market, of which only achieved in Colombia glutaraldehyde and sodium hypochlorite known as Clorox ® at 0.53%. Both are equally effective.
Glutaraldehyde is used pure and left all night, but has the disadvantage that it is expensive considering that it must be done every day. The Clorox ® is supremely economical but has the drawback that should be diluted 1:10. It also stops all night.
Procedure:
We need to have a dental unit container or tank to store water that is used with patients, meaning that the pipes are not connected directly to the aqueduct. Once you're finished with daily consultations, removes all handpieces their respective connectors and added the 1:10 Clorox ® solution. Then it is swept by each of the pipes so that these are filled with the solution overnight. The next day the solution is removed and replaced by water to circulate through the pipes and remove all the Clorox ® that may exist.
If UD. Following all previous recommendations, can assure their patients that their practice is actually sterile.
Remember, the only way to prevent cross-contamination is assumed that all patients are contaminated.
Ruben Dario Giraldo M.
Source: Journal Infodent
The handling of instruments and equipment in a dental office to avoid cross contamination, is vital if we consider that this depends on the patient's health to the point of jeopardizing his own life.When we speak of asepsis is necessary to make a detailed review of all objects that are susceptible to contamination during procedures that take place so we can design a protocol covering all aspects to be taken into account.
These objects can be distinguished into 5 groups as follows:
1. Disposable material
2. Instrumental sterilizable
3. Teams
4. Surfaces
5. Water pipes unit
WASTE MATERIAL
This group includes the application of anesthesia needles, bibs or fields for patients, and physical barriers (plastic liners). One can not imagine a dentist that does not use disposable needles, in fact currently only get needles for this kind of needles.
The bibs or fields used for each patient must be absorbent paper and plastic as possible below so that fluids do not damage the clothes. They are not recommended plastic bibs that no absorption of fluids. Neither the cloth, unless you have an autoclave for sterilization and use one per patient.
Physical barriers are necessary for all equipment and supplies that can not be sterilized, among which include the dental chair, the handle of the lamp, the instrument trays, connector’s handpieces with their hoses, hose Snuffer saliva, and the phone.
For complete dental chair is difficult to get a plastic cover, but you can line the seat, armrests and the back area which are the points of splash contamination during procedures.
Connectors for handpieces and suction hose for saliva, can be used long thin bags as those used to make ice, and the handle of the lamp in the chair you can buy the balloons and pumps used for children's parties or halved depending on the form this takes.
The way syringe (water-air), may also lined with a bag long making a hole through which the tip. For this it is free and is contaminated with the patient's mouth, and are manufactured in Colombia a triple syringe plastic shields that are perfectly well adjusted and changed with each patient. This produces Quirudent ® and is available in dental deposits.
Sterile instruments
This group includes all the instruments that can be sterilized in either dry heat oven, autoclave or in solution. It is necessary to consider several aspects such as temperature and time of sterilization.
For dry heat oven temperature should be 160 º C -170 º C for a minimum of 1 hour. To the autoclave, the temperature should be 121 º C - 135 º C at a predetermined constant pressure on each apparatus during 35 - 40 minutes.
For sterilization solutions are completely reliable only benzalkonium chloride and glutaraldehyde, the latter being less corrosive to the instruments. After cleaning the instruments to be sterilized, fully immersed in the solution. Disinfection is accomplished in 1 hour and sterilization in 8 hours. These solutions once prepared in this activity for 20 days, after which they are no longer reliable and should be replaced.
EQUIPMENT
These handpieces have high and low speed, and the curing lamp. Almost all current handpieces are autoclavable, with a maximum temperature of 135 º c. The dry heat oven BEARINGS damages. In the absence of an autoclave, immersed in cleaning solution after 8 hours. Once removed from the solution, it is necessary to fully wash and oils to minimize corrosion at BEARINGS.
An office should have minimum 3 high-speed parts. The micro motor that receives the counter-angle and straight piece can be lined with one of these bags I've been talking and there is no risk of contamination. This way you can have a single micro and two or three against angles (low-speed part).
The lamp light cured lining it is not recommended that you must have excellent ventilation to prolong the life of the bulb. This can be disinfected with gauze soaked in a product called Lysol ® disinfectant spray. This product has as active ingredients 79% ethanol and dimethyl benzyl ammonium 0.1%. According to research is the only one that can eliminate 100% of pathogens contaminating the equipment without damaging them?
It is necessary to disinfect the equipment to 10 minutes and dry with the environment. Here in Colombia is achieved only at Fedco stores at an approximate cost of $ 17,000 º, about 8.50 Dollars. In the U.S., costs half. It is a great advantage to purchasing this product with a good use eliminates the problem of computers that can not be sterilized.
SURFACES
The surfaces of the furniture that is contaminated and in general everything that can be moistened to be disinfected with Lysol ® can be treated following the manufacturer's instructions.
DISINFECTION OF WATER PIPES
In a recent study, the CRA or Clinical Research Associates, determined that the contamination in the pipes through which water exits the handpiece high speed and the syringe can be detrimental to the health of patients. This study tested various disinfecting solutions that are available in the U.S. market, of which only achieved in Colombia glutaraldehyde and sodium hypochlorite known as Clorox ® at 0.53%. Both are equally effective.
Glutaraldehyde is used pure and left all night, but has the disadvantage that it is expensive considering that it must be done every day. The Clorox ® is supremely economical but has the drawback that should be diluted 1:10. It also stops all night.
Procedure:
We need to have a dental unit container or tank to store water that is used with patients, meaning that the pipes are not connected directly to the aqueduct. Once you're finished with daily consultations, removes all handpieces their respective connectors and added the 1:10 Clorox ® solution. Then it is swept by each of the pipes so that these are filled with the solution overnight. The next day the solution is removed and replaced by water to circulate through the pipes and remove all the Clorox ® that may exist.
If UD. Following all previous recommendations, can assure their patients that their practice is actually sterile.
Remember, the only way to prevent cross-contamination is assumed that all patients are contaminated.
Ruben Dario Giraldo M.
Source: Journal Infodent
