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Volume3 Issue2
S
upporting
Y
our
P
ractice
Use achecklist
Usinga tailoredchecklist for decon-
taminatinganoperatory is considered
abestpractice. Achecklist standardizes
officecleaningprocedures andensures
that noarea ismissed. Agoodgeneral
checklist for operatorydecontamina-
tion should include theseprocedures in
the followingorder:
Flushwaterlines
, includingall air/
water syringes, high speed lines, and
ultrasonic lines, immediately follow-
ing treatment; removehighvolume
suctionandair/water syringe tips
anddiscard if singleuse. Introduce
cleanwater through suction lines
toclear lines. If reusablemetal high
volume suction tips areused, leave
the tiponduringflushing toaid in
lumencleaning. Clean suction traps
after eachpatientor at least at end
of eachday.
Rinse laboratorycases
if this
hasnot alreadybeendoneand
transport to the laboratory for
disinfection.
Transport instruments fordecon-
tamination
andbegindecontam-
ination. At aminimum, ensure that
contaminated instrumentsdonot
becomedryprior tocleaningas this
increases thedifficultyof cleaning.
Removeanddiscardbarriers
(leavingbarriers inplaceprior
to transporting instrumentswill
make it obvious toother staff
that theoperatoryhasnotbeen
decontaminated.)*
Cleananddrypatient chair and
operator andassistant stools.
Dis-
infectants aregenerallynot recom-
mendedonupholsteredmaterials;
followmanufacturer instructions for
cleaning.
Sanitizeanypackagingmaterial
remaining from the last treatment
,
and thendisinfect. At the same time,
cleananddisinfect the rest of the
treatment contact surfaces in the
operatory.
Replacematerialsandunitdose
newmaterials
for nextpatient.
Placenewbarriers
, and transport
sterile instruments to theoperatory
for thenextpatient. Donot open
the instrumentsuntil thepatient is
in thechair toensure that correct in-
strumentshavebeendispensedand
so thatpatient canobserve that the
presented instruments arebagged
and sterile.
*CDC recommends removinganddiscarding
barriersbetweenpatientsand thenexamining
the surface “tomake sure itdidnotbecome
soiled inadvertently. The surfaceneeds tobe
cleanedanddisinfectedonly if contamination
isevident.”
1
Mostofficesassume thebarrierwas
breachedand routinelydisinfect these surfaces
prior toplacingacleanbarrier.
Disinfect countertops at the
expenseof appearance
Whenpurchasingcountertops, consult
thedental officedesignerwho is typi-
cally familiarwith theneed for routine
disinfection. Follow the instructions, if
available, of thecountertopmanufac-
turer. There isprobablynodisinfectant
thatwill effectivelypreserve thecolour
and sheenof acountertopafter being
subjected to the rigorsof disinfection;
however, thebrighter thecolour of the
countertop, thehigher the riskof the
colour becomingdull after constant
disinfectant use.
Use sodiumhypochlorite
solution for laboratory items
Laboratory items (impressions, crowns,
wax rims etc.) shouldfirstbe thorough-
ly rinsedand then immersed ina1/10
dilutionof sodiumhypochlorite solu-
tion (5%or 5.25%),made freshdaily, or
thoroughly sprayedwith the same solu-
tionand left incontact for 10minutes.
After 10minutes, rinseall laboratory
items. Becausenot all alginates canbe
immersed,manufacturer’s instructions
need tobeconsultedprior todisinfec-
tionof alginates. Crowns canalsobe
steam sterilized, but time isgenerallya
limiting factor.
a
THEAUTHORS
Dr.NitaMazurat
Dr.Mazurat is an
associate professor in the
department of restorative
dentistry, college of dentistry,
University ofManitoba.
Dr.SuhamAlexander
Dr.Alexander is in private
practice inOttawaand is
a clinical editor forOasis
Discussions atCDA.
Reference
1.Centers forDiseaseControlandPrevention.Guidelines for InfectionControl inDentalHealth-CareSettings–2003.MorbidityandMortalityWeekly
Report.2003;(52)No.RR-17.
Are the claims of
disinfectants valid?
Source:HealthCanadaGuidanceDocument–Managementof
DisinfectantDrugApplications,2014
“Most chemical products represented
for disinfectant uses onhard, non-por-
ous environmental surfaces and inani-
mate objects are regulated by Health
Canadaasdisinfectantdrugsunder the
FoodandDrugsActandRegulations.
Chemical products regulated as dis-
infectantdrugsmayalsoberepresented
for use as food-contact or non-food
contact sanitizers onhard, non-porous
environmental surfaces and inanimate
objects; these products are referred to
as ‘disinfectantsanitizers.’
Disinfectant Drugs require a pre-mar-
ket assessment and issuance of a drug
identification number (DIN) prior to
being sold in Canada. As part of the
pre-market assessment, the efficacy,
safety andqualityof thedrug is evalu-
ated, and as a condition of market au-
thorization applicants are required to
submitdraft labelling forassessment to
HealthCanada.”
