Volume 7 • 2020 • Issue 4

Infection Prevention and Control at the Dental Office •  Note expiry dates for packaging materials. This means that the packaging needs to be used in the sterilization process prior to that date. •  Follow the manufacturers’ instructions for the numbers of instruments suggested for the packaging. Request this information if it is not available in the Manufacturers’ Instructions for Use (MIFUs). The rationale is that if the instruments are loose (as opposed to being in cassettes), even when laid flat in a single layer in the sterilizer, they must not contact other instruments during sterilization as steam may not be able to touch every surface. •  Purposefully binding instruments together with commercial binding products that resemble rubber bands or ponytail holders does not allow steam to reach the surface of every instrument and should be avoided. The placement of numerous instruments in a package and use of binding products were used when dry heat was an acceptable method of sterilization in Canada. •  Packaging must be intended for health care reprocessing purposes and labelling needs to be safe and compatible with the packaging. All labelling must be compliant with standards required for labelling including use of print/ink that is non‑toxic and is intended for use in health care settings. This includes the type of marker used and the type of adhesive used for labels. •  All packages must be labelled. The rationale for labelling is to allow efficient and effective recall when needed and for instrument and device traceability for patient care. •  Labelling is performed using health care approved labels or writing using soft-tipped markers that are approved for the sterilization process. Labels and writing are only placed on the plastic side of plastic/paper peel pouches or on the tape when using wrappers so that steam is not prevented from being drawn properly into the package. •  Packaging, unless otherwise directed, is single use only. •  Packaging that comes as a tube or roll is intended to be sealed with a heat sealer, not tape. •  Self-sealed packages must be sealed with the enclosure perfectly folded without creases or wrinkles. •  Avoid mixed packages (for example, different metals) and metals with textiles unless the MIFUs from the packaging allow it. •  Only use a package within a package if the MIFUs state that this can be done. •  Package for aseptic presentation, which means that the instrument is packaged to allow the grip end to be at the opening or chevron end of the package. Pouches have a chevron that demonstrates which end is the opening end. •  Instruments that are sharp and packaged separately in peel pouches should be protected with tip protectors. •  All hinged instruments need to remain open during cleaning and reprocessing. Inserts that resemble heavy paper cards with slots maintain instruments in an open position during sterilization and clips manufactured for this purpose perform the same function when cassettes are used for packaging. •  Packages of sterile instruments that are compromised following reprocessing (including, but not limited to, being torn, punctured, or dropped) need to be reprocessed as if they had been used for patient care. Similarly, packaged instruments removed from storage and brought into a patient treatment area that remain unopened, but were exposed to aerosols during patient care, need to be reprocessed as if they had been contaminated. •  Sterilization of instruments and devices that are not packaged, formerly called ‘flash sterilization’ now termed Knowor determine the type of sterilizers that are used in your practice as this will determine which parameters to follow for MIFUs when sterilizing. S upporting Y our P ractice