Disinfection Demystified (DACP 112 W3L2)

Disinfection Demystified

instruments, Surfaces, & product efficacy

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What is Disinfection?

What is disinfection?

Disinfection refers to processes using chemical agents that destroy most microorganisms.

Disinfection is crucial for controlling disease-producing pathogens remaining on surfaces after sanitizing.

Disinfection does not kill resistant bacterial spores or viruses. This is the key difference from sterilization, which destroys all forms of life, including spores.

In dentistry, only EPA-registered products with tuberculocidal activity should be used to disinfect dental treatment areas, as the Mycobacterium tuberculosis microorganism is highly resistant.

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Instruments, Surfaces, and Product Efficacy

Noncritical instruments include radiology machine heads, blood pressure cuffs, pulse oximeters, and lead aprons. These areas are often touched directly.

01

noncritical instruments

Contaminated instruments/gloved hands touch these areas during treatment. Specific examples include handpiece holders, mouthpieces, and resin lights.

Transfer surfaces

02

Heat-sensitive instruments that cannot be autoclaved (sterilized). Includes plastic and rubber items used in the oral cavity.

03

semi-critical items

The narrow-bore tubing systems that deliver water to the high-speed handpiece, air/water syringe, etc.

Dental Unit Waterlines

04

Instruments,

Many variables impact the efficacy of chemical products . . .

Surfaces,

chemical products

05

& product efficacy

The efficacy of chemical disinfecting products . . .

changes with various circumstances

• Instruments or surfaces may remain dirty/un-disinfected if something interferes with the chemical process.
• Blood and tissue fluids act as a barrier that hides microorganismsare, preventing the disinfectant from reaching all instrument surfaces.
• Soap is the number-one contaminator of disinfecting agents, as it reacts with the disinfectant and weakens its effectiveness.

• If there is an incorrect dilution, improper contact time, or soap residue, disinfection may not destroy all microorganisms.

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Semicritical Instruments

contact mucous membranes/nonintact skin but don't penetrate soft tissues or bone

• These items are contaminated because they have contacted mucous membranes or nonintact skin during patient use.
• Semi-critical instruments are generally recommended to be sterilized after use; however, when sterilization is not feasible—specifically, when the item cannot tolerate heat sterilization (i.e., they are heat sensitive)—then high-level disinfection is used.
• This process requires the items to be immersed in high-level disinfectants, which are often registered with the EPA as "sterilant/disinfectant."

Dental Unit Waterlines (DUWLs)

includes the narrow-bore tubing systems that deliver water to the high-speed handpiece, air/water syringe, and ultrasonic scaler, and dental saliva ejector tubing

• Maintain water quality to meet EPA safe drinking water standards (less than 500 bacterial colonies or CFUs per mL).
• Perform on-going maintenance protocols, such as chemical treatment, in-line microfilters, and flushing.
• Flush waterlines for 30 seconds at the beginning of the day and 20 seconds after each patient to reduce microbes and clear stagnant water.

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Noncritical Instruments

contact intact skin, splatters

• These surfaces are susceptible to contamination by aerosol and must be disinfected when visibly soiled with blood or saliva.
• The amount of direct patient contact and aerosol contamination must be considered when determining the appropriate procedure.
• Noncritical items can be barrier-protected or disinfected.
• Disinfection is the appropriate process for these surfaces, requiring the use of intermediate-level disinfectants (EPA-registered hospital disinfectants with a tuberculocidal claim).

40%

40% of the items and surfaces you will need to disinfect will be noncritical items and transfer areas.

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Transfer surfaces become contaiminated when touched.

They include handpiece holders, mouthpieces, resin lights, and other places we touch with contaiminated gloves or instruments during treatment.

• These surfaces are disinfected using higher intermediate-level disinfectants (such as iodophors or quaternary ammonium).
• Since they are environmental surfaces that do not typically penetrate soft tissue or bone (Critical instruments) or contact mucous membranes (Semi-critical instruments), high-level disinfection is used instead of sterilization to achieve the necessary reduction in pathogens.

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