608 Dental Office Safety

Cleaning Instruments Before Sterilization

Cleaning should precede all disinfection and sterilization of dental instruments. The necessary cleaning involves the removal of debris (organic or inorganic) from an instrument or device. If visible debris is not removed, it will interfere with microbial inactivation and can compromise the disinfection or sterilization process.

Manual vs. Automated Instrument Cleaning

Debris can be removed from an instrument either by scrubbing the instrument manually with a surfactant or detergent and water or by using automated equipment (ultrasonic cleaner or washer-disinfector) and chemical agents. After cleaning, instruments should be rinsed with water to remove chemical or detergent residue. Splashing should be minimized during rinsing and cleaning.

Considerations in selecting cleaning methods and equipment include their effectiveness, their compatibility with the items to be cleaned, and the occupational health and exposure risks they pose. Because instruments cleaned with automated cleaning equipment do not need to be presoaked or scrubbed, the use of automated equipment can increase productivity, improve cleaning effectiveness, and decrease worker exposure to blood and body fluids. Therefore, using automated equipment can be more efficient and safer than manually cleaning contaminated instruments.

If manual cleaning is not performed immediately, instruments should be placed into a container and soaked with a detergent, a disinfectant/detergent, or an enzymatic cleaner to prevent drying of patient material and make manual cleaning easier and less time consuming. The Centers for Disease Control (CDC) also recommends using long-handled brushes to keep the hand as far away as possible from sharp instruments.

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