Pretreatment
In order to improve the cleaning quality of dental instruments, pretreatment of instruments in the clinic is very important. After the treatment is completed, the small instruments used should be wiped with dressings or alcohol cotton balls next to the chair to remove blood stains, stains, adhesives, filling materials and other residues on the surface of the dental instruments. The instruments should be stored in a moisturizing state or sent to the disinfection room as soon as possible to prevent the dirt from drying and affecting the quality of cleaning and disinfection.
Instrument recycling classification
Instruments should be recycled in a closed state and moisturized, especially the working end, which can be placed in a recycling and cleaning rack containing a multi-enzyme solution and placed in a recycling box with a cover for temporary storage; spray enzyme moisturizer can also be used for moisturizing. The recycling container should be cleaned, disinfected, and dried after each use. Pay attention to personal protection during recycling, check whether the gloves are damaged, take standard precautions, and prohibit direct contact with the tip of sharp instruments with your hands to avoid needle sticks. Small instruments such as needles and instruments such as mobile phones should be classified and processed.
Manual cleaning operation steps Rinse
Rinse the instrument under running water to initially remove contaminants. Scrub and scrub: After rinsing, the instrument needs to be soaked in enzyme cleaning solution. During soaking, the liquid surface needs to cover the instrument and keep it fully moist. Scrub and scrub again. Final rinse: After scrubbing and scrubbing, rinse with purified water.
Ultrasonic cleaning
1. Ultrasonic cleaning machine can improve the cleaning effect and efficiency. It is suitable for instruments that are difficult to clean, such as blood-stained dental forceps, and burs and other instruments with complex structures. The ultrasonic cleaning time should be 3min-10min, and the cleaning time can be appropriately determined according to the contamination of the instrument and the power of the ultrasonic machine. Note: Ultrasonic cleaning is only an auxiliary cleaning of manual cleaning. The mobile phone cannot be vibrated to clean, which is easy to damage the bearing, especially the expensive mobile phone (such as implant mobile phone).
2. It is recommended that medical cleaning machines be used to clean mobile phone instruments. Dental mobile phones are precisely manufactured and complex in structure. They are in close contact with patients’ saliva, blood, etc. during diagnosis and treatment, so special equipment is used for cleaning. Cleaning process: Rinse under running water to remove obvious dirt on the surface of the dental mobile phone. Put the dental mobile phone into the mechanical cleaning equipment, fix the dental mobile phone, select the correct cleaning program, and start the equipment to start cleaning. Its cleaning water flow and air flow conform to the internal structure of the dental handpiece.
Drying of instruments
Oral instruments need to be dried before high-temperature sterilization. Place the instruments in a drying oven for drying. The appropriate drying temperature can be selected according to the material of the instrument.
Oil filling and maintenance of handpieces
It is recommended to configure a special automatic oil filling machine for dental handpieces. How to use: Select the oil filling time and machine position. Start the cleaning and oil filling program. After the oil filling is completed, start the drying program. Time: 35 seconds per handpiece. Improve work efficiency. The closed device reduces pollution. Oil filling and maintenance of oral handpieces: Oil filling is lubrication, which is used to clean the debris in the gap of the bearing or turbine parts and lubricate the bearings and transmission parts. Frequent oil filling can greatly increase the service life of the handpiece. Oil filling should be done after cleaning and before sterilization to protect the handpiece from being sterile before use and avoid contamination. The inner cavity of the handpiece should be kept dry before oil filling.
The instrument inspection
It should be carried out by visual inspection or using a magnifying glass with a light source to inspect the oral instruments after drying. Detail standard: There should be no stains, water stains, and other residual substances and rust spots on the surface, spiral structure, and joints of the instrument. Instruments that fail to meet the cleaning standards should be reprocessed. Damaged or deformed instruments should be reported and replaced in a timely manner.
Instrument packaging and sealing
Oral instrument sterilization bag packaging requirements: The packaging material should be selected according to the characteristics of the instrument and the frequency of use. Low- and medium-risk oral instruments can be placed in a spare clean container directly after disinfection or sterilization. Small dental instruments should be stored in dental instrument boxes.
The requirements for paper and plastic packaging are as follows: There should be a sterilization chemical indicator on the outside of the package, and the name of the item, the packager, the sterilizer number, the sterilization batch, the sterilization date and the expiration date should be marked. If there is only one sterilizer, the sterilizer number may not be marked.
The paper and plastic packaging should be sealed completely, with a sealing width of ≥6mm, and the distance between the instrument in the bag and the sealing of the packaging bag should be ≥2.5cm. It is recommended to use a fully automatic sealing machine, which can effectively avoid uneven manual pressing force and damage to the paper and plastic bag. It can also print information such as sealing time, expiration date, operator, pot number, instrument name, etc.
Cotton fabric sterilization packaging requirements: It cannot be stiff or damaged. Seal with special sterilization tape. A chemical indicator card or a “creeping” card should be placed in the bag. The wrapping cloth needs to be cleaned once and the quality of the wrapping cloth should be checked each time it is used. It is suitable for all oral diagnosis and treatment instruments, and is more suitable for surgical instruments with larger volume and larger quantity.
Loading principles for disinfection and sterilization
A reasonable weight of loaded items should be selected according to the size of the sterilizer cavity, and the weight of loaded items shall be subject to the manufacturer’s instructions. The loaded items should ensure smooth circulation of steam in the sterilization chamber. This will ensure uniform temperature everywhere inside. It should be conducive to the discharge of air from the sterilization chamber, so as to ensure that the steam pressure and temperature in the container are consistent. Temperature, pressure and other sensors must not be blocked to avoid affecting the normal operation of the sterilizer. Loading method: Do not stack sterilized items tightly to prevent blocking of the various sensor control ports. After blocking, the sterilizer will not be able to correctly reflect the temperature in the sterilization chamber. Continuous temperature rise may cause abnormal pressure and temperature in the sterilization chamber, and even lead to sterilization failure. In severe cases, it will cause sterilizer failure. For containers with lids, the lids should be opened to allow air and steam to exchange through the gaps. If the lids are too tight, the containers will easily burst during sterilization. How to place paper-plastic packaging bags: Use a stand and a tray, and lay the paper-plastic packaging bags flat on the tray, with the paper on top and the plastic on the bottom.
Chemical indicator cards and related records
The results presented by each sterilization indicator should be systematically recorded and traceable. The retention period of monitoring data and records should be ≥3 years for reference when problems arise.
