Washing-dental-instruments, all the insider information on cleaning dental instruments using water & detergents in a thermal disinfector

"The purpose of disinfection is to kill, or irreversibly deactivate, the micro-organisms responsible for causing illness, that may be present on the surfaces of contaminated objects, in order to "interrupt the chain" of infection."

The requirement for Dental instrument cleaning and the solutions.

Blood and bone fragments, Saliva, cement residue, and any other infectious agents that may be adhering to the instrument.

Medical Device Directives from government bodies.

"Instruments must be processed in a system, which has a range of standardised procedures, that can be validated, by the use of a repeatable programme".

Robert Koch Institute

States that a preference should be given to machine based Disinfection procedure over manual methods

Competitive techniques in use in the past and also in the present.

Not verifiable, with no recognised standard, as it is not possible to provide a repeatable manual process. Hollow instruments are difficult items to clean and disinfect efficiently by hand.

High detergent costs

Dubious standard of contamination control.

High Temperatures are not possible when washing by hand even with gloves.

The seven step systematic protection system for washing-dental-instruments in a machine

Waste disposal of infected material (all particles are to be treated as infectious unless proven otherwise).

Cleaning & Disinfecting

Instrument inspection & maintenance, discarding one time use only instruments where necessary.

Preparation for sterilisation and placing in the holders and baskets before placing in the autoclave

Sterilisation at temperatures audited by the machine.

Hygienic storage facility, placing in containers, trays, sealed bags etc.

Thermal Disinfection the Advantages of a water and detergent thermal disinfection machine.

A Safe & gentle processing valuable items the mechanical action is under constant control at all times and is audited.

Thorough cleaning, internal/external, as water is driven or pumped into all the small nooks and crannies within the instruments, with the use of the proper holders and baskets.

Reduction of Hand-washing less washing by hand scrubbing with brushes etc., is required which is labour saving.

Ultrasonic Baths, are reduced which can save time and damage to instruments during the placing washing and removal from the ultrasound bath.

Chemical Disinfection labour is reduced due to reduced hand rinsing and drying.

Consistent standards of hygiene at all times leave the machine clean and dry to an auditable, standardised process every time. These systems may be able to provide a print out form at the end of each wash, to provide an audit trail.

Contamination reduction. Less handling and fewer processes.

Reproducible process every time.

Detergents - chemical action, in dental instrument cleaning .

Thermosept RKI as alkaline powder detergent for manual dosing via a scoop.

Thermosept RKF as alkaline liquid detergent for automatic dosing via dosing pumps.

Thermosept NKP as neutraliser an acid rinse to neutralise the alkaline residue that may be left on the instruments befor the final rinse; again using dosing pumps.

Thermosept KSK as a rinse aid, which aids the fast drying process within the disinfector during the time the drying heaters are in operation.

Have a look at the sinners diagram

Chemical Action the third factor for all cleaning problems in washing-dental-instruments

Alkaline Detergent without tensides

Neutralising acid - acidic, free from tensides, phosphates and nitrogenous complexing agents

Liquid alkaline detergent based on activated chlorine

Citric acid neutralising agent

Temperature 93ºC for 10 minutes

Glass expansion v Soil expansion the expansion of soils and the instruments being of a different rate aids the removal of solid particles from the instruments.

Rapid expansion rates ‘un-stick’ soils

Controlled and reproducible temperature, these temperatures are contained within programmes, which fail to safe should the required temperature or time parametre not be met.

Rinse: high enough to disinfect if necessary, this means the rinse can be of any temperature within the scope of the machine and in most cases will be 93ºC held for up to 10 minutes.

Time

7 litres of water per fill; this takes time, about one minute depending on the water supply pressure and flow rate.

Reduced water heat up = low energy if a hot water supply can be provided that will reduce the time required to heat the water within the machine.

kWh rating of heaters the larger the heaters the faster the heating time so a 13amp plug machine is going to be slower than one fitted to a 3 phase supply.

Heat rate of 8ºC per minute

Double skinned machines with good insulation within the body of the machine will not radiate so much heat into the room and heat up quicker.

Mechanical action

This will be removed on the drain cycle portion of the programme.

These wash arms are driven by the water pressure; which ensures the whole cabinet is drenched by the jets and sprays, so no part of the cabinet is missed during the wash processes.

Basic cleaning programme when washing-dental-instruments

Pre-wash - for particulate removal this will remove the larger particles and send them to the filtration system where they will be held until the drain cycle carries them away.

Main wash - Alkali, high pressure, high temperature this portion of the cycle is where the jets and sprays really come into play by removing the smallest soiling and holding them in suspension until the drain cycle.

See my page on how detergents work at....

Detergent information and basics Acid Neutralising rinse - to rebalance pH on the surface of the instruments to ensure no damage by chemical reaction, which occurs whilst in storage awaiting use after washing-dental-instruments.

A Soft water rinse - usually de-mineralised water to remove any chemicals within the machine.

The Final rinse, usually de-mineralised at high temperature to thermal disinfect and provide a clean and dry instrument at the end of the cycle.

The drying cycle which will send hot air around the cabinet to thouroughly dry the instruments.

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