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2.5 Principle IV: Make Instruments and Equipment Safe

On-site sterilizationCDC requires heat sterilization of all patient-care items that touch patients’ mucous membranes and that can withstand repeated exposure to high heat. In Maryland, instruments may be heat sterilized on- or off-site. (For more information about instrument sterilization, see "Instrument Sterilization Fundamentals.")

It is impractical for dental sealant programs to use chemical immersion to sterilize contaminated instruments because of the toxicity of the chemicals, which necessitates proper ventilation; time constraints (sterilization takes 10–12 hours); and the transport of toxic chemicals. Reusable instruments can be used if they can withstand heat sterilization. Disposable instruments are a good alternative to reusable instruments, but using disposable instruments may increase cost and waste and presents disposal challenges. Depending on the number and type of instruments needed, disposable instruments may be more cost effective than reusable instruments when considering the costs of packaging materials and transporting the autoclave.

Programs that use handpieces or air/water syringes that are detachable from the unit should use an autoclave for sterilization between patients and should follow the manufacturer’s instructions for sterilization and care. If the handpiece or air/water syringe is permanently attached to the unit, programs should barrier protect the handle and either use disposable tips or sterilize metal tips between patients.

Of special concern to programs is how to handle multi-use syringes used in the sealant-application process. These syringes can easily become contaminated but cannot be disinfected or heat-sterilized. The barrel of the syringe should be covered with a replaceable barrier. OOH-funded school-based sealant programs must use a new disposable syringe tip for each patient. Programs that use syringes to apply etchants and sealants may wish to consider using single-use, disposable syringes, rather than the multi-use type.2