Cleaning is the first step in any disinfection and sterilization process. It involves the removal of any organic or inorganic waste from an instrument or device. If visible debris is not removed, it can interfere with microbial inactivation and compromise the disinfection or sterilization process. Semicritical instruments or devices come into contact with either unintact skin or mucous membranes.
This classification covers almost all instruments and devices that enter the mouth but do not come into contact with sterile tissue or the vascular system. Ideally, these items should be sterilized or, at a minimum, disinfected at a high level or sterilized with cold chemicals. High-level disinfection is defined as the destruction of all organisms except bacterial spores. Some instruments and materials are for single use only. These should be separated in the operating room and those that are sharp or pose a risk of injury should be discarded in a sharp-object container.
Safe items, such as a saliva ejector, can be thrown away. The reusable instrument tray or cassette is then taken to the cleaning and sterilization area for processing.
To ensure patient safety, dental equipment must follow infection control and occupational safety standards as set by the Centers for Disease Control and Prevention (CDC), American Dental Association (ADA), California OSHA, California Dental Board, and other agencies. These standards are based on corroboration of data and regulations restricted to the province. In my experience visiting dental offices and dental medical schools, I have never seen cold chemical sterilization performed correctly.
To ensure proper sterilization, it is important to use FDA-approved devices for instrument reprocessing and follow the manufacturer's instructions for use. Most dental offices have a designated area for instrument reprocessing that is separate from the dental treatment room.
This helps to ensure that all instruments are properly sterilized before being used on patients.