Sterilization and Disinfection of Patient Care Items and Devices

Guidelines for Practice Success | Managing Regulatory | Centers for Disease Control and Prevention

Every dental practice should have procedures in place that detail how to handle and disinfect instruments and equipment that might be contaminated with blood or body fluids. All dental healthcare workers should be familiar with CDC’s definition of the terms “sterilization,” “disinfection” and “cleaning,” which begin on page eight of its Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 [PDF]. Information is also available in the Centers for Disease Control and Prevention’s (CDC) Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care.

While a single liquid chemical germicide might not satisfy all disinfection requirements in a given dental practice or facility, which disinfecting agent to use in any single situation is sometimes a matter of professional judgment with guidance provided by product label claims, the manufacturer’s instructions for use (IFU), and federal and local government regulations. It’s important that members of the dental team be trained to recognize which products should be used in which situations and how those products should be managed and stored. Team members should also be familiar with the specific roles of the various federal agencies that have policies or regulations on these products.

Even though which disinfecting agent to use in any single situation is sometimes a matter of professional judgment with guidance provided by product label claims, anyone using these cleaning agents should always follow the manufacturer’s instructions for use and any applicable federal or local government regulations. This is especially important when using cleaning agents and disinfectants that are registered with the Environmental Protection Agency (EPA), which regulates surface disinfectants, or the Food and Drug Administration (FDA), which regulates immersion sterilants.

When using disinfectants, be sure to pay close attention to recommendations to product-specific manufacturer’s directions including:

how much to use
whether to use as is or dilute
contact times
precautions to follow to ensure safe use
proper storage and disposal

The CDC’s Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care contains many helpful resources, including recommendations for Sterilization and Disinfection of Patient Care Devices, which can be found on page 14 of the document. Other helpful information in the document includes suggestions on how you can assess your staff’s awareness of the proper use and storage of disinfectants.

Staff should be trained in the safe use of all hazardous chemicals, including disinfectants, before they use the chemicals. The training policies and standard operating procedures should be included in the office- specific Hazard Communications manual. One way to make certain the team is aware of the instructions for use for different disinfectants and the best situations for their use is to discuss the topic during a team meeting. Adequate training:

reinforces the proper procedures for their use, storage and disposal
communicates the differences between low and intermediate disinfectants
stresses the need to monitor and abide by product expiration dates
reminds users to read the directions for disinfection every time they use them
reminds staff to maintain and reference the current Safety Data Sheets (SDS) for all disinfectant products
details what Personal Protective Equipment (PPE) should be worn when using each disinfectant

Be sure to document each training session and include information about the date of the session, the topics discussed, the names of all attendees, etc.

Additional guidance for the cleaning and disinfection of environmental surfaces, including for cleaning blood or body substance spills, is available in the resources linked below.

Resources: