Decontamination
Basket with Hand Piece Connectors Pic 2
Continued »
It would take four hours to clean ı20 instruments – at a cost of €42.26/£34 in terms of labour. Throughput – 30 instruments per hour. (Pic ı) A washer disinfector will cost around
€4,900/£4,000 and will clean those same ı20 instruments in around 35 minutes. Using instrument cassette trays (that can then be transported directly from the washer disinfector into the autoclave) and allowing time for loading/unloading, in four hours it could clean 823 instruments. Throughput – 205 instruments per hour. On a seven-hour day, therefore, the cost
for manually scrubbing is seven hours multiplied by €ıı.00/£8.50 which works out at €77.00/£6ı.25. Washer disinfector purchase price
€4,900/£4,000 divided by €77,00/£6ı.25 means that it is recovered in around 64 days.
Ultrasonic bath Ultrasonic cleaning is a very effective method of removing contamination from instruments. It is particularly useful when trying to remove hardened on substances or protein-rich contamination such as dried blood. Ultrasonic cleaners use a process called cavitation, where bubbles are specially formed in a solution of water and detergent. The bubbles implode on contact with contamination on instruments placed in the solution, and these implosions release a surprising amount of energy in the process, sufficient to forcibly remove even stubborn contamination on instruments. However, ultrasonic cleaners are not the
complete answer to instrument cleaning, because even though contamination can be removed from the instruments, the instruments themselves will still be immersed in a toxic soup of contaminated water within the ultrasonic cleaner. When instruments are removed from the ultrasonic cleaner, they still need to undergo a washing process before being ready for inspection and sterilisation in the autoclave. An ultrasonic bath will take a maximum of 45 instruments per load. A cycle
Ultraclean3 Benchtop Pic 3
takes around ı0 minutes, following which the instruments still need to be thoroughly rinsed and then dried manually. Conservatively, this will take another ı0 minutes. Throughput – ı35 instruments per hour. On a seven-hour day, therefore, based
on the time saved compared with using an ultrasonic bath, a washer disinfector will pay for itself in around ı50 days. So, it is clear that whatever method you
are currently using and even taking into account running costs and detergent, a washer disinfector will have easily paid for itself in less than six months – and it doesn’t need to take a holiday!
A word about handpieces Handpieces, particularly, are difficult to effectively clean, inspect and sterilise due to their intricate nature and their inability to be easily dismantled. Laboratory tests show that sterilisation can only be effective following adequate cleaning. Efficient cleaning and lubrication will also determine handpiece functionality, reducing wear and tear and therefore the need for costly ongoing maintenance and premature replacement. Dental hand pieces present a particular challenge because they have both external and internal surfaces which become contaminated during use. When the air and water is switched off, the negative pressure is also likely to result in contaminated fluid and air being drawn into the air and water lines within the hand piece. The majority of good quality handpieces
can be safely cleaned in a washer disinfector – look for the shower symbol which is located on the body of the instrument. The UltraClean 3 range of washer disinfectors from Prestige Medical incorporate special connectors for hand pieces with irrigation channels (Pic 2) which enable the hand pieces to be cleaned and disinfected both externally and, critically, internally – forcing water up through the internal tubes and channels. The addition of forced air drying, which eliminates the need to dry with paper towels or leave to air dry, means that at the end of the process the handpiece is clean and ready for lubrication before sterilisation, as recommended by the
Advance Vacuum Autoclave Pic 4
handpiece manufacturers themselves. (Pic 3)
Instrument sterilisation A validated cleaning process, coupled with the appropriate lubrication of the internal components would then be followed by sterilisation. The majority of instruments used by dentists are classed as ‘hollow’ devices. For example, given their design, for effective hand piece sterilisation, it is necessary for the air to be removed from the lumens and hollows to allow steam penetration by using a ‘B Class’ vacuum autoclave. This is especially important if the hand piece is to be pouched before sterilisation. The Prestige Medical Advance B Class autoclave (Pic 4) also features a non vacuum cycle for maximum flexibility in use and, with a capacity of six trays, can process more instruments per cycle than most other autoclaves.
In summary There is a wide range of decontamination equipment on offer from a variety of manufacturers, both from the UK, Europe and further afield. Inevitably, there can be a temptation to go for the cheapest option. However, as with the purchase of handpieces, it is wise to look for a reputable manufacturer who can not only provide you with a good quality product at a competitive price, but can also offer full ongoing service and technical support, including access to spare parts. In summary, then, with the current
generation of equipment, the whole decon- tamination process to meet best practice standards can actually reduce the time you spend on processing instruments in the practice. Most reputable manufacturers will offer a range of decontamination solu- tions and should be able to provide you with sensible advice on choosing the best type of equipment to suit your needs.
ABOUT THE AUTHOR
Christine Bowness is the business manager – UK and Ireland for Prestige Medical. For more information, visit
www.prestigemedical.co.uk
Ireland’s Dental magazine 41
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