Dental clinic sterilisation and safety

Why sterilisation matters at the dentist

Dental instruments touch your gums, blood and saliva, so anything used on one patient must be made safe before the next. The US Centers for Disease Control and Prevention (CDC) bases dental infection control on standard precautions: treating every patient as if they could carry an infection, and protecting everyone the same way.

When things go wrong, it is usually because a step was skipped. The CDC’s summary of dental infection prevention lists lapses such as failing to heat-sterilise dental handpieces (drills) between patients and failing to test sterilisers.

How instruments are sterilised, step by step

The CDC’s sterilisation guidance describes the chain every reusable instrument should go through.

1. Cleaning. Used instruments are cleaned first to remove blood and debris. The CDC calls cleaning “the basic first step” because heat cannot sterilise through dirt. This is often done in an ultrasonic cleaner or washer.
2. Drying and checking. Instruments are dried fully. Wet instruments can weaken the packaging and let germs back in.
3. Packaging. Instruments are sealed in sterilisation pouches. Each pack should be labelled with the steriliser used, the load and the date, so it can be traced if anything goes wrong.
4. Autoclave. The pouches go into a steam steriliser (autoclave). The CDC says most dental instruments can take heat and should be heat-sterilised, and instruments that go into gum or bone should always be heat-sterilised.
5. Storage. Sterile pouches are kept closed in clean, dry, covered cabinets.
6. Opening at the chair. The pouch is checked and opened just before use. A pouch that is wet, torn or punctured goes back to be processed again.

How a clinic knows the steriliser worked

The CDC’s monitoring guidance asks for three checks:

Items that are used once and thrown away

Some items cannot be cleaned safely and are used for one patient only. CDC training material gives examples such as syringe needles, polishing cups and plastic brace brackets. Gloves are also used once and changed for each patient. The CDC notes that disposable versions exist for most items that cannot be heat-sterilised.

Clean surfaces between patients

The chair, light handles, switches and X-ray parts can pick up spray during treatment. The CDC’s guidance on surfaces says hard-to-clean surfaces should be covered with a plastic barrier and that “this barrier should be changed between each patient”. Surfaces without a cover are cleaned and then disinfected before the next patient.

Clean hands and fresh gloves

The WHO says hand hygiene is a core part of infection control and helps prevent infections picked up during health care. In a dental clinic this means cleaning hands with soap and water or an alcohol hand rub, and a fresh pair of gloves for each patient.

X-rays: how much radiation?

Dental X-rays use very small doses. Figures from RadiologyInfo, run by radiology societies:

The American Dental Association says X-rays are not needed at every visit; how often depends on your age and needs. If you are or might be pregnant, tell your dentist before any X-ray.

What you can ask us to show you

You can ask any dental clinic these questions, including ours. A clinic that follows the standard steps should be glad to answer.

• Can I see my instruments come out of a sealed pouch?
• Do you heat-sterilise handpieces (drills) after every patient?
• Where are instruments cleaned and sterilised? Can I see the room?
• How do you check that the autoclave works? When was the last spore test?
• Which items do you use once and throw away?
• Are you wearing fresh gloves for me?

Our own protocol

Our step-by-step protocol and photos of our sterilisation room will be shown here. If you would like to know how we sterilise instruments before then, ask us when you book or at your visit. You can also read about what happens at a first visit.