The human oral cavity is the most important "buffer" through which food enters the intestines. It is this area of the body that is one of the most vulnerable. Through the mouth it is very easy to bring into the body not only harmful bacteria, but also toxic components and dangerous viruses.
When treating a patient’s teeth, a specialist should take sanitary standards very seriously so as not to bring dangerous microorganisms into the patient’s oral cavity. That is why disinfection and sterilization in dentistry are given special attention. Conducting sanitary measures is no less important than direct treatment of people. The tools that a doctor uses must necessarily undergo specialized processing and meet all safety standards, in accordance with health care requirements.
It is important that not only the doctor himself knows about such events, but also those people whom he treats. It would be useful for each patient to receive information about the features of sterilization in dentistry.
What must be sanitized
All instruments that come into contact with the mucous membrane or blood of the patient, which is often released during even the simplest dental procedures, must undergo treatment. Therefore, sterilization in dentistry includes sanitary measures, during which disinfection takes place:
- dressings;
- beakers, flasks and other utensils used in laboratory research;
- syringes and needles;
- all rubber products;
- devices that come in contact with damaged surfaces of the oral cavity;
- small dental instruments, which include boron, drilbor, canal filler, etc.
Just like in any other medical field, in dentistry there is such a thing as a sterile table. In this case, we are talking about the surface that is used for tools that may be required by the doctor during the treatment of the patient.
Laying a sterile table: algorithm of actions
Before preparing the work surface, the nurse must wear a mask, having previously tucked hair under the worn hat. After that, she must treat her hands with a disinfectant and put on sterile clothes (gloves and a bathrobe). Also, the nurse must make sure that the beaks is tight and the sterilization date is indicated on it. Only after this can she proceed to further manipulations.
The algorithm for laying a sterile table is as follows:
- The bix opens, in which sterile underwear is located. For this, the medical worker presses a special pedal.
- A clean sheet is taken from the bix, which covers the mobile table. First, a special film is laid, and then four layers of fabric, which should cover the entire surface of the table and hang from it by at least 15-20 cm.
- The nurse captures the upper layers of the sheet with sterile tweezers and turns away from herself, folding them with an accordion on the back of the table. Special linen hoes are fixed along the edges.
- Using a sterile film, a mesh with medical equipment is removed, for the sterilization of which an open type of air treatment was used. Instruments are laid out on a table in the usual dental procedure.
- The nurse once again checks that all necessary equipment is on the work surface.
- Holding the sterile hoes, she covers the tools so that part of the sheet hangs down.
The shelf life of prepared tools (including dressings) is no more than 6 hours. If the equipment is on the table longer, then the sterilization algorithm is repeated. Otherwise, the tool preparation procedure is considered violated. Therefore, the clinic staff must strictly follow the requirements.
It is also worth considering the main stages of instrument sterilization in dentistry. Similar procedures are carried out according to three steps. First of all, disinfection is performed. Only after this procedure is direct sterilization performed.
Disinfection
At the initial stage of processing, it is necessary to get rid of possible harmful microbes in the room where the examination and treatment of patients will be carried out. Disinfection is not only for floors, walls and hard furniture. Processing is even air.
If a patient suffering from a serious infectious disease is supposed to be in the dental department, focal disinfection should be performed. But even if we are talking about more “light” patients, the general cleaning is carried out every day. This type of treatment is called preventive disinfection. However, sterilization in the dental department does not end there.
Types of disinfection
This treatment method depends on the variety of medical equipment in contact with the skin and mucous membranes of the patient. Based on this, disinfection of different levels is possible:
- Low. In this case, we are talking about the disinfection of instruments that come into contact exclusively with intact skin. When processing low levels, preparations based on chlorine, phenol, ethyl or isopropyl alcohol are used. Such components do not destroy the fungus or bacteria, but they are suitable for the removal of other pathogenic particles.
- High. In this case, we are talking about processing instruments that are in contact with the tissues and blood of the patient, and are also used to prepare injection solutions. For the treatment of this type, 6% hydrogen peroxide is intended, which is mixed with aldehyde and chlorine. Peracetic acid based agents may also be used. Such components cope well with most pathogens. However, with the products of the reproduction of fungi, they remain powerless.
- Intermediate. This treatment allows you to get rid of large lipid viruses and bacteria in a vegetative form. However, intermediate disinfection is absolutely not effective in the fight against non-lipid microviruses, as well as bacterial waste products. However, this treatment is sufficient to prepare instruments in contact with the mucous membranes and when working with lacerations on the skin.
Disinfection methods
Since sterilization of dental instruments involves its disinfection, it is worth considering the features of this procedure. Processing of this type happens:
- Mechanical. In this case, the surfaces are wiped with a damp cloth, operating and bed linen are washed. The furniture and floor in the office is treated with a conventional vacuum cleaner. Also to mechanical disinfection is the ventilation of rooms.
- Biological. With the help of bacteriophages, various harmful microorganisms are eliminated. However, it should be borne in mind that this type of antagonist is far from affecting all bacteria. Biological treatment is carried out only for hard surfaces.
- Physical. In this case, we are talking about the effect of high temperatures on objects to be disinfected. Physical disinfection includes: boiling in water with soda, processing with steam or dry air. This method is considered quite reliable. In addition, during the procedures, employees of a medical institution are less likely to harm their health.
- Chemical. During sterilization in dentistry, it is this method of disinfection that is most often used. In this case, we are talking about fairly aggressive chemicals, so when processing a clinic employee should be especially careful. Items that undergo a chemical type disinfection procedure are carefully placed on a grate and immersed in a special chamber with a solution. The container in which the equipment is located can be plastic, glass or enameled. Chemical products themselves must be stored in vessels that are tightly closed. On the containers the exact name of the drug, the date of its manufacture and the period during which a particular product is allowed to be used are indicated. In the process of chemical treatment, nurses must wear respiratory masks, goggles and gloves. It is also important to ensure that the room in which the procedure takes place is well ventilated or ventilated. Chemical solutions should not be diluted with warm or hot water. In this case, there is a risk that the health worker will inhale dangerous fumes.
If we talk about the means that are used for chemical disinfection, it can be oxygen-containing, guanide-containing, halogen-containing, surfactants, alcohols, etc. "Lysoformin 3000" is widely used in medical institutions. This is a liquid transparent substance of a bluish tint. The drug does not have a pronounced smell. This medication refers to toxic agents. For this reason, use of "Lysoformin 3000" should be extremely careful. For the processing of dental equipment, a solution is required based on a proportion of 150 ml per square meter.
Direct sterilization
The next stage in the preparation of medical instruments is a more serious treatment. Sterilization is necessary for inventory that comes in contact with clean tissues of the human body, blood vessels and blood.
In some situations, complete sterilization may be required. For her, special equipment is used. However, standard sterilization methods often used in dentistry are usually sufficient. It is worth considering them in more detail.
Thermal
This method is also divided into several types. Such sterilization can be:
- Steam. The autoclave is mainly used. A high degree of disinfection can be achieved with steam, which is supplied under strong pressure. A temperature of 120 degrees is enough for pathogens to die. The duration of the procedure is from 15 to 60 minutes. The duration of cleaning is related to the degree of contamination of the inventory, and also depends on the material from which it is made. Additionally, the autoclave is equipped with a special safety valve. Thanks to it, you can always monitor and adjust the pressure during processing.
- Using an air sterilizer (dry heat cabinet). A similar type of processing is carried out for those objects which, due to their structure, cannot be disinfected with gas or steam. Procedures of this type are used a little less often. When using an air sterilizer, it is possible to quickly get rid of microorganisms that are exposed to higher temperatures (180 degrees).
- Microwave. Similar procedures are performed if it is necessary to clean a small amount of dental items. During microwave processing, the instruments are in a partial vacuum, and are also exposed to microwaves. The duration of the procedure is half an hour.
Chemical sterilization
This type of processing can also be of several types:
- Plasma It uses 20 percent hydrogen peroxide.
- With the use of ozone. The duration of the procedure is 1 hour.
- Using vapors of various chemical compounds. Ethylene oxide (suitable not only for processing glass, rubber, metal and polymers, but also hardware) or formaldehyde and water vapor (also helps clean glass, metal or polymer surfaces) can be used to perform this procedure.
In addition to chemical sterilization, there is another method of disinfection. However, it is no longer used for the preparation of dental premises.
Radioactive sterilization
The principle of this procedure is that ionic energy is converted into chemical or thermal. Due to this, DNA is destroyed in dangerous pathogens. The process of reproduction of pathogenic microorganisms stops.
However, today a similar method is used exclusively in factories where mass production of medical equipment is carried out.
Disadvantages and advantages of sterilization methods
Each of the methods has its pros and cons. For example, with dry sterilization, the strength of metals and glass deteriorates significantly. If we are talking about high temperatures, then when processing above 160 degrees, the small parts of the devices become very fragile. In addition, with dry sterilization, a specialist cannot control how well the cleaning is carried out.
Today, the steam processing method is more popular. In this case, even devices that are sensitive to high temperatures do not change their characteristics.
Also quite often used in dentistry and cold sterilization. With this treatment, the devices are immersed in a disinfecting solution, which is additionally used to clean optical devices. As a rule, this is a liquid, the basis of which is glutaraldehyde. However, the use of other solutions is sometimes allowed, depending on the type of inventory.