Dental Sterilization & Disinfection

Sterilization describes a process that destroys or eliminates all forms of microbial life. Disinfection describes a process that eliminates many or all pathogenic microorganisms. Factors that affect the efficacy of disinfection and dental sterilization include cleaning of the medical devices,temperature and pH of the disinfection process, methodology of sterilization and infection process. Of which, the crucial steps, are covered and looked at daily at our dental hospital for the safety of our patients whilst getting dental treatment with us:

1. Sterilization Policies and Controls
2. Central Sterile Supply Management (CSSD)
3. Cleaning of Medical Devices
4. Water Quality Control in CSSD
5. Inspection and Packaging of Medical Devices
6. Sterilized Distribution and Storage
7. Sterilized Process Monitoring
8. Biological Sterilization Indicator Verification System
9. Dental Treatment Rooms Cleanliness
10. Building High-powered Air Ventilation Suction System
11. Sterilization Technologies – Autoclaves & Indicators

1. Dental Sterilization Policies and Controls

Designed and constructed right from start, dental hospital thailand has been set up with American Joint Comission International (JCI) sterilization processes sterilization policies and controls in mind.

The JCI standards are based on established scientific principles, hospital cleanliness standards and sterilization techniques by organization that include:

• American standards by Center of Disease Contorls (CDC)
• World Health Organization (WHO)
• American Dental Association (ADA)
• Association for Professionals in Infection Control and Epidemiology (APIC)
• Association of periOperative Registered Nurses (AORN)
• Association for the Advancement of Medical Instrumentation (AAMI)
• US Food & Drug Administration (FDA)

Our dental hospital meets and exceeds required standards in Thailand with steps beyond requirements as patient safety is our top priortiy.

Sterilization policies and control are set up to provide a clean, disinfected environment for each and every patient everytime. To adhere for a clean and safe environment, detailed initatives done on daily basis include:

• ultra-violet and ozonation filtered water
• disposable items
• hand hygiene adherence
• protection wear
• general and infectious waste disposal

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2. Central Sterile Supply Management (CSSD)

BIDH dental hospital uses the international guideline for disinfection and dental sterilization that presents evidence-based recommendations on the preferred methods for cleaning, disinfection and sterilization within ur sterilization processes and flow.

Dental instruments are precision tools used in dental treatments impacting patients directly. Instruments require regular maintenance. At BIDH dental hospital, selection of equipments and instruments are chosen with considerations made not just for its technological advancements functionalitly but also on cleanliness and sterilization designs and approach.

Sterilization efforts goes further than standard thai requirements at Dental hospital Thailand. We use single use non-woven materials to protect our sterilized dental instruments that are is more bacteria resistant than conventional woven wraps normally used at normal dental clinics and hospitals.

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3. Cleaning of Medical Devices

Dental instruments at our dental hospital undergoes several rounds of checks to ensure total safety and total sterilization. Dental instruments are initially soak in rapid multi-enzyme detergent for pre-disinfectant cleaning. The enzymes digest all human secretions including blood, saliva, proteins, carbohydrates, lipids and mucopolysaccharides that carries possible bacteria and viruses. Thereafter, the instruments are placed in ultrasonic machines to clean and remove tiny or invisible dirt trapped in instrument corners or spiral.

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4. Water Quality Control in CSSD

Water quality is an important consideration that can affect cleaning, disinfection, sterilization processes and the longevity of dental equipments and instrucments. Water is one of the components for device decontamination and equipment management.

Dental hospital Thailand looks water quality based on AAMI guidelines. Water quality is the descriptor of the levels of various impurities present in water. Initial rinsing may use tap water, but during final rinsing of cleaned medical devices, treated water of more stringent criteria for ions, microorganisms, organics are checked for.

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5. Inspection and Packaging of Medical Devices

International standards CE certified sterilization units are used to maintain clinical handpieces. Our appliances are individually packed and sealed by an impulse autosealer machine then autoclaved by pre-vacuumed autoclave units in viewpacks. Every single pack of dental appliance is dated by date and batch with chemical indicators indications.

Autoclave machines are tested daily for its effectiveness to sterilize viewpacks. Our dental hospital in Thailand separates autoclave machines for sterilization of instruments to clinical handpieces. After instruments are autoclaved, instrument are re-checked, packed, dated and stored in a separate clean area

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6. Sterilized Storage and Distribution

Our central supply sterilie department organizes its rooms to flow through in separate clean and dirty areas to prevent potential cross-contamination of instruments. Sterilized clean instruments are consistently kept under controlled cool temperatures and humidity to prevent bacteria growth. Backup generators are in place should a power supply disturbance occur.

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7. Sterilization Process Monitoring

At every stage, chemical indicators and measurement monitors are made to double check and re-confirm that instruments are sterile and our sterilization machines are performing effectively. At BIDH, mechanical measurements on our autoclaving machines are charted at every machine cycle. Temperature, light differentiates, pressure gauge readings are recorded during each pre and post vaccuum autoclaving period.

For the autoclaved dental instruments, sterile tape external indicators mark the individual packs that have undergone steam sterilization. Additionally, internal indicators using 3M Sterigage is also used to check that each parcel of critical dental instrument package has been exposed to steam at the correct temperature and time. The Steriage check is Class 5 level check, the highest level of examination, used to determine factors affecting treatment infection and death.

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8. Biological Sterilization Indicator Verification System

Infection control and dental sterilizations is of top priority. Simply having pressure-steam machines or autoclaves does not guarantee total sterilization. Aside from chemical indicator checks, our dental hospital uses double level biological checks on top of chemical checks for critical instruments and equipment.

The Attest Biological Rapid Monitoring System by 3M ESPE is used to verify the effectiveness of our sterilization efforts daily. The 3M Attest sterilization is a proven and reliable system with a 20 year product history using biological indicator system for monitoring steam sterilization. The Attest sterilizations system is used to ensure that our dental hospital sterilization controls and standards are well assured and above those of required standards.

Having a self-contained biological indicators significantly reduce the possibility of contamination. Biological checks minimize false positives and ensure more accurate results.

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9. Dental Treatment Rooms Cleanliness

Planmeca dental care units at our dental treatment rooms are cleaned and disinfected after every single use with patient. Single-use disposable towels that contains high level disfectants are used with our dental units during cleaning.

The pre-selected high level disfectant used at our dental hospital is tested and clinically certifed to be effective against bacteria and staphylooccus aureus. Mycobacterium Tuberculosis, Psuedomonas aeruginosa, Salmonella enteric, Trichophyton mentagrophytes are disactivated within 3 minutes of contact to the disinfectant. Whilst, MRSA,VRE, staphylococcus aureus with reduced susceptibility to vancomycin, AIDS (HIV), Hepatitis B, C, Influenza A2 Virus as well as Herpes simplex types 1 and 2 are disabled within 2 minutes.

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10. High-powered Air Ventilation Suction System

Because BIDH is planned and built ground up as a specialist dental hospital, our building is designed specificially to operate and function as a dental hospital fitted with high-powered air ventilation suction system throughout the building and in each treatment room. This ensures that all contaminates, any mercury vapours and any harmful evaporable contents in the air are safely removed creating a safe environment for our patients.

Our operating theatre rooms fixtures, materials and equipment are seamless chosen and designed to prevent dust traps, bacteria contamination.

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