Decontamination of reusable dental instruments has been a subject of debate within the dental profes sion since the publication in 2009 of Health Technical Memorandum 01-05: Decontamination in primary care dental practices. This paper provides a brief history of instrument reprocessing in dentistry and reviews the evidence on pre-soaking, cleaning, sterilisation and storage.
Aasim SA, Mellor AC, Qualtrough AJ ( 2006) The effect of pre-soaking and time in the ultrasonic cleaner on the cleanliness of sterilized endodontic files. International Endodontic Journal39: 143-9.
2.
Bagg J., Smith AJ, Hurrell D., McHugh S., Irvine G. ( 2007) Pre-sterilisation cleaning of re-usable instruments in general dental practice. British Dental Journal202: E22.
3.
Benson PE, Ebhohimen A., Douglas I. ( 2010) The cleaning of photographic retractors: a survey, clinical and laboratory study. British Dental Journal208: E14.
4.
Bhumisirikul W., Bhumisirikul P., Pongchairerks P. ( 2003) Long-term storage of small surgical instruments in autoclaved packages. Asian Journal of Surgery26: 202-4.
5.
British Dental Association (1986) Guide to blood borne viruses and the control of cross infection in dentistry . BDA: London.
6.
British Dental Association (2003) Advice sheet A12, Infection control in dentistry. BDA: London.
7.
British Dental Association (2009) Advice sheet A12, Infection control in dentistry. BDA: London.
8.
Brusca MI, Nastri N., Mosca CO, Nastri ML, Rosa AC ( 2004) Long-term sterility of orthodontic-surgical appliances . Acta Odontologica Latinoamericana17: 23-7.
9.
Burkhart NW, Crawford J. ( 1997) Critical steps in instrument cleaning: removing debris after sonication. Journal of the American Dental Association128: 456-63.
10.
Carp RI ( 1982) Transmission of scrapie by oral route: effect of gingival scarification. Lancet1: 170-1.
11.
Centers for Disease Control and Prevention ( 1987) Recommendations for prevention of HIV transmission in health-care settings. MMWR Morbidity Mortality Weekly Report36: Suppl 2S.
12.
Centers for Disease Control and Prevention ( 1990) Possible transmission of human immunodeficiency virus to a patient during an invasive dental procedure. MMWR Morbidity Mortality Weekly Report39: 489-93.
13.
Clinical Research Associates (2000) Automated pre-sterilization instrument cleaning. Clinical Research Associates Newsletter24: 2.
14.
Department of Health (2003) Risk assessment for vCJD and dentistry. DH: London.
15.
Department of Health (2007a) Advice for dentists on re-use of endodontic instruments and variant Creutzfeldt-Jakob Disease (vCJD). DH: London. http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Dearcolleagueletters/DH_074001 (accessed 30 August 2010).
16.
Department of Health (2007b) Dentistry and vCJD: the implications of a "carrier state" for a self-sustaining epidemic due to endodontic dentistry. DH: London.
17.
Department of Health (2007c) Potential vCJD transmission risks via dentistry: an interim review . DH: London. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081170 (accessed 30 August 2010).
18.
Department of Health (2009) Health Technical Memorandum 01-05: Decontamination in primary care dental practices. DH: London.
19.
E isen S., Eisen D., Farmelant J. ( 2006) Evaluation of spatter generation and contamination during instrument cleaning prior to sterilization. Journal of the Massacheusetts Dental Society55: 26-9.
20.
Head MW, Ritchie D., McLoughlin V., Ironside JW ( 2003) Investigation of PrPres in dental tissues in variant CJD . British Dental Journal195: 339-43.
21.
Health Protection Agency (2006) Eye of the needle . HPA: London . http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1205394781623 (accessed 30 August 2010).
22.
ngrosso L., Pisani F., Pocchiari M. ( 1999) Transmission of the 263K scrapie strain by the dental route. Journal of General Virology80: 3043-7.
23.
Kurita H., Kurashina K., Honda T. ( 2006) Nosocomial transmission of methicillin- resistant Staphylococcus aureus via the surfaces of the dental operatory. British Dental Journal201: 297-300.
24.
Letters S., Smith AJ, McHugh S., Bagg J. ( 2005) A study of visual and blood contamination on reprocessed endodontic files from general dental practice. British Dental Journal199: 522-5.
25.
Lipscomb IP, Pinchin H., Collin R., Keevil CW ( 2007) Effect of drying time, ambient temperature and pre-soaks on prion-infected tissue contamination levels on surgical stainless steel: concerns over prolonged transportation of instruments from theatre to central sterile service departments. Journal of Hospital Infection657: 2-7.
26.
Lowe AH, Bagg J., Burke FJ, MacKenzie D., McHugh S. ( 2002) A study of blood contamination of Siqveland matrix bands . British Dental Journal192: 43-5.
27.
Marsden P. ( 2010) A pilot study investigating compliance with essential quality requirements of HTM 01-05: Decontamination in primary dental care practices in Surrey [dissertation]. MSc, University of Kent.
28.
Martin M., Bartzokas C. ( 1985) The boiling of instruments in general dental practice: a misnomer for sterilization. British Dental Journal159: 18-20.
29.
McDonald JC, Chen Y., Zekveld C., Cherry NM ( 2005) Incidence by occupation and industry of acute work related respiratory diseases in the UK, 1992-2001. Occupational Environmental Medicine62: 836-42.
30.
Miller C. ( 1990) Instrument cleaning involves multiple steps. Dentist68:23-5.
31.
Miller C. ( 1993) Cleaning, sterilization and disinfection: basics of microbial killing for infection control. Journal of the American Dental Association124: 48-56.
32.
Miller C. ( 1994) Clean instruments properly to achieve optimum sterility . RDH14: 24-5.
33.
Miller CH, Riggen SD, Sheldrake MA, Neeb JM ( 1993) Presence of microorganisms in used ultrasonic cleaning solutions. American Journal of Dentistry6: 27-31.
34.
NHS Scotland Sterile Services Provision Review Group ( 2004) Survey of decontamination in general dental practice. NHS Scotland: Edinburgh. http://www.scotland.gov.uk/Publications/2004/11/20093/45220 (accessed 30 August 2010).
35.
Nubar E. ( 1972) Fallacy of cold sterilization. Journal of the American Dental Hygenist Association46: 172-5.
36.
Porter SR, Peake G., Scully C., Samaranayake LP ( 1993) Attitudes to cross-infection measures of UK and Hong Kong patients. British Dental Journal175: 254-7.
37.
Ramos-Gomez F., Ellison J., Greenspan D., Bird W., Lowe S.Gerberding JL ( 1997) Accidental exposures to blood and body fluids among health care workers in dental teaching clinics: a prospective study. Journal of the American Dental Association128: 1253-61.
Redd JT, Baumbach J., Kohn W., Nainan O., Khristova M., Williams I. ( 2007) Patient-to- patient transmission of Hepatitis B virus associated with oral surgery. Journal of Infectious Disease195: 1311-14.
40.
Rosa AC, Brusca MI, Manto MC, Mosca CO, Nastri N. ( 2001) Effects of handling and storage on sterile dental instruments . Acta Odontologica Latinoamericana14: 35-9.
41.
Sanchez E., Macdonald G. ( 1995) Decontaminating dental instruments: testing the effectiveness of selected methods. Journal of the American Dental Association126: 359-66.
42.
Shah SM, Merchant AT, Dosman JA ( 2006) Percutaneous injuries among dental professionals in Washington State. BMC Public Health6: 269.
43.
Smith A., Dickson M., Aitken J., Bagg J. ( 2002) Contaminated dental instruments. Journal of Hospital Infection51: 233-5.
44.
Smith AJ, Bagg J., McHugh S. ( 2006) No to chlorhexidine. British Dental Journal200:31.
45.
Smith WH, Davies D., Mason KD, Onions JP ( 1982) Intraoral and pulmonary tuberculosis following dental treatment. Lancet1: 842-4.
46.
Tate WH, Goldschmidt MC, Ward MT, Grant RL ( 1995) Disinfection and sterilization of composite polishing instruments. American Journal of Dentistry8: 270-2.
47.
Taylor DM ( 2000) Inactivation of transmissible degenerative encephalopathy agents: a review. The Veterinary Journal159: 10-17.
48.
Walker JT, Budge C., Vassey M., Sutton JM, Marsh PD, Bennett P., Raven ND(2009) vCJD and the cleanability of endodontic files - a case for single-use . ENDO3: 115-20.
49.
Walker N., Burke FJ, Palenik CJ ( 2006) Comparison of ultrasonic cleaning schemes: a pilot study . Primary Dental Care13: 51-6.
50.
Whitworth CL, Martin MV, Gallagher M., Worthington HV ( 2004) A comparison of decontamination methods used for dental burs. British Dental Journal197: 635-40.
51.
Whitworth CL, Davies K., Palmer NO, Martin MV ( 2007) An investigation of the decontamination of Siqveland matrix bands. British Dental Journal202: E12.
52.
Whitworth CL, Davies K., Palmer NO(2009) Can protein contamination be removed from hand endodontic instruments ? Primary Dental Care16: 7-12.
53.
Will RG, Ironside JW, Zeidler M., Cousens SN, Estibeiro K., Alperovitch A., Poser S., Pocchiari M., Hofman A., Smith PG ( 1996) A new variant of Creutzfeldt-Jakob disease in the UK. Lancet347: 921-5.
54.
Zobeley E., Flechsig E., Cozzio A., Enari M., Weissmann C. ( 1999) Infectivity of scrapie prions bound to a stainless steel surface. Molecular Medicine5: 240-3.
