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Ultrasonic Handpieces

When and how often should Handpieces be sterilized.. is cavi wipe sufficient? How to bring up topic when there is only 2 in the office.



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The CDC Guidelines state that they should be heat sterilized in between each patient, surface disinfection isn’t adequate. Here is what the Guidelines specifically state on page 30 of https://www.cdc.gov/mmwr/PDF/rr/rr5217.pdf:
 
Multiple semicritical dental devices that touch mucous membranes are attached to the air or waterlines of the dental unit. Among these devices are high- and low-speed handpieces, prophylaxis angles, ultrasonic and sonic scaling tips, air abrasion devices, and air and water syringe tips. Although no epidemiologic evidence implicates these instruments in disease transmission (353), studies of high-speed handpieces using dye expulsion have confirmed the potential for retracting oral fluids into internal compartments of the device (354–358). This determination indicates that retained patient material can be expelled intraorally during subsequent uses. Studies using laboratory models also indicate the possibility for retention of viral DNA and viable virus inside both high-speed handpieces and prophylaxis angles (356,357,359). The potential for contamination of the internal surfaces of other devices (e.g., low-speed handpieces and ultrasonic scalers), has not been studied, but restricted physical access limits their cleaning. Accordingly, any dental device connected to the dental air/water system that enters the patient’s mouth should be run to discharge water, air, or a combination for a minimum of 20–30 seconds after each patient (2). This procedure is intended to help physically flush out patient material that might have entered the turbine and air and waterlines (2,356,357).
 
Heat methods can sterilize dental handpieces and other intraoral devices attached to air or waterlines (246,275,356, 357,360). For processing any dental device that can be removed from the dental unit air or waterlines, neither surface disinfection nor immersion in chemical germicides is an acceptable method. Ethylene oxide gas cannot adequately sterilize internal components of handpieces (250,275). In clinical evaluations of high-speed handpieces, cleaning and lubrication were the most critical factors in determining performance and durability (361–363). Manufacturer’s instructions for cleaning, lubrication, and sterilization should be followed closely to ensure both the effectiveness of the process and the longevity of handpieces.
 
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Every time someone new is hired in an office and at least once yearly, offices are required to do infection control training (this is stated in the same Guidelines as the link above). It sounds like your office might be due for this training. You can always print out the Guidelines and bring recommendations to the doctor and assistant(s) by showing them these recommendations.

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