| FAQ - Diseases and Disease Agents - Archived Through 2012
How do you handle the sterilization of instruments used on known hepatitis patients? Can you put them in the ultrasonic cleaner or separate them and handscrub them? If you use the ultrasonic cleaner, do you have to then empty it and sterilize it?
Instruments used on known hepatitis patients do not require special reprocessing procedures. The same sterilization and other infection control precautions should be used regardless of a patient's HIV, hepatitis, or other disease status.
The Centers for Disease Control and Prevention's guidelines for infection control in dentistry state: "Universal precautions were based on the concept that all blood and body fluids that might be contaminated with blood should be treated as infectious because patients with bloodborne infections can be asymptomatic or unaware they are infected … Standard precautions integrate and expand the elements of universal precautions into a standard of care designed to protect HCP and patients from pathogens that can be spread by blood or any other body fluid, excretion, or secretion. Standard precautions apply to contact with 1) blood; 2) all body fluids, secretions, and excretions (except sweat), regardless of whether they contain blood; 3) nonintact skin; and 4) mucous membranes. Saliva has always been considered a potentially infectious material in dental infection control; thus, no operational difference exists in clinical dental practice between universal precautions and standard precautions."(1)
In other words, the same sets of instrument processing, personal protection equipment, and engineering and work practice control precautions can be expected to protect against all bloodborne disease agents.(1) As such, instruments used on a known hepatitis patient need not be segregated from other contaminated instruments, can be cleaned in an ultrasonic cleaner, and do not require special post-cycle maintenance or cleaning of ultrasonic equipment.
1) CDC. Guidelines for Infection Control in Dental Health-Care Settings --- 2003. December 19, 2003 MMWR 52(RR17);1-61 http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm