| FAQ - Instrument Processing - 2014
How should amalgam carriers be disinfected & sterilized? Dental assistant claims & dentist claims they quit working when they go in the ultrasonic cleaner & sterilizer. She was wiping them down with Product A only because of this. I didn't think this was acceptable. Is it okay to put them in the cold chem. instead? Any advice?
As you are probably aware, the 2003 CDC guidelines for infection control in dentistry states the following regarding patient-care items:
Patient-care items (dental instruments, devices, and equipment) are categorized as critical, semicritical, or noncritical, depending on the potential risk for infection associated with their intended use (Table 4) (242). Critical items used to penetrate soft tissue or bone have the greatest risk of transmitting infection and should be sterilized by heat. Semicritical items touch mucous membranes or nonintact skin and have a lower risk of transmission; because the majority of semicritical items in dentistry are heat-tolerant, they also should be sterilized by using heat. If a semicritical item is heat-sensitive, it should, at a minimum, be processed with high-level disinfection (2). 1
Definition: Contacts mucous membranes or nonintact skin; will not penetrate soft
tissue, contact bone, enter into or contact the bloodstream or other
normally sterile tissue.
Dental instrument or item: Dental mouth mirror, amalgam condenser, reusable dental impression
trays, dental handpieces* 1
An amalgam carrier is categorized as a semicritical patient care item and should be heat sterilized after use.
In this instance, it is unclear if routine, appropriate procedures are in place for the use and handling of the instrument. For example, excess amalgam can collect in the lumen of the amalgam carrier. If such amalgam is not completely removed promptly upon completion of the procedure, it can solidify in the lumen and cause future instrument problems. Excess amalgam should be removed from the amalgam carrier prior to autoclave steam sterilization.
It is recommended that you contact the manufacturer of the amalgam carrier for further information on the use, handling and maintenance of the product. The manufacturer can provide more information specific to instrument processing and sterilization procedures for their product. For example, the manufacturer can tell you specifically if cold sterilization solutions should or should not be used for their product. Depending upon the situation, there may also be other products that they recommend for use in order to solve a particular problem. Failure to comply with manufacturer’s instructions for use (IFU), handling and maintenance of the product can potentially void the product warranty. Ask OSAP does not provide technical support for specific products.
OSAP does have resources for portable/mobile dentistry setting which can be accessed at this link:
1) Kohn WG, Collins AS, Cleveland JL, Harte JA, Eklund KJ, Malvitz DM, Centers for Disease Control and Prevention (CDC). Guidelines for infection control in dental health-care settings—2003. MMWR Recomm Rep 2003;52(RR-17):1-61. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm Accessed on March 25, 2014.