| FAQ - Instrument Processing - 2015
I am trying to find the correct way to clean/sterilize pumice wheels. I have offices that are placing them into sterilization pouches but then after they are sterilized, mold starts growing on them. Trying to find the best way to first clean them before going into sterilization pouches.
The 2003 CDC guidelines for infection control in dentistry states as follows:
If laboratory items (e.g., burs, polishing points, rag wheels, or laboratory knives) are used on contaminated or potentially contaminated appliances, prostheses, or other material, they should be heat-sterilized, disinfected between patients, or discarded (i.e., disposable items should be used) (260,407). Heat-tolerant items used in the mouth (e.g., metal impression tray or face bow fork)
should be heat-sterilized before being used on another patient (2,407). Items that do not normally contact the patient, prosthetic device, or appliance but frequently become contaminated and cannot withstand heat-sterilization (e.g., articulators, case pans, or lathes) should be cleaned and disinfected between
patients and according to the manufacturer’s instructions. Pressure pots and water baths are particularly susceptible to contamination with microorganisms and should be cleaned and disinfected between patients (422). In the majority of instances, these items can be cleaned and disinfected with an EPA registered hospital disinfectant. Environmental surfaces should be barrier-protected or cleaned and disinfected in the same manner as in the dental treatment area.1
6. Follow manufacturers’ instructions for cleaning and sterilizing or disinfecting items that become
contaminated but do not normally contact the patient (e.g., burs, polishing points, rag wheels,
articulators, case pans, and lathes). If manufacturer instructions are unavailable, clean and heat sterilize
heat-tolerant items or clean and disinfect with an EPA-registered hospital disinfectant with
low- (HIV, HBV effectiveness claim) to intermediate- level (tuberculocidal claim) activity, depending on the degree of contamination (II). 1
Infection Control and Management of Hazardous Materials for the Dental Team states:
Grinding, Polishing, and Blasting
As stated before, perform laboratory work on previously disinfected impressions, appliances, and prostheses. Bringing untreated materials into the laboratory establishes the potential for cross-contamination.
Operation of a dental lathe provides an opportunity for the spread of infection and for injury. The rotary action of the wheels, stones, and bands generates aerosols, spatter, and projectiles. Whenever one is using the lathe, one should wear protective eyewear, properly place the front Plexiglas shield, and ensure that the ventilation system is operating properly. The use of a mask is highly recommended. The air-suction motor should be capable of producing an air velocity of at least 200 ft/min. Maximum containment of aerosols and spatter can be achieved when a metal enclosure with hand holes is fixed to the front of the hood of the lathe. One can sterilize or disinfect all attachments, such as stones, rag wheels, and bands, between uses or throw them away. The lathe unit must be disinfected twice a day.
One should use fresh pumice and pan liners for each case (Figure 16-3). The modest cost of the materials and the proven significant microbial contamination in reused pumice prohibits repeated use.
Polishing of appliances and prostheses before delivery is a necessary activity. Polishing exposes the operator to potential cross-contamination and physical injury. However, if the item being polished has been prepared aseptically, the risks of infection are reduced to a minimum. To avoid the potential spread of microorganisms, one should obtain all polishing agents (e.g., rouge) in small quantities from larger reservoirs. One should never return unused material to the central stock but should throw it away. Most polishing attachments (e.g., brushes, wheels, and cups) are single-use, disposable items. One should sterilize reusable items between uses, if possible, or at least disinfect the items.
One should follow the manufacturer’s instructions for cleaning and sterilizing or disinfecting items that become contaminated but that normally do not contact the patient (e.g., burs, stones, polishing points, rag wheels, articulators, case pans, and lathes). If the manufacturer’s instructions are not available, one should clean and heat sterilize heat-tolerant items or clean and disinfect, depending upon the degree of contamination.2
The USAF Dental Evaluation & Consultation Service offers a fact sheet for the laboratory which can be accessed at this link:
Ask OSAP does not review, evaluate, certify, recommend or endorse products. Ask OSAP also does not provide technical support for specific products. If you have further questions about procedures and specific products it is recommended that you consult with the manufacturer’s written instruction manual and/or contact the manufacturer of your product.
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 August 7, 2015.
2) Miller CH. Infection Control and Management of Hazardous Materials for the Dental Team, 5th edition. Elsevier/Mosby Publishers. Pages 187 -188.
3) USAF Dental Evaluation & Consultation Service. Laboratory and Radiography. http://www.airforcemedicine.af.mil/shared/media/document/AFD-130322-065.pdf Accessed on August 7, 2015.