|FAQ - Regulatory - Archived Through 2012
Does OSAP or the CDC have requirements for cleaning and reusing sponges used during endo procedures? This office also insists on reusing irrigation needle tips used to clean the canals by soaking in cold sterile. Can these irrigation needle tips be safely reused? I am also concerned about the number of times they reuse endo files. How safe is it to reuse endo files and how many times can they be reused before breaking down the file? What is the best system to clean, disinfect, and sterilize endo files. And how do I approach a doctor when I am a new employee to change their sterilization techniques.
First and foremost, if the endodontic sponge manufacturer labels them as single use disposable devices/items, they must be discarded after each patient use. If the label does not provide re-use instructions from the manufacturer you should also consider them as single use disposable items. Even though the CDC Guidelines do not specifically address endodontic sponges, dental infection control experts state that it is difficult to effectively, adequately, or reliably clean the inside of the sponge and they should be discarded after each patient use unless the manufacturer indicates otherwise.
The same holds true for irrigating needles. The diameter of the needle lumen can make it difficult to clean and effectively sterilize.
The authors of From Policy to Practice: OSAP's Guide to the Guidelines list irrigating syringes as a single-use item and states that these items are always single-use/disposable. (1)
The authors of Infection Control & Management of Hazardous Materials for the Dental Team state that a disposable item is manufactured for a single use or for use on only one patient. Such items are manufactured from plastics or less expensive metals that are usually not heat tolerant or are not designed to be cleaned adequately. Thus an item that is labeled as disposable must be disposed of properly after use, and one should not attempt to pre-clean and sterilize or disinfect it for reuse on another patient. (2)
The Center's For Disease Control and Prevention's (CDC) Infection Control Guidelines for Dental
Healthcare Settings state that a single-use device, also called a disposable device, is designed to be used on one patient and then discarded, not reprocessed for use on another patient (e.g., cleaned, disinfected, or sterilized). Single-use devices in dentistry are usually not heat-tolerant and cannot be reliably cleaned. Examples include syringe needles, prophylaxis cups and brushes, and plastic orthodontic brackets. Certain items (e.g., prophylaxis angles, saliva ejectors, high-volume evacuator tips, and air/water syringe tips) are commonly available in a disposable form and should be disposed of appropriately after each use. Single-use devices and items (e.g., cotton rolls, gauze, and irrigating syringes) for use during oral surgical procedures should be sterile at the time of use. (3)
Because of the physical construction of certain devices (e.g., burs, endodontic files, and broaches) cleaning can be difficult. In addition, deterioration can occur on the cutting surfaces of some carbide/diamond burs and endodontic files during processing and after repeated processing cycles, leading to potential breakage during patient treatment. These factors, coupled with the knowledge that burs and endodontic instruments exhibit signs of wear during normal use, might make it practical to consider them as single-use devices. (3
You may want to consider asking the person responsible for the office infection control training if the CDC Infection Control Guidelines for Dental Healthcare Settings have been reviewed by the staff. If not, you could consider suggesting it as a topic for staff meetings. Doing so may invite open discussions by the staff.
1) From Policy to Practice: OSAP's Guide to the Guidelines. Copyright 2004 by OSAP.
2) Infection Control & Management of Hazardous Materials for the Dental Team, 3rd. edition. by
Miller & Palenik. Elsevier/Mosby Publishers. Copyright 2005.
3) Center's For Disease Control and Prevention's (CDC) Infection Control Guidelines for Dental