| FAQ - X-Rays - Archived Through 2012
On the plastic bite pegs for the pano machines, do you cover them with plastic or do you change them between each patient and gas sterilize them? What if the patient bites through the plastic?
Ideally, disposable pano bite pegs/guides or reusable guides that can be heat sterilized would be preferred. However, bite pegs/guides, chin rest, head positioning guides, and hand grips may be barrier protected.
We would also like to include additional information from the CDC's Infection Control Guidelines for Dental Healthcare Settings. Although it does not specifically mention pano bite pegs/guides, it does address radiograph accessories. In part, the guidelines state the following:
When taking radiographs, the potential to cross-contaminate equipment and environmental surfaces with blood or saliva is high if aseptic technique is not practiced. Heat-tolerant versions of intraoral radiograph accessories are available and these semi-critical items (e.g. film-holding and positioning devices) should be heat sterilized before patient use. (1)
Digital radiography sensors and other high-technology instruments (e.g., intraoral camera, electronic periodontal probe, occlusal analyzers, and lasers) come into contact with mucous membranes and are considered semi-critical devices. They should be cleaned and ideally heat-sterilized or high-level disinfected between patients. However, these items vary by manufacturer or type of device in their ability to be sterilized or high-level disinfected. Semi-critical items that cannot be reprocessed by heat sterilization or high-level disinfection should, at a minimum, be barrier protected by using an FDA-cleared barrier to reduce gross contamination during use. Use of a barrier does not always protect from contamination. One study determined that a brand of commercially available plastic barriers used to protect dental digital radiography sensors failed at a substantial rate (44%). This rate dropped to 6% when latex finger cots were used in conjunction with the plastic barrier. To minimize the potential for device-associated infections, after removing the barrier, the device should be cleaned and disinfected with an EPA-registered hospital disinfectant (intermediate-level) after each patient. (1)
Manufacturers should be consulted regarding appropriate barrier and disinfection/sterilization procedures for digital radiography sensors, other high-technology intraoral devices, and computer components. (1)
OSAP's Infection Control In Practice, November 2003 issue, states that intraoral x-ray accessories such as film-holding and positioning devices are classified as semi-critical items. Whenever possible, use disposable bite guides and other x-ray accessories. Heat-tolerant versions of these devices also are commercially available. (2)
Heat-sensitive semi-critical instruments that cannot be reprocessed by heat sterilization or by high-level chemical disinfectant/sterilant should be barrier protected to minimize contamination during use. After use, remove the barrier and clean and intermediate-level disinfect the intraoral surfaces of the device between patient uses. (2)
1) CDC's Infection Control Guidelines for Dental Healthcare Settings:
2) Infection Control In Practice: Infection Control and Dental Radiography, Vol. 2, No. 8
November 2003 issue