| FAQ - X-Rays - Archived Through 2012
What is OSAP's suggestion to control the infection of digital dental x-ray sensors?
First and foremost, you should follow the manufacturer's directions. The warranty may not be honored if the manufacturer's directions are not followed.
The August 2002 issue of Dental Products Report includes an article written by infection control expert Chris Miller, PhD. The article title is: "High-tech equipment: Keeping it germ-free".
Dr. Miller offers advice on questions to ask before buying equipment, precautions for special equipment, and general approaches to equipment decontamination. Dr. Miller does provide information in this article about digital radiography equipment. Following is a summary:
Because they are reusable, it is important to properly handle the sensors in order to prevent cross-contamination. There are three different types of sensors. These include:
(1) The charged-couple-device (CCD ) sensor. This sensor is attached to a cable and should not be heat-sterilized. This sensor should be covered with a fresh barrier extending down from the cable that prevents any contact with patient materials or contaminated hands. According to Dr. Miller, if the CCD should become contaminated, it may be disinfected using the spray-wipe-spray technique according to manufacturer's directions. This involves spraying on a disinfectant and wiping with a gauze pad, then spraying again (following the contact time indicated on the disinfectant label). Then rinse off the disinfectant with water and let dry.
(2) The complementary metal-oxide semiconductor with active pixel sensors (CMOS/APS).
It is wired and should be treated with plastic barriers according to manufacturer's
directions, just like the CCD sensor.
(3) The third type of sensor is the Photo-Stimulable Phosphor Plate (PSP) sensor. The
sensor is wireless and is placed in the patient's mouth, much like regular film. This
sensor should be covered with a fresh barrier for each use. Care must be taken not to
tear the barrier inadvertently during use because it cannot be heat-sterilized or
chemically disinfected. (See manufacturer's information for specifics). (1)
The Centers for Disease Control and Prevention's Infection Control Guidelines for Dental Healthcare Settings state:
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 (tuberculocidal) after each patient. Manufacturers should be consulted regarding appropriate barrier and disinfection/sterilization procedures for digital radiography sensors, other high-technology intraoral devices, and computer components. (2)
Additionally, the United States Air Force's Dental Evaluation and Consultation Service provides the following information:
At this time, however, there are no sensors that can withstand heat sterilization or complete immersion in a high-level disinfectant. (3)
Because the sensors and associated computer components vary by manufacturer and are expensive, manufacturers should be consulted regarding specific disinfection products and procedures. (3)
1) Dental Products Report. August 2002: "High-tech equipment: Keeping it germ-free". By Chris Miller, PhD.
2) Centers for Disease Control and Prevention's Infection Control Guidelines for Dental Healthcare Settings:
3) United States Air Force Dental Evaluation and Consultation Service: