Decontamination in primary care dental practices - Gov.uk

Decontamination: Health Technical Memorandum 01-05 – Decontamination in primary care dental practices (2013 edition)3 Cleaning instrumentsGuidance on the installation, validation, maintenanceand testing of ultrasonic cleaners and washerdisinfectorscan be found in Section 3.Introduction3.1 The principal methods of cleaning reusable dentalinstruments currently available are: cleaning using awasher-disinfector; manual combined withultrasonic cleaning; manual.3.2 Effective cleaning of instruments is an essentialprerequisite before sterilization and will reduce therisk of transmission of infectious agents. Whereverpossible, cleaning should be undertaken using anautomated and validated washer-disinfector inpreference to manual cleaning, as a washerdisinfectorincludes a disinfection stage that rendersinstruments safe for handling and inspection.3.3 Manual cleaning, governed by an appropriateprotocol, is acceptable within the essential-qualityrequirementsframework. Within the best-practiceframework, however, manual cleaning should beconsidered only where the manufacturer specifiesthat the device is not compatible with automatedprocesses (including ultrasonic cleaning) or whenthe washer-disinfector is temporarily unavailable(for example for repair or validation). Exceptionally,where local experience indicates that pre-washingmay be helpful (for example in the removal oftenacious dental materials), such action may beappropriate before automated cleaning.3.4 New instruments should be cleaned and sterilizedbefore using for the first time, unless supplied assterile.3.5 Instruments cleaned as soon as possible after usemay be more easily cleaned than those left for anumber of hours before reprocessing. Where this isnot possible, water immersion or the use of a foamspray or gel intended to maintain a moist orhumid environment are thought useful in aidingsubsequent decontamination. Long periods of wetstorage should, however, be avoided.3.6 When working with substances that can harden oninstruments (for example cements), the instrumentsshould be cleaned immediately. Instruments thatcannot be cleaned should be discarded.3.7 Where recommended by the manufacturer,instruments and equipment that consist of morethan one component should be dismantled to alloweach part to be adequately cleaned. Members of thedental team should be appropriately trained toensure competence in dismantling, cleaning,sterilizing and reassembling of instruments.Amalgam carriers are an example ofinstrumentation requiring this approach.General requirements for cleaningmethods3.8 Where possible, refer to manufacturers’ instructionsrelating to instruments, dental equipment, cleaningdevices and cleaning solutions.3.9 Whenever possible, cleaning should be undertakenusing an automated and validated process inpreference to manual cleaning. Manual cleaningshould be considered where manufacturers’instructions specify that the device is notcompatible with automated processes.3.10 Ensure that instruments can be cleaned using amethod available to the practice.3.11 Validation is the means by which an entire processis verified, tested and documented, with the abilityto be consistently reproducible. Ensure thatultrasonic and washer-disinfector cleaningprocedures used in the practice are validated.This is to demonstrate that all instruments andequipment cleaned by these methods are reliablyand consistently cleaned using predetermined andreproducible conditions.3.12 Technical details for validation standards andprocedures are provided in Section 3. Theassistance of decontamination specialists will benecessary from time to time in order to ensurethat equipment and procedures remain valid inengineering terms.16