Reprocessing in the dental surgery is not a simple matter of sterilising instruments, it's and entire "reprocessing protocol" to protect patients and staff from potential infections from blood, saliva or aerosol-borne infections.

1. 12 auxiliary September/October 2016
R
eprocessing in the
dental surgery is not
simply a matter of
sterilizing instru-
ments, it’s an entire
“reprocessing protocol” to protect
patients and staff from potential
infections from blood, saliva or
aerosol-borne infections.
The Dental Board of Australia guide-
lines on infection control state dental
practitioners must practise in a way that
maintains and enhances public health
and safety by ensuring that the risk of the
spread of infectious diseases is prevented
or minimised.1
To support the dental profession,
Chris Jobson from European dental hand-
piece and steam sterilizer manufacturer,
W&H, conducted a series of free CPD
educational presentations for guidance on
“Decontamination and Sterilization in the
Dental Setting” at ADX16 Sydney and in
other state capitals during 2016.
Mr Jobson says one of the most
critical areas is the proper cleaning and
reprocessing of hollow reusable medical
devices (RMDs) such as handpieces,
using an effective, reproducible and
verifiable process.
Automated handpiece units
“It has been recognised by both
Australian Standards and the ADA
Infection Control Guidelines that
automated handpiece lubricating units
are recommended over manual lubri-
cation of dental instruments to avoid
over-lubrication, which may inhibit the
penetration of steam into the handpiece
during sterilization,” Mr Jobson said.
“Over-lubrication can also lead to the
build-up of grit and contaminants which
may assist biofilm build-up as well as
cause the handpiece to wear prematurely,
greatly reducing its service life.”
Mr Jobson noted that the Australian
Standard states it is the responsibility of
each practice owner and the steri room
staff to employ a verified process of
cleaning instruments using a detergent that
will effectively remove contaminants prior
to sterilisation. Australian Standards and
ADA Infection Control Guidelines both
specifically note that cleaning is a process
of washing with water and detergent.
Ultrasonic cleaners use detergent to
clean hand instruments and similarly, a
suitable detergent should always be used
to clean dental handpieces. Therefore,
further investigation for some evidence of
effectiveness is warranted for automated
handpiece cleaning and lubricating units
that claim a cleaning functionality, yet do
not use detergent.
The W&H Assistina 3x3 does pro-
vide an independently verified process2
for both internal and external cleaning
as well as the automated lubrication of
handpieces. The compact bench-top unit
is capable of internally cleaning (drive
mechanism), externally cleaning and
lubricating up to three handpieces in just
6.5 minutes ready for sterilising, making
it ideal for all dental practices.
Reprocessing in the dental surgery
By David Petrikas
infection | CONTROL
Figure 1 and 2. W&H provides a complete infection control solution that includes the Lisa Class B steriliser and innovative
Assistina 3x3 handpiece maintenance unit.

2. 14 auxiliary September/October 2016
The W&H ActiveFluid™
detergent
used to clean the handpieces in the Assis-
tina is a gentle, slightly alkaline (pH 7.6)
water-based cleaning agent containing an
anionic surfactant - ideal for cleaning and
neutralising acidic organic contaminants
such as blood and saliva whilst inhibiting
the growth of viruses and bacteria within
the Assistina process chamber.
Choose the right sterilizer
“With some RMDs being more chal-
lenging to reprocess than others,
any mistake has direct implications for
the safety of the dental team and patients.
This is especially confusing as not all
steam steriliser cycles are capable of ster-
ilising every type of RMD such as hollow
and wrapped loads,” Mr Jobson said.
Always use
correct sterilization cycle
Mr Jobson pointed out that only a
“B Type”’ cycle is capable of steri-
lising all load types and should always
be used when handling mixed loads to
ensure effective sterilisation of all instru-
ments including Hollow A, Hollow B
and wrapped loads - even in the case of
smaller loads.
W&H was the first benchtop steam
steriliser manufacturer to design a steri-
lizer with exclusive “B Type” cycles only
to ensure each and every load is properly
sterilised, relieving the reprocessing staff
from the responsibility of selecting the
appropriate cycle for the type of load cre-
ated. This is an important foundation and
safeguard for reliable infection control.
The W&H “Lisa” steriliser comes with
more automated functions, including auto
load sensing to reduce the cycle time, an
in-built air detector ensuring full exposure
of instruments to saturated steam (even
with hollow loads) and inbuilt cycle-data
logging with user identification including
password for load release to ensure proper
oversight of the sterilisation process.
Instrument tracking
The W&H Lisa supports automated
instrument tracking (or batch control
identification) using a dedicated W&H
LisaSafe bar code label printer which
will only produce a label for those
sterilisation cycles where the parameters
for time, temperature and pressure have
been met.
Batch control identification is now
widely used in both private and public
practices to automate and streamline
instrument tracking for those critical
instruments (mandatory according to the
Australian Standard) and provide a link
between the instruments used on a patient
and a verified sterilisation cycle.
The W&H Lisa also automatically
stores each cycle’s parameters on a
downloadable memory card and Lisa can
be permanently attached to a PC to auto-
matically log all cycle batch data to the
practice PC to be included with the daily
back-up of data.
For assistance on setting up and equip-
ping a reprocessing area to meet the
required infection control standards,
contact your local A-dec Territory Man-
ager or A-dec equipment dealer. For
more information, call A-dec Australia
on 1800-225-010 or see www.wh.com.
1. DBA Guidelines
2. As verified by Robert Koch Institute and Swissmedic.
Figure 3 and 4. The new W&H Assistina 3x3 now accommodates up to 3 instruments including turbines, straight and contra-angle
handpieces, air motors and air-driven scalers; An innovative cleaning ring travels along the instruments, spraying a cleaning solution
at very high pressure through 6 spray nozzles. This patented system avoids heating both the cleaning solution and the instruments.
By eliminating brushing and scrubbing, micro-scratches on the instruments which can harbor future debris are also avoided.