IV. Cleanup Procedures
Following the completion of dental procedures, remove contaminated gloves, wash hands and put on a pair of heavy duty utility gloves. Remove contaminated barriers, place regulated waste in its container, and carry instruments to the sterilization area. if instruments cannot be cleaned, place the cassette in the bucket in the sink with water to use as a holding tank to keep the instruments wet until they can be processed. Return to the clinic, wash heavy duty gloves, dry, remove gloves and then wash hands. Place clean barriers on surfaces. Nitrile latex heavy duty gloves are recommended for processing instruments because they are more puncture and chemically resistant and they can be steam autoclaved if necessary.
Continue to wear mask and protective eyewear during cleaning and instrument processing procedures.
All blood or tissue contaminated material should be placed in the biohazardous waste disposal at the site it was generated. Do not try to separate it at the end of the day from regular trash. It must be placed in a covered container that is properly identified. In the Department Clinic, we place all waste in the same container because it is disposed of by the University.
Sharps (needles, blades, orthodontic wire, carpules, etc.) must be placed in a rigid leakproof container and disposed of properly. When the container is full,(not over filled) seal and dispose of by an appropriate licensed carrier.
If instruments will not be cleaned immediately, place them in a holding tank of detergent or water until they are ready to be processed. If the items in the presoak are considered reusable sharps, the container must be labeled with a biohazardous stamp.
The ultrasonic or instrument washer is the preferred method to clean instruments. An ultrasonic should be maintained 3/4 full of solution to prevent overheating. Operate the cleaner according to manufacturer’s directions and with the lid on.
Do not run instruments longer than necessary in the ultrasonic because it may cause pitting. In a properly operating ultrasonic, a good rule of thumb is one minute per instrument.
Rinse the instruments well after the cycle, dry and inspect the instruments to make sure the ultrasonic is doing its job before sterilizing them. The same with the instrument (cassette) washer.
The solution in the ultrasonic will be changed at least once a day, or more often in high usage. At the end of the day, the tank will be emptied and cleaned. It will sit open until the next day. Only recommended manufacturer’s solutions will be used in the ultrasonic cleaner. Do not use disinfectants.
In some cases hand instrument scrubbing may be necessary. If needed, it is recommended to keep the instruments below the surface of the solution when scrubbing to reduce splatter. Rinse and pat dry. The instruments are now ready to be sterilized. Refer to Appendix C. Always wear heavy- duty nitrile gloves when processing contaminated instruments.
At the end of the day, instrument scrub brushes should be packaged and heat sterilized. Hard surfaces should be cleaned at the end of the day or more often if necessary in the lab/sterilization area.
Using the spray-wipe- spray method (Refer to Appendix B) disinfect only items that cannot be covered with a barrier, are not disposed of, or not heat sterilized. Flush out the water in the air/water hose and the handpiece hose for 10-15 seconds. If any long delays occur, flush out lines for I minute. Wash and remove utility gloves when used and wash hands. Cover switches and other parts of unit with clean barriers. At the end of the day, disinfect the parts covered with barriers if you feel it is necessary, except the electrical switches.
To cleanse the interior of the suction tubing, flush with fresh water between patients and a cleaner at the end of the day with a commercial cleansing solution.
Place on the unit a sterilized handpiece, prophy angle and air/water syringe tip. Setup would be the same as “The Beginning of the Day.”
When cuspidors or suction devices are used, the traps should be cleaned at least once a day. Saliva ejector & high speed vacuum parts should be cleaned to remove buildup.
Traps on central suction should be cleaned weekly or according to use. Appropriate PPE will be worn when performing this task. A biohazardous sticker is located on the trap container.
Air compressors should have a source of clean air return and many types have filters that should be cleaned or changed daily.