Reprocessing Dental Handpieces

By Dr. Katherine Schrubbe, RDH, BS, MEd, PhD.

Compliance with CDC guidelines for reprocessing is vital to the safety of the dental staff and patients.

There seems to be a lot of buzz about dental handpieces these days. For whatever reason, the question of reprocessing these devices for patient use is once again a popular conversation in dental practices. Dental handpieces are medical devices accompanied by instructions for use (IFU). As discussed in a previous article, IFU are provided for medical devices and products in accordance with federal Food and Drug Administration (FDA) standards and provide information on cleaning, disinfection and 1 In any dental setting, IFUs must be strictly followed to ensure patient safety, as well as peak performance of the devices. Whether the organization is a DSO, a large group practice or a solo practice, there must be a sufficient number of instruments to serve the patient schedules in order to avoid shortcuts in reprocessing.

sterilization of patient care items.

Categories of patient care items

The Centers for Disease Control and Prevention sorts patient care items into three categories (referred to as the Spaulding classification), based on the potential risk for infection associated with their intended use: critical, semicritical or noncritical.2,3


Centers for Disease Control and Prevention. Guidelines for Infection Control in Dental Health-Care Settings – 2003. MMWR 2003;52(No. RR-17); 20.

At the ends of the spectrum are the critical and noncritical patient care items. According to the CDC, all critical items should be heat sterilized between patient use, as they have the greatest risk of transmitting infection. Noncritical items, which pose the least risk of disease transmission, should be cleaned and disinfected with an EPA-registered hospital disinfectant.2,4

In the middle of the spectrum are semicritical items. These items come in contact with mucous – or non-intact – membranes, but they do not penetrate soft tissue, contact bone, the bloodstream or other normally sterile tissues.2


Dental handpieces are considered semicritical items. The CDC states, “dental handpieces and associated attachments, including low-speed motors and reusable prophylaxis angles, should always be heat sterilized between patients and not high-level or surface disinfected.  Although these devices are considered semicritical, studies have shown that their internal surfaces can become contaminated with patient materials during use. If these devices are not properly cleaned and heat sterilized, the next patient may be exposed to potentially infectious materials.”4,5,6

In other words, there are no shortcuts to patient safety around handpieces, including low-speed motors use primarily for hygiene appointments. Eleven states require heat sterilization of dental handpieces: California, Florida, Indiana, Kansas, Missouri, New Mexico, Ohio, Oregon, South Carolina, Virginia, and Washington.7 And, the CDC guidelines fully apply in the remaining 39 states. Additional guidance from the CDC states, “handpieces and other intraoral devices that can be removed from the air and waterlines of dental units should be cleaned and heat-sterilized between patients. Follow the manufacturer’s instructions for cleaning, lubricating, and sterilizing these devices. These devices include high-speed, low-speed, electric, endodontic, and surgical handpieces, as well as all handpiece motors and attachments, such as reusable prophylaxis angles, nose cones, and  contra-angles.”8


The updated guidance from the CDC provides a 3-point summary:

  1. Clean and heat sterilize handpieces and other intraoral instruments that can be removed from the air lines and waterlines of dental units.
  2. For handpieces that do not attach to air lines and waterlines, use FDA-cleared devices and follow the validated manufacturer’s instructions for reprocessing these devices.
  3. If a dental handpiece cannot be heat sterilized and does not have FDA clearance with validated instructions for reprocessing, do not use that device.9
Dr. Katherine Schrubbe, RDH, BS, M.Ed, PhD

References

  1. Schrubbe K. Instructions for use. Efficiency in Group Practice. Available at http://www.dentalgrouppractice.com/instructions-for-use.html. Accessed April 24, 2018.
  1. Centers for Disease Control and Prevention. Guidelines for Infection Control in Dental Health-Care Settings — 2003. MMWR 2003;52(No. RR-17); 20.
  1. Miller CH, Palenik CJ. Infection Control and Management of Hazardous Materials for the Dental Team. 5th ed. St. Louis: Mosby Elsevier; 2013; 122.
  1. Centers for Disease Control and Prevention. Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health, March 2016.
  1. Chin J.R., Miller C.H., Palenik, C.J. (2006). Internal contamination of air-driven low-speed handpieces and attached prophy angles. J Am Dent Assoc. 137(9):1275-80. Available at http://www.ncbi.nlm.nih.gov/pubmed/16946433. Accessed May 10, 2018.
  1. American Dental Association. Oral health topics; infection control. Available at https://www.ada.org/en/member-center/oral-health-topics/infection-control-resources. Accessed May 10, 2018.
  1. The Dental Student Network list of state licensing agencies. Available at http://www.studentdoctor.net/dental/state_boards.html. Accessed April 24, 2018.
  1. Centers for Disease Control and Prevention. Dental Handpieces and Other Devices Attached to Air and Waterlines. Available at https://www.cdc.gov/oralhealth/infectioncontrol/questions/dental-handpieces.html. Accessed May 10, 2018.
  1. Centers for Disease Control and Prevention. Statement on Reprocessing Dental Handpieces, April 11, 2018. Available at https://www.cdc.gov/oralhealth/infectioncontrol/statement-on-reprocessing-dental-handpieces.htm. Accessed May 10, 2018.
  1. US Department of Health and Human Services. Public Health Service Food and Drug
    Administration. Reprocessing Medical Devices in Health Care Settings: Validation Methods and Labeling Guidance for Industry and Food and Drug Administration Staff. March 17, 2015. https://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm253010.pdf.  Accessed May 10, 2018.
  1. Vavrosky K. 5 infection control mistakes you may be making and not even realize. Dental Products Report, July 11, 2016. Available at http://www.dentalproductsreport.com/hygiene/article/5-infection-control-mistakes-you-may-be-making-and-not-even-realize?page=0,1.  Accessed May 10, 2018.

Are you busy or productive?

There is an old song that goes like this, “sitting on the dock of the bay wasting time…” Although sitting on the dock of the bay relaxing and enjoying the quiet is truly needed in our lives; “wasting time” is a great way to get to stuck in your personal and professional life.

There are a multitude of people who talk about moving forward, desiring to act upon their goals, but never get “there” because they are stuck sitting on the dock, and wasting a lot of time.

1. Consider your schedule: Are you busy reacting to busy-work, or are you productive with goal accomplishment?

2. Evaluate your need for “dock-time” are you using too much of it to avoid feeling overwhelmed, and therefore creating laziness and a feelings of imposter syndrome?

3. Create active daily and weekly goals and be accountable for them. Write them down to ensure better successful outcomes.

Organize your schedule into time periods of accomplishments, allowing for achievement and relaxation. There are several great resources out there to help you begin a life of productive habits. A couple of my personal favorites: “The Miracle Morning” by Hal Elrod and “Train your Brain for Success” by Roger Seip (particularly the 2-hour solution section).
Now go! Get off the dock!

What is preventing your Success?

Are you finding yourself asking why you are not as successful as you want to be?  The difference between successful people and unsuccessful people is the reaction to what happens around them.  Successful people are always moving forward, prepared for any action.  Unsuccessful people have no plan and simply react to the circumstances around them.

  • Take full personal responsibly-no more excuses
  • Identify what you want to accomplish and write down the steps it would take to get “there.”
  • Surround yourself with successful people in successful environments and eliminate distractions.
  • Become accountable to a trusted adviser to ensure you finish what you start.

 

What is your plan?  Be excited as you enjoy the journey of success!

 

By:  Corey Jameson-Kuehl

How is your Garden??

Currently, most of our flower gardens are in full bloom; and depending on what part of the county you hail from, your vegetable gardens are ready for harvest as well!

Has it been a successful season?  Were the plants healthy and high-yielding, or did you have weeds over take the garden and your initial hard work went to waste?

At this mid-year time, reflect on the “garden” of your choices.  Just as a well-maintained garden can produce abundance, weeds of distractions, toxic people, and negative environments it can create unrest and a cycle of poor choices.  Eliminate the elements that do not produce healthy fruit in your life.  Work hard to cultivate and protect your “crops” for your future success!

 

BY:  Corinne Jameson-Kuehl

Beyond the Prophy: With True Passion The Money Will Follow with Corinne Jameson-Kuehl, RDH

 

Topics we discuss:

  • Being okay with not being a “normal” hygienist
  • Evolution as a dental business owner
  • Being real with how you feel
  • The mass exodus of dental hygienist from the profession
  • Getting to the root of the issue
  • Caring for yourself first
  • Creating the best team as an entrepreneur
  • Understand your strengths
  • Expanding clinically and having contentment
  • Bootstrapping a business

Corey@CustomDentalSolutions.com

Where to find Beyond the Prophy®:

Facebook: @Beyondtheprophy