We hope you managed to catch our recent webinar with Dentistry Online on handpiece reprocessing. We have received a lot of questions on this topic. So today we will be having a look at some of your frequently asked handpiece questions, answered by our Managing Director Laura Edgar.
Check with your HP manufacturer’s guidance – usually only before as they would be pouched and out through a vacuum cycle.
If you are using a washer disinfector, then you would Oil your handpiece according to your manufacturer’s instructions. This will normally be after the washer disinfector and possibly drying and before you place it into a vacuum autoclave.
Please ensure you check your HP is suitable for use in a washer disinfector, it is the user’s responsibility that the HP is suitable for the washer and that you have this validated by the washer manufacturers, the HP manufacturers and that you have checked the suitability of the detergent your planning to use.
Always make sure when oiling your using the right oil adaptors to ensure the oil reaches all of the correct places in the HP.
So this depends on the type of autoclave you are using and the type of cycle you choose. There are 3 type of autoclave – B , N and S.
Type B Autoclaves are vacuum autoclaves – these are designed to be used with solid items, hollow air retentive items like HP’s or porous loads like textiles – these can be pouched or not as the vacuum can ensure the steam is able to pass through the pouch surface and fill the load with steam replacing the air.
Type N Autoclaves do not have vacuum pump so they are using gravity to remove the air – this is passive displacement of air and as such is not strong enough to replace the air inside a handpiece let alone pass a pouch .
Type S Autoclaves are designed to be used with specific loads – some are load tested for HP’s but often are used without pouches as they are not a full vacuum.
Instruments like HP’s must go in a vacuum autoclave to ensure internal sterility. Pouching them prior to processing them means that you can remove the HP from the autoclave in the pouch and maintain its sterility up until the point it is used. If you do not pouch prior to autoclaving in a B type vacuum then when you open the door, it immediately becomes “sterilised” rather than sterile.
You cannot use pouches in Non-vacuum Type N autoclaves and items must be pouched afterwards – this means again the solid items are sterilised and not sterile until the point they are open. The inside of a HP will not have been touched by the steam if a N type cycle is used so will remain as it was prior to processing.
I would recommend that you plan to upgrade your N type to a Vacuum – either S type validated for HP use, or a full vacuum which you can use for both hollow and solid loads.
In all cases I would recommend an internal cleaning and disinfection system that you can use with your HP’s. This will remove any contamination and inactive any pathogenic material. Using a cleaning and disinfection process prior to sterilisation will make the sterilisation cycle more effective.
So there is no evidence for this on typical loading – It is important to leave as much air as possible around each object when placing in the autoclave. All equipment such as clamps must be sterilised in the open position to ensure all parts of the equipment get sterilised and that you don’t overload. Your Autoclave manufacturer instructions should give some guidance on this. Handpieces if it was my suggestion would be at the bottom tray to help prevent oil dropping on other items.
This is an interesting one – it depends on which part – the Legislation is the Health and Social Care Act – this gives all clinicians a legal duty of care and responsibility to protect patients from unnecessary risks such as those associated with HP’s. There is nothing that prohibits the use of N Type autoclaves currently stated in the HTM01-05 – however, this doesn’t align with the HP manufactures guidance and the EN13060 which states which loads or instruments each autoclave type is designed for.
The HP manufacturer guidance is what must be followed and what the CQC should be checking your process against this – so if this provides a method of cleaning and disinfection as it should, then it should be completed and processed in the vacuum cycle suitable for that instrument. They do leaves big gaps in the HTM01-05 but the subsequent scientific evidence is clear that N types cannot sterilise Dental HP’s as type B and some Type S’s can.
I do agree having an SOP is critical for your handpieces. I think this is important for a couple of reasons. Mainly to ensure that the correct recommended processes are happening for each different type and brand of HP as the instructions for care and maintenance can differ slightly. This also provides a policy to which you can observe your teams to ensure compliance and of course, the CQC can compare the activities in the decon room against.
An SOP just needs to be a clear description of the process, including the products to be used at what contact times, I always think pictures are a useful addition for induction and training.
The WL system has been validated against the Washer Disinfector Standard (ISO15883) and exceeds it – so using the manual system is just as good in terms of cleaning and disinfection efficacy as a washer disinfector. With both systems manufacturers approval is important.
This is a hard one – because all practices have different priorities – cost, staff and patient safety, using all the modern technology, saving time etc. If the primary concern is money, then these systems are an additional cost, HOWEVER, they do reduce the issues with HP break downs, repairs bills and surgery down time. It would be worth looking at how much is being spent on repairs and replacements of HP’s and trying to calculate how much wasted time? The WL system is very cost effective and is manual so can be done quickly, whereas the machine options require a larger initial investment but don’t need a human to run them. So there are pros and cons to both.
If you have any more questions that were not answered here we would be more than happy to help you. Please use the contact form below to ask us your handpiece reprocessing questions.
Dental Handpieces are a critical tool used in routine and complex dental treatments. Inside the head of a high-speed handpiece, a turbine the size of
In the dental decontamination cycle, cleaning is the critical, underpinning step. Instruments that haven’t been thoroughly cleaned cannot be reliably sterilised — organic soil and
