The Decontamination Cycle – Disinfection

In the dental decontamination cycle, disinfection is a bridging step between cleaning and sterilisation. It is commonly misunderstood and often conflated with cleaning – they are however two distinct processes.

What is disinfection?

Disinfection is the process of reducing the total number of viable microorganisms on a surface or instrument. Disinfection kills or inactivates microorganisms, through either chemicals or through thermal devices.

Cleaning, on the other hand, is the physical removal of gross soil, such as blood — through methods like manual scrubbing. An instrument may look visually clean and free of bioburden, but harmful microorganisms can still remain on its surface. 

Cleaning should always be performed before disinfection, soils such as blood can shield microorganisms from the disinfection process, preventing their destruction.

Why is disinfection important?

The disinfection stage of the decontamination cycle offers several process benefits to practices:

Improved operator safety

After the initial clean, instruments are inspected, packed, and sterilised. Incorporating a disinfection stage dramatically improves operator safety by reducing the number of microbes on instruments during these manual handling stages.

Improved sterilisation outcomes

Sterilisation processes are validated to achieve a defined Sterility Assurance Level (SAL), commonly 10⁻⁶ in healthcare. An SAL of 10⁻⁶ means that, under the validated conditions, the probability of a viable microorganism surviving the sterilisation process is no greater than 1 in 1,000,000.

Effective cleaning and disinfection substantially reduce the initial microbial load on an instrument before sterilisation. This reduction in bioburden supports the effectiveness and reliability of the subsequent sterilisation cycle.

Teon Washer Disinfector

What disinfection methods are available to dental practices?

All disinfection methods fall into two main categories: chemical and thermal. Both methods have distinct use cases and applications.

Chemical Disinfection

Chemical disinfection uses a liquid disinfectant solution to reduce microbial load. It is generally less preferred to thermal disinfection due to the high number of variables required for effective use. Despite this, chemical disinfectants still have a role in infection control — particularly for heat-sensitive instruments that cannot withstand the high temperatures of a washer-disinfector or steriliser

When using chemical disinfectants:

  • Always pre-clean instruments prior to disinfection. We cannot disinfect what is visibly dirty.
  • Instruments should be fully submerged in the solution, with any hinges or joints opened.
  • Ensure the disinfectant is used at the correct concentration to enable effective disinfection.
  • Always adhere to the disinfectants contact time.
  • After disinfection – instruments should be rinsed throughly with potable water to remove chemical residues.
  • Throughly dry instruments with a lint free cloth prior to storage.
  • Use PPE when handling and using chemical disinfectants.

 

Thermal Disinfection

Thermal disinfection uses high temperatures to denature proteins and render instruments safe and disinfected. In dental the primary method for thermal disinfection is the washer-disinfector. After instruments are cleaned and rinsed in the washer-disinfector, the temperature of the load is raised and held for a specified period – usually 80°C for 10 minutes; or 90°C for 1 minute. 

Thermal disinfection is highly effective against all types of microorganisms. Bacterial Spores can however resist thermal disinfection which is one of the reasons why instruments still require sterilisation after processing in a washer-disinfector.

Common Questions - Do Ultrasonic Cleaners disinfect instruments?

No—ultrasonic baths are designed to clean instruments, not disinfect them.

Ultrasonic baths operate through cavitation, using high-frequency sound waves to create microscopic bubbles that implode against instrument surfaces. This provides an exceptional physical scrub, making them highly effective at dislodging trapped soil, blood, and bioburden from hard-to-reach hinges and lumens.

However, ultrasonic baths do not reach the high temperatures required to thermally disinfect instruments. Furthermore, while the detergents added to the bath aid in breaking down organic debris, they are formulated as cleaning agents rather than high-level disinfectants. An instrument removed from an ultrasonic tank may look visually spotless, but live microorganisms can still remain on its surface.

BIB forte eco Dental and Medical Instrument Disinfectant
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Instrument Disinfectant

While standard ultrasonic detergents only clean, adding a liquid disinfectant like BIB forte eco transforms your ultrasonic bath into a dual-action cleaning and disinfection system. Formulated specifically for dental and medical instruments, burs, and endodontic tools, BIB forte eco gives you the flexibility to achieve effective chemical disinfection either as an ultrasonic additive or as a standalone cold-soak immersion solution.

  • Aldehyde & Phenol Free: Gentile on sensitive instruments while providing broad-spectrum antimicrobial action.

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  • Cost-Effective Concentrate: High-yield formulation ensures low cost-per-use for busy practices.

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