Dental Made Easy

Managing a dental clinic and the necessary dental equipment repair tasks can be timeconsuming because of the amount of equipment that must be routinely sterilised, disinfected and maintained. The dental equipment repair and replacement must be timely to ensure patient and staff safety. This article share on what guidelines should be followed to maintain a dental clinic and dental equipment.

Dental equipment represents a notable monetary investment for most practices and if anything goes wrong repairs or replacements can be costly. Many pieces of dental equipment are made up of minute parts forming complicated and delicate inner workings that can be destroyed through age and repeated use. Damaged equipment poses a possible danger for both the patient and the user; for this reason, as one could be involuntarily placing patients at risk if the user is not following to the manufacturer’s maintenance etiquettes.

Guidelines for Maintenance

A checklist of maintaining the dental equipment is a great tool to ensure that the important task isn’t missed or aren’t performed late. Performing regular dental equipment maintenance helps it to run smoothly and it minimises the risk of poor functioning. By maintaining it properly and timely, can also extend the life of the instruments.

There is a regime what needs to be followed in order to maintain the dental equipment. There has to be a checklist of daily, weekly, monthly and yearly task to help the staff to organise the clinic or hospital. Below mentioned are some steps of how to maintain a piece of dental equipment:

Daily basis:

• Water should be flushed through the handpieces and air/water syringes
• The handpieces should be sterilised on a daily basis
• The equipment should be sterilised after each patient
• The suction cleaner should be cleaned through the operatory HVE and saliva ejector tubing’s
• The delivery unit traps should
  be clean
• The ultrasonic cleaner should be drained and wiped
• Hazardous and infectious waste should be replaced.

Weekly basis:

• The traps on delivery units should
  be changed
• Handpieces couplers and O-rings should be checked and replaced.
• The gasket on handpiece should also be replaced
• Performing a biological spore test in each steriliser
• Safety hazards in the office should
  be checked.

Monthly:

• Plaster trap should be checked, cleaned and replaced
• Model trimmer should be clean
• Clean the panoramic/cephalic cassettes and intensifying screen
• Nitrous oxide systems and emergency oxygen units should be checked to ensure that they are working properly and do not need to be replaced or repaired
• Master trap should be checked, cleaned or replaced if required
• Check patient monitoring equipment is up to code and working properly

Annually:

• Change steriliser door gasket and cassette seals
• Compressor oil should be changed
• Inspect fire extinguisher, smoke alarm and emergency lighting
• Schedule inspection, calibration, and certification of x-ray equipment.

Dental Equipment Maintenance Kit

In extension to performing routine dental equipment repair and maintenance, keeping an emergency kit for last minute dental equipment servicing is a must for every clinic. Few things for what to keep in kit include:

• Handpiece: Lube, cleaner & additional turbines, chucks and bur tools
• Air compressor: Oil and intake valves
• Vacuum: Intake filter, line cleaner, traps and canisters
• Spare light bulbs: Handpieces, curing lights and operatory lights
• Spare O-rings and gaskets.

Keeping certain basic self-maintenance items make it simpler to implement simple dental equipment repair chores while they are small and easily controlled problems, without giving them progress to more
serious issues.

Preventive Maintenance and Repair Guidelines

All dental equipment needs preventive maintenance. The list would include, X-ray machines, dental chairs, handpieces, automatic film developers, dental lights, air compressors, dental vacuum systems and many more. It also depends on how the clinic is equipped, accordingly there may be other equipment which requires preventive maintenance.

The manufacturers of each equipment always provide information on how to handle or take care of the equipment supplied. This information of handling the equipment should be included in the maintenance plan for the dental clinic. Repair of the dental equipment is very necessary. Especially in rural areas. Timely repair services for dental equipment is very important in rural areas. There will be a problem of revenue lost due to unavailability of a dental operatory if the maintenance and repair of the equipment is not up to date. Repair costs, which are very expensive are increased by the charges for travelling time of the repair person to the location. Members from the clinic should learn how to perform basic repair of the dental equipment used in the clinic. Most of the equipment manufacturers offer repair courses for the staff while providing the equipment to the clinics or the people purchasing it. The staff of the clinic or the buyers of the equipment should research about the repair and maintenance before determining which equipment to purchase. One should keep the most needed parts handy so that they are readily available when needed.  Usually a dental clinic will enter into a maintenance and repair contract while purchasing the equipment with a local dental supply company. By doing this, it can be cost-effective if the clinic or hospital is close enough to minimise the travel costs. These contracts will ensure that all preventive maintenance will be performed timely keeping the cost in mind and that equipment failure does not take away time of the staff from providing clinical care.

Procedure of Sterilisations and Routine Checks for the Equipment

Sterilisation is a necessary action in the reprocessing of reusable dental instruments that have become infected, or are probably contaminated, with saliva, blood or other biological fluids. This includes dental handpieces. The aim of sterilisation is to break the chain of possible cross-infection between patients by eliminating micro-organisms, including spores. However, prion proteins are not fully deactivated by the sterilisation process. Therefore, adequate instrument cleaning is important to materially remove contamination, including prion proteins, prior to sterilisation.

The decontamination of reusable dental instruments includes:

• Cleaning
• Thermal disinfection
• Rinsing
• Drying
• Inspection for dryness, functionality and cleanliness
• Wrapping before sterilisation when using a vacuum steriliser
• Sterilisation
• Wrapping after sterilisation when using a non-vacuum steriliser.

Sterilisation using a steam steriliser is suggested as the most efficient, cost-effective and safe way of sterilising dental instruments in primary care dental practices. The sterilisation method must be validated to assure that instruments are certainly and consistently sterilised using predetermined and reproducible conditions. To destroy microorganisms, the instruments need to be displayed to vapour at a detailed temperature for a particular holding time. Although other alternatives exist, the favoured temperature-pressure-time the link for all small steam steriliser is 134–137°C, 2.1–2.25 bar standard pressure for at least a 3-minute holding time.

It is advised to use reusable instruments that can resist both an automated cleansing/disinfection method and steam sterilisation or to use single-use instruments. Reusable instruments that cannot resist steam sterilisation must be disinfected as recommended by the instrument manufacturer.

There is currently no recognised system for the active decontamination of dental handpieces. Research to evaluate the effectiveness of several methods of handpiece decontamination is ongoing. At present, it is best practice to understand manufacturer’s guidance for handpiece cleaning. After cleaning it is then necessary to sterilise handpieces in a steam steriliser. Although the effectiveness of sterilisation of the interior structures is unclear, processing in a steriliser assures that the external surfaces are sterilised and may also add to risk reduction through further thermal disinfection of the internal structures. When buying new handpieces, one should ensure that they can face thermal disinfection and steam sterilisation. Always treat dental handpieces in a steam steriliser as part of their decontamination. Substitute existing handpieces that cannot withstand steam sterilisation. Follow the handpiece manufacturer’s decontamination instructions.

If necessary, reach the handpiece manufacturer to ask clarification of their instructions. Lubricate handpieces before and/or after sterilisation as recommended by the manufacturer. If lubrication is needed both before and after sterilisation, use separate designated ‘cleaned only’ and ‘sterilised’ canisters of lubricant, labelled accordingly.

The important thing the dentist need to keep in mind is that programmed ‘handpiece cleaning machines’ can be utilised to lubricate handpieces. These machines are not approved for cleaning and do not disinfect. However, their treatment may increase handpiece life and can be particularly useful if handpieces are washed in a
washer disinfector.

Conclusion

Above all, cleansing, sterilising, and organising instruments can drain time, and therefore, money. The more smooth instrument processing procedure is, the more time doctors and the team can spend nursing patients.

And the smarter the practice is about cleaning and sterilising dental instruments, the better-equipped one will be to stop the transmission of germs. By protecting instruments, patients, and clinicians, one will be well on way to maximising the investments made in practice.

The goal of infection control is to lessen the appearance of contagious diseases. Infection prevention is everyone’s responsibility as is implementing clean and safe surroundings in which to treat patients.