Chemical indicators: A must for proper sterilization

There’s no process more vital to patient well-being than the sterilization process. Chemical indicators are a thorough, effective visual cue dental professionals can use to confirm they’ve achieved sterilization.

When it comes to providing the highest quality oral care and promoting infection control in the practice, the sterilization of all dental instruments is paramount.

All sterilization processes should consist of three types of monitoring to ensure the procedure has been fully carried out: mechanical, biological, and chemical. Mechanical monitoring indicates that the machinery is operating at the correct temperature, for the specified time, at the proper pressure. This information should be recorded for every load of instruments sterilized.

Despite the quick turnover of dental instruments, biological monitoring or spore testing is only required weekly, but may be required more frequently if you are accredited through the Joint Commission or are sterilizing an implantable device.3 Chemical indicators are essential because they make it possible for us to confirm that instruments have gone through the sterilization process between biological monitoring. But do all dental professionals fully understand them and give them the attention they deserve?

Chemical indicators

Instrument packaging should have two types of chemical indicators: external and internal. Indicators on the outside of the packaging demonstrate whether instruments have been exposed to heat or not, whereas those inside indicate whether the sterilizing agent—steam, in many cases—penetrated the material to reach the instruments.

The indicators change color when the steam or chemicals used reach specific parameters, verifying the validity of the sterilization process.

There are other variations in both types of indicator to take into consideration. For example, a single-parameter internal chemical indicator will give feedback regarding a specific aspect of sterilization. It could indicate a measurement of time or temperature, but not both. A multiparameter internal chemical indicator can react to two or more of those set parameters. Multiparameter indicators are far more reliable, but they’re only available for steam sterilizers.

Also available are dual indicators which assess both external and internal areas.4 These operate without a monitoring strip, but to work properly, the correct pouches need to be purchased and used. For a built-in indicator, placing the strip inside the cassette can serve the same purpose, but a type 5 integrator and a single parameter indicator tape are needed if the cassette is wrapped in woven fabric.5

By using pouches/bags with built-in internal and external indicators, the need to insert another indicator strip into the cassette is all but eliminated; however, it is recommended that those built-in indicators are multiparameter, which only work with steam, as opposed to those that can only measure one parameter.



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