Remove watch and rings (except wedding rings). Work bare below the elbows; wash hands with plain or medicated soap
Fill the steriliser reservoir with reverse osmosis (RO) or sterile water
Confirm the steriliser is working correctly by completing an automatic control test (for all types of sterilisers) and steam penetration test (for vacuum sterilisers)
Store printout or record the cycle sterilisation parameters (temperature, pressure and holding time) in sterilizer logbook; record if passed or failed tests
Check sufficient sterile instruments are available for the session. Run steriliser as required; record cycle number in patient’s notes
Don heavy duty gloves, apron and goggles for cleaning surfaces with disinfectant and preparing fresh solutions of detergents and disinfectants
Fill dental unit waterlines reservoir with RO, distilled or sterile water. Flush lines for 2 minutes. Replenish biocide in waterlines
Prepare fresh solution of detergent for ultrasonic bath, fill with solution and run bath empty for 2 minutes to degas bath; function test regularly
Check all clinical surfaces are clean and free of clutter. Wipe all surfaces with a hard surface cleaner. Clean chair and headrest
Switch on air conditioning or open windows to ensure good ventilation
In preparation for patient treatment
Cover chair, light switches, handles, suction and air and waterlines with disposable coverings. Items can be passed into ‘dirty zones’ but contaminated items should not be passed out into ‘clean zones’
Place sterile instrument set on the bracket table and lay out all materials to be used in the clean zone. Storage containers of dental materials should not be placed in the ‘dirty zone’
During patient treatment
Recheck patient’s medical history. Patient’s notes, radiographs and computers should remain in the clean zone and not be touched with gloved hands
Observe standard precautions; treat all patients as potentially infectious
Place goggles and bib on the patient
Clean hands with alcohol hand rub before and after removing gloves at the end of procedure
Don personal protective equipment (PPE) (gloves, masks, protective eyewear and clothing). Change between patients and dispose of as clinical waste (yellow or orange waste sack)
Reduce aerosols contamination by the use of high-volume suction and rubber dam (if appropriate)
Work sharp safe: use resheathing device or safety syringes or single-handed technique to dispose of needles
Clinician should dispose of single-use sharps (needles, sutures, scalpels, steel burs) and fully discharged Local Anaesthetic cartridges into clinical (hazardous) waste ‘sharps bin’ immediately after use. Only fill to three-fourths full
Segregate medicines waste, e.g. partially discharged LA cartridges and needles from other sharps waste (yellow-lidded sharps bin for incineration)
Dispose of amalgam waste in a special white-lidded mercury waste receptacle
Remove disposable coverings at the end of treatment and dispose of as clinical waste
After treatment (wear appropriate PPE, remove before leaving treatment or decontamination area; clean hands before and after removing gloves)
In treatment room: Clean and disinfect all contaminated work surfaces in the dirty zone
Rinse and disinfect impressions and other dental appliances before sending to laboratory
Prepare surgery for next patient; flush waterlines for 30 seconds between patients
Instrument decontamination: Transport instruments to decontamination room/area in clean container with secure lid. Deposit in dirty zone
Strictly segregate dirty from clean instruments
Clean hands and don fresh PPE, e.g. apron, heavy duty gloves (protective eyewear and mask if manually cleaning instruments)
Pre-soak instruments if cannot be cleaned immediately
Whenever possible keep instruments together in their trays, for instrument tracking
Clean instruments in ultrasonic bath (metal instruments only) or preferably use washer disinfector fitted with connectors for handpieces, dry and inspect to ensure visibly clean. Wrap instruments if using a vacuum sterilizer
Disinfect and lubricate handpieces (preferably in an automated handpiece cleaner)
Sterilize instruments at 134°C for 3 minutes; keep cycle printout
Store dry instruments in covered trays or instrument packs in clean dry environment; use stock control
Remove PPE and clean hands with alcohol hand rub or soap and water on exiting the room
At the end of each session, clean hands before and after removing gloves
Clean and disinfect all work surfaces thoroughly in both dirty and clean zones
Wipe down the dental chair, bracket table, tubing and spittoon
Drain off water in sterilizer and replace with freshly prepared or bottled water
Do not eat or store food or drink in the treatment or decontamination room
At the end of the day, clean hands before and after removing gloves
Dispose of all clinical waste sacks from treatment room and store in secure area
Disinfect the aspirator, its tubing and the spittoon, and clean trap
Drain down dental unit waterline and disinfect (if not using a continuous dosing systems). Empty and disinfect reservoir bottle. Store dry and inverted
Drain down and clean ultrasonic bath, and leave dry
Clean steriliser chamber and inspect seals
Empty and drain sterilizer water reservoir; clean and leave dry
Dispose of any partially used bottles of water as they will be contaminated
Change out of tunic/uniform and launder daily
Note: This is an outline only; read best practice guides for more detailed protocols.
