Dry heat sterilizers

From: kevinutley@comcast.net <kevinutley@comcast.net>
Subject: dry heat sterilizers
To: escostudyclub@yahoo.com
Date: Wednesday, February 16, 2011, 8:07 AM

I spoke with a noted orthodontic office design person yesterday about my upcoming expansion/renovation of my office.  She told me that orthodontists are getting away from dry heat sterilizers (Dentronix) and going to autoclave type systems that allow bagging during sterilization.  Her thought is that this “looks” better from a patients point of view.  Pretty much a marketing move.   I didn’t have time to question her about corrosion…etc., so I let it go.  What are your perceptions about this?

Kevin C. Utley

10 responses to “Dry heat sterilizers

  1. I disagree–we used a statim steam machine and also the cox dry heat and both worked great and look great. Allan Sheridan

  2. Although I’m in Australia, and we have different perspectives, I think she’s right.
    Try the best of both worlds – stick with the dry heat (way better technology for orthodontic use), but bag instruments after sterilising!
    If you’re really paranoid, autoclave the bags separately (I’m assuming you have an autoclave for handpieces).
    A triumph of spin over substance.

  3. In California, the dental board’s regulations, which are based on CDC recommendations, REQUIRE that instruments either are bagged before and during sterilization and remain bagged until opened at chairside, OR that they remain inside the unopened sterilizer until removed for immediate use. In other words, it’s not good enough to put the pliers racks in the dry heat sterilizer, remove them after the cycle cools, put them in bags or unbagged into a cabinet, and store them until needed later. This is true for any instrument that comes in contact with oral mucosa or penetrates tissue. It’s really overkill, since we’re not splattering these instruments when they’re bagged after sterilization or stored in a sanitary cabinet, and we’re not doing surgery with them. If you are doing surgery, such as placing a TAD, then sure bagged (or properly wrapped) sterilization is necessary. Pliers we use after unbagged sterilization and clean storage are no more of a risk to the patient than the spoons and forks they put into their mouth in a restaurant that just runs the dirty flatware through a hot water dishwasher. Do restaurants have to bag their flatware (even after washing) before putting them out for the public to handle in cafeteria self-serve lines? No. But regulations don’t necessarily meet the rationality test. What about those gloves we use? They’re not required to be sterile, just factory-clean single-use exam gloves. It’s all irrational, “CYA” regulation, so that the regulators can’t be accused of being negligent. The regulators find it easy to paint us all with a broad brush rather than tailoring the regulation to the specialty.

  4. The problem with office design people is that they don’t have to live in the offices that they create. Some try to distinguish themselves by being different. Sometimes that does not work to your advantage. I have 2 Dentronix, that are great when used with the ultra sound that they sell, and an autoclave for handpieces etc. I agree with the above comments, you need a dry heat.

  5. Thanks for the replies. I use the Dentronix ultrasound/dry heat system, and have been very satisfied. I will probably start bagging them after sterilization.

  6. What is the heat and time required to sterilize orthodontic pliers?
    We use a dry heat system.

  7. Wrapping instruments along with a chemical indicator is the only way to validate your sterilization process; 1) The instruments will not be sterile if the staff forgot to press the “start” button on the sterilizer.
    2) Also the only way to know if the cleaning lady paid herself a free treatment with your instruments is if the packaging material was tampered with. Visit http://www.dockorth.com if you are serious about infection control in your office.

  8. Adam,
    Do you have a financial interest in Dockorth.com?

  9. One thing which gives me a hard time is archwire markers. I know there are disposable markers but I don’t find them very economic. Any suggestions?

  10. Spend the money on the disposable markers. Though it is OK to shop price. The old wax pencil in the drawer is just no longer an option. Think of it like gloves. It is disgusting what we pay for gloves, but you have to do it. Shop price, but you still need new clean one(s) for each patient.

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