6 Six classes of chemical indicators (Table 2) are recognized by the International Organization for Standards (ISO) three of these are commonly used in dentistry. 5 CHEMICAL MONITORINGĬhemical monitoring involves the physicochemical change of a chemical system in the presence of heat. These models are more accurate than the electromechanical systems. These upgrades provide a printout or display of the functional data and generate an alert message if a malfunction occurs. Recent models of sterilizers use sensors that are directly connected to the electronic control system, allowing for digital controls, LCD displays, and recording devices. Overloading will result in sterilization failures. Without appropriate space within the sterilizing chamber for the heat, steam, or vapor to circulate, sterilization cannot occur. 4 For example, overloading the packages/pouches in sterilizers is a common occurrence in some practice settings. Many sterilizer failures occur because of improper technique. All sterilizers do not have the same operating systems so dental hygienists should read the manufacturer’s instructions before use. 1 Physical monitoring should also include a review of basic operating instructions. Thermometers, timers, pressure gauges, and fluid levels are all indicators that need observation. In a busy clinical setting, this important aspect of monitoring may easily get bypassed. Physical or mechanical monitoring involves physically checking the sterilization equipment during use to ensure that the cycle indicators are coming on at the appropriate times, which indicate that the equipment is functioning properly. Common reasons for sterilization failure are listed in Table 1. 3 Without proper monitoring, these failures may get overlooked, resulting in serious consequences for the practice. 2 Sterilization failures can and do occur. Inadequate sterilization is a significant cause of exogenously acquired infections in health care. 1 While biological monitors are the most accurate, each of the three plays a vital role in the process. The Centers for Disease Control and Prevention (CDC) suggests that three different types of monitoring methods be used in clinical practice: mechanical, chemical, and biological. The appropriate monitoring of sterilization is an essential component of every dental quality assurance program and the dental hygienist is perfectly poised to hold a leadership role in the monitoring process and to serve as a role model for other office staff.
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