Dental office infection control myth busters: handpieces

This article originally appeared in Dental Assisting Digest e-newsletter. Subscribe to this informative monthly ENL designed specifically for the dental assistant here.

I’ve found that there is so much misinformation out there about infection control in the dental setting. Instead of relying on a good source for information, people tend to “do what they’ve always done,” or, they hear something but never check to see if it’s true.

When you want to go to the authorities on infection control, you need to go to the Centers for Disease Control (CDC) and the Organization for Safety, Asepsis and Prevention (OSAP). These are the people who set the guidelines for how we should clean, disinfect, and sterilize our surfaces, instruments, and operatories.

A COMMON MYTH I HEAR WHEN I VISIT DENTAL OFFICES HAS TO DO WITH HANDPIECES AND WHETHER THEY SHOULD BE STERILIZED. I’ve been told, “This is a gray area, and not something that has to be done.” While it’s true that the CDC is clear about handpiece sterilization, the CDC is not a regulatory agency. It doesn’t make laws. Rather, it creates guidelines and comes up with recommendations.

Handpieces today are meant to be sterilized and are for the benefit of patients. Many state dental boards pick up what the CDC recommends and write the recommendations into their Dental Practice Acts, making the recommendations laws. Do you know what your state Dental Practice Act says about infection control?

It’s not just the dentist’s job to know what infection control procedures should be in place in the practice. Dental assistants make up the greatest number of oral health-care workers and, as such, are responsible for ensuring that patients receive the highest standard of care.

But let’s get back to those handpieces. I hear that people don’t like handpieces to be sterilized because this will ruin the turbine, causing it to need to be replaced often. Turbines are tiny and expensive, so having to frequently change one not only costs money but leaves the office with one less handpiece. This can be a longer period of waiting if the turbines are sent out to be changed. Being short a headpiece is aggravating, to say the least.

Properly disinfecting handpieces

What ruins the turbines is not the sterilization process itself, but rather the improper lubrication. There is no way any one of us can deliver lubrication, express the oil, and clean a handpiece the way a lubrication station does. The station delivers the precise amount of oil and cleaner, and using compressed air, it properly expels debris and excess oil while simultaneously lubricating the handpiece. This must be done after each use to ensure that our handpieces are properly lubricated before going through the sterilization process.

Remember that after use, handpieces should never be wiped down with disinfectant. All handpieces should be run under water and brushed with a soft brush to clean any debris around the head and the fiberoptic light. Once this is completed, the handpiece can be placed in the lubrication station for processing.

When handpieces come out of the autoclave, yes, I realize we are sometimes in a hurry, and sometimes there aren’t enough handpieces to go around. And here is a story I hear all too often. The autoclave “dings” and someone rushes to take out the handpiece. The person rips open the package runs the handpiece under cold water to cool it off before rushing it to the operatory for use. Stop! This is hard on the handpiece casing and can cause it to crack.

All instruments that are removed from the autoclave must go through every single cycle, including the drying cycle, before being removed. If you’re short on instruments and find yourself cutting corners on infection control to get through the day, then you’re doing it wrong. At that point, it’s time to have a talk with the dentist about the need for more instruments to do your jobs properly and deliver the best patient care.

Remember, there is only one way to do infection control, and that’s the right way!