| (a) Sterilization is required for all surgical and other instruments
that may be used intraorally or extraorally, where these instruments may be
used invasively or in contact with or penetration of soft tissue, bone or
other hard tissue. Other nonsurgical instruments, such as plastic instruments,
that may come into contact with tissue must be disinfected with an American
Dental Association-registered solution that is tuberculocidal.
(b) All instruments subject to sterilization must undergo at
least one of the following procedures:
(1) Steam autoclave
(2) Chemical Vapor
(3) Dry-heat oven
(4) Ethylene oxide
(5) Chemical sterilant (used in dilution amounts and time periods
according to manufacturer's recommendations or accepted OSHA standards). Sterilization
equipment and its adequacy shall be tested and verified in accord with American
Dental Association (ADA) recommendations.
(c) Following a dental procedure, all instruments and operatory
equipment that may have become contaminated with blood, saliva, or tissue
debris must be, at a minimum, disinfected and preferably sterilized by a CDC
or ADA-approved method before utilization again for patient care.
(d) Prior to sterilization, all instruments must be free of
any visible debris and must be either scrubbed thoroughly with a detergent
and water solution or debrided in an ultrasonic device containing cleaning
solution.
(e) Oral prosthetic appliances and devices from a dental laboratory
must be washed with a detergent and water solution, rinsed, disinfected, and
rinsed before the appliance or device is placed into patient's mouth.
(f) Disposable (non-resterilizable) items, including but not
limited to gloves, needles, intravenous fluids, intravenous administration
tubing, intravenous catheters/needles, and like items, shall not be used in
the treatment of more than one patient.
(g) All items contaminated by body fluids during patient care
must be treated as biohazardous material. Before extracted teeth are returned
to a patient or other party, the teeth must be rendered non-biohazardous.
All contaminated single-use items must be disposed of through established
OSHA guidelines for such disposal. Teeth or tissue fragments to be used for
microscopic, testing, or educational purposes must be sterilized prior to
use. Such tissues must be handled and stored as biohazardous material until
sterilization is performed.
(h) When it is necessary to send items (including but not limited
to impressions, bites, working casts, prosthetic appliances or devices) to
a dental laboratory for fabrication on repair, those items that are contaminated
by body fluids must be considered biohazardous. Before such items are delivered
to the dental laboratory or technician, they must be rendered non-biohazardous
according to established OSHA guidelines.
(i) When it is necessary to return items (including but not
limited to impressions, bites, working casts, prosthetic appliances or devices)
to a dental office from a dental laboratory which item has been fabricated
or repaired, those items that have been potentially contaminated shall be
rendered non-biohazardous. Before return to the dentist by the dental laboratory
or technician, the item must be rendered non-biohazardous according to established
OSHA guidelines.
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