Sterilization and Disinfection in Orthodontics

Abstract

On a daily basis, the practicing dentist and his personnel are at risk of being exposed to a wide range of patients with blood borne diseases such as HIV/AIDS, hepatitis B, hepatitis C, and airborne diseases such as Influenza and Tuberculosis (Deger, 2004; Ozer, 2005). Infection can be directly transmitted by oral fluids, blood, contaminated instruments and surfaces or via the respiratory system (Toroglu et al., 2001; Shah et al., 2009). To accomplish infection control accurately and to reduce the risk of cross contamination, all patients have to be treated while practicing universal precautions, the latter including the imperative steps of disinfection and sterilization (Deger, 2004; Akcam and Ozdiler, 1999). Orthodontists do not perform oral surgery, but come in direct contact with blood and oral fluids of healthy patients or infectious diseases patients when placing or removing fixed appliances (Toroglu et al., 2001). Some orthodontic instruments used regularly have hinges and cutting edges, and this makes disinfection prior to sterilization a sensitive procedure (Holht et al., 1998). Instruments have to be cleaned and dried prior to sterilization in order to minimize damage and corrosion when applicable, and to increase lifespan. Various dental supplies and instruments that are used every day make specific studies about infection control necessary, as their components and/or their maintenance procedures might differ. The standards of infection control and universal precautions remain generally unchanged, but technologic advancements, new products, new material and new data require constant evaluation and adjustments of the techniques accordingly (Deger, 2004). It is therefore our obligation to apply the most recent disinfection and sterilization practices to achieve the best results (Akcam and Ozdiler, 1999; Ozer, 2005, Haydar, 2000). The first general infection control instructions for dentistry were published by Center for Disease Control and Prevention (CDC) in 1986 and are being updated every year in this respect. The main principle is to consider each patient as being infected because many infectious diseases can be present in one individual without any signs and symptoms, especially at an early stage (Kulekci, 2000b). The American Dentist Association recommends to all staff part of the dental team to apply the universal precautions prevent infection and cross-contamination. The universal precautions suggest standard application of infection control and sterilization techniques for each patient. (Kulekci, 2000a; Acar, 2007).