Cleaning dental instruments: measuring the effectiveness of an instrument washer/disinfector.

PURPOSE: To analyze the cleaning effectiveness of one type of instrument washer available for use in a dental office. MATERIALS AND METHODS: Dental instruments were heavily contaminated with blood and specific test bacteria. They were placed in cleaning baskets or within instrument cassettes, processed through the instrument washer, and analyzed for remaining blood and viable bacteria. RESULTS: Information obtained indicated that the washer is an effective cleaning system for dental instruments.

Effect of ultrasonic cleaning on microorganisms.

PURPOSE: To establish a method to measure microbial kill caused by ultrasonic cleaning. Secondarily, to estimate the escape of bacteria from the ultrasonic cleaning solutions during operation of the unit. MATERIALS AND METHODS: Three commercial enzymatic detergents and saline were used as cleaners. Depending on detergent, initial operational temperature was 21 degrees C, 37 degrees C or 60 degrees C. Streptococcus mutans ATCC 25175 (S. mutans suspensions) was adjusted to a final concentration of 1.0 x 10(3) cells/mL in saline. Suspensions (2000 mL) at the desired temperatures were added to the cleaner. Aliquots were removed, serially diluted in letheen broth and spread plated over mitis salivarius agar. Appropriate amounts of detergent solutions were added to S. mutans suspensions and the cleaner operated for 20 minutes. Aliquots were then removed and plated. The process was repeated twice. Plates were aerobically incubated at 37 degrees C for 7 days and the colonies counted. The procedure was repeated using three temperatures of S. mutans suspensions (21 degrees C, 37 degrees C or 60 degrees C), but without detergent or ultrasound. Also, detergents were added to 21 degrees C S. mutans suspensions and allowed to sit for 20 minutes without ultrasonic cleaning. Microbial sampling was done as previously described. RESULTS: Results when ultrasound was used indicated that little kill (5-15%) occurred in 21 degrees C or 37 degrees C detergent solutions. Greater kill (25-35%) was noted with 21 degrees C and 37 degrees C saline. Complete kill was accomplished with 60 degrees C saline or the 60 degrees C detergent solution. When ultrasound and detergent were not used, there was no kill in 21 degrees C and 37 degrees C saline, but complete kill in 60 degrees C saline. In the absence of ultrasound no kill was noted in 21 degrees C S. mutans suspensions to which detergent had been added. Total kill of S. mutans was observed in 60 degrees C saline or 60 degrees C detergent with ultrasound or after a 20-minute exposure in 60 degrees C saline without ultrasonic cleaning. Very few bacteria escaped from the ultrasonic cleaning solutions into the air during the cleaning process. Placement of the unit lid effectively reduced emissions to zero.