Survey of the decontamination and maintenance of dental handpieces in general dental practice

Key Points Uses robust methodology to provide a useful insight into dental handpiece decontamination. Demonstrates that 97% of dental surgeries studied autoclaved their handpieces between patients. The variety in processes for cleaning, lubricating, packing and sterilisation suggests that handpiece manufacturers need to clarify and validate their reprocessing instructions. Objectives To determine how dental handpieces are decontaminated and maintained in general dental practice. Design Observational survey. Setting The survey was carried out in general dental practice in Scotland. Survey visits ran from January 2003 until the end of March 2004. Methods Data were collected by interview and observation in 179 dental surgeries in Scotland. Results In virtually all surgeries, handpieces were cleaned before disinfection or autoclaving (99%; n = 177), most commonly by wiping the external surface with a cloth impregnated with disinfectant. Most surgeries lubricated their handpieces after cleaning and before sterilisation (91%; n = 162), although a number of surgeries (24%; n = 42) also lubricated their handpieces after sterilisation. In the majority (97%; n = 174) of dental surgeries, all handpieces were autoclaved after use, most frequently (89%; n = 160) in a bowl and instrument steriliser. In 38 surgeries (21%), handpieces were being wrapped (paper pouches) before sterilisation in bowl and instrument sterilisers. A minority of surgeries (20%; n = 36) had a dedicated handpiece for surgical procedures. Conclusions: The majority of dental handpieces are manually cleaned externally with a disinfectant impregnated cloth and processed in a type N (bowl and instrument) bench top steam steriliser. Handpieces are lubricated with non-water soluble lubricants at different stages of reprocessing, indicating clarification is required in this area. More work is required by manufacturers to establish a validated cleaning and lubrication process to facilitate the sterilisation of handpieces.