There's an old Romanian proverb that says: "If you want to sweep the steps clean, start at the top."
Cleanliness, and especially the control of infectious organisms is certainly right at the top of the priority list in any dental practice. Choosing the right disinfectants and sterilants is both practical and essential - so this guide is here to inform you of the most important things to consider when choosing, as well as to provide you with the best options for buying the perfect product.
Why is Disinfection so Important?
As a rule, healthcare professionals tend to be hyper-aware of the risks of poor or substandard dental disinfection. Cross-infection is always a danger, and since the start of the 2020 pandemic, the risks have only increased. Effective hygiene procedures will cover not only hand-hygiene, but also the thorough disinfection of the dental clinic, identifying high risk surface areas, devices and equipment in particular.
Is there a difference between disinfecting and sterilizing?
The CDC guidelines for cleaning and disinfecting environmental surfaces in dental offices clarifies the differences between disinfecting and sterilizing as follows:
“Disinfection destroys most pathogenic and other microorganisms by physical or chemical means. In contrast, sterilization destroys all microorganisms, including substantial numbers of resistant bacterial spores…”
The guidelines specify and define general housekeeping surfaces and non-critical surfaces, as well as clinical contact surfaces, such as countertops and dental units. The appropriate chemicals will work best for the different areas. For lower risk procedures and areas, simple cleaning and disinfection will be all that is needed - but in higher risk areas a complete sterilization may be necessary.
What is the Proper Way to Use Dental Disinfectants?
Dental instruments, devices, and equipment can be broadly categorized according to their risk for infection. The three classes are:
- Semi-critical, and
In order to understand the difference, we can define them roughly as follows:
Critical: Any instrument or device that penetrates or comes in contact with soft tissues or bone are defined as critical. Obviously the risk here is greatest, and therefore these should be sterilized by heat. Examples of critical devices include periodontal scalers, scalpel blades, and surgical dental burs.
Semi-critical: A medical device that comes into contact with mucous membranes or non‐intact skin is defined as semi-critical. Here the recommendation is to sterilise by moist heat after cleaning. Some of these devices or instruments may be heat-sensitive. In this case, the alternatives are to use either a low temperature sterilisation process or a high level instrument grade chemical disinfectant. Suitable products are listed below for your convenience.
Non-critical: This is a medical device that only comes into contact with intact skin (but not mucous membranes) and therefore poses the least risk of transmission of infection. This level of device should be cleaned as necessary with detergent solution. If further treatment is deemed necessary, you can disinfect with a low level or intermediate level instrument grade disinfectant after cleaning. There are a number of viable products for this purpose in this list.
It should be clear from the above that it is important to select the proper disinfection or sterilization procedure for each specific device.
Disregarding the manufacturing specifications for intended use could cause damage to equipment. More importantly, since these specific chemicals are by nature toxic to living organisms, it means that sterilants and disinfectants must always be handled very carefully!
Customers should always be provided with the information needed to match the disinfectant or sterilant to the proper devices, instruments and critical levels.
What Should I Keep in Mind when Choosing a Disinfectant?
There are many products to choose from, so to help you make the best possible choice, please consider the following guides:
Consider the Contact Time. Many disinfectants dry before the necessary contact time is achieved, especially those with long contact times or high levels of alcohol. Since time is always of the essence in a busy dentist’s office, choose a product that has a realistic contact time.
Match the disinfectant to your equipment. Dental equipment is seldom cheap or easy to replace. Make sure the product you use will not harm your devices, equipment or surfaces.
Match the disinfectant to your cleaning tools. Certain kinds of cleaning equipment react badly with some kinds of disinfectant or sterilant. For example, cotton and some microfiber cleaning tools can bind with quaternary ammonium compound-based disinfectants (quats), preventing the release of the disinfectant onto the surface without the user being aware of it. The effectiveness of the process will be severely undermined - so make sure you know which products to use for each procedure.
Take it easy on your staff, clients and guests! Some products have strong odors, or they may be irritating to the eyes, skin or respiratory tracts, and may require the use of personal protective equipment (PPE). Limit the use of such disinfectants, and rather choose a product that is friendly to the consulting environment. The products below are some of the most suitable in this regard.
Which are the Best Dental Disinfectants?
Every dental practice is different, and there is a staggering variety of different products to choose from. How can we know which is best? As we have mentioned above, keep in mind that disinfectants generally come in three classes:
- High level disinfectants - cold sterile solutions
- Intermediate level disinfectants
- Low level disinfectants
Furthermore, these three different classes of product also come in a variety of applications, including liquids which are sprayable, aerosols and pre-moistened wipes. On this point the CDC recommends: “When used correctly, disposable disinfectant wipes, cloths, or towelettes are effective for cleaning and disinfecting environmental surfaces in dental settings. Any disinfectant used in a dental setting should be registered by the Environmental Protection Agency (EPA) and be approved for use in health care settings (i.e., hospital grade).”
To make your selection easier, we have collected the most effective and most popular items below.
MetriCide 28 Day Cold Sterilization 1 Gallon
MetriCide 28 day Cold Sterilization is ideal for stainless steel instruments, thermometers, anesthesia equipment, respiratory therapy equipment, and also rubber and plastic objects. It is suitable for non-critical, semi-critical and critical devices.
Metricide 28 disinfectant is dependent on a minimum effective concentration of glutaraldehyde, as measured by a chemical indicator. So in order to help prevent healthcare-acquired infections (HAIs) and safeguard healthcare personnel, it is recommended that you test the glutaraldehyde solution before each use.
The Metrex 10 2800 metricide 28 high level disinfectant sterilant is highly recommended for immersible and heat-sensitive equipment and instruments. It contains surfactants.
As far as dental disinfectant liquids go, BirexSE® has few competitors. For more than 20 years it has been known, trusted and used in the dental industry, and is considered as the top tier among its peers. Birex meets the 2003 CDC guidelines for hospital disinfectant liquid and dental disinfectant spray on the intermediate level.
It is usually used as a concentrate, and that makes it highly cost-effective as a one-step surface cleaner and broad-spectrum, antimicrobial disinfectant. As a concentrate, it takes up less storage space too.
EPA-approval states that it is effective against TB Mycobacterium, HIV-1, staphylococcus, salmonella, pseudomonas, streptococcus, and drug-resistant organisms such as MRSA, and H1N1 (swine flu).
The patented 3-in-1 formula of the disinfectant liquid is highly effective in its purpose, while shielding sensitive environmental surfaces from discoloration and damage. As it disinfects it also deodorizes, leaving no unwanted smells or antiseptic odors.
OPTIM 33TB Disinfectant Cleaner from SciCan
If you are looking to save time and avoid double work, then Scican OPTIM 33TB cleaner and disinfectant is the perfect choice. The standard dental industry procedure is to usually clean first, and then disinfect afterwards. This product cuts the workload in half by efficiently combining the two activities into one. Effective cleaning happens simultaneously with a broad-spectrum anti-microbial activity and a short contact time.
This is possible because the active ingredient is - 0.5% Accelerated Hydrogen Peroxide, based on AHP patented technology. That means your environmental surfaces are sure to be sufficiently and safely decontaminated in a shorter time. Often products with long contact times are less effective because there simply isn't enough time in a dental practice for busy personnel to wait the required time. Fast turn-around rates require faster acting disinfectants, with no need to wait for contact times to be effective.
OPTIM 33TB surface disinfectant is listed with a toxicity of category 4, which is another huge plus. The EPA requires no warning labels for this category, which means no volatile organic compounds, and no added stress on personal health and safety, or environmental responsibility.
Metrex Cavicide Disinfectant is a convenient, ready-to-use, intermediate-level combined cleaner and disinfectant. It is effective on all non-porous surfaces, including plastic, stainless steel, glass, tile, and Formica, making it ideal for cleaning and decontamination of environmental and medical device surfaces.
Cavicide is highly effective (within 3 minutes) against a number of common organisms, including TB, Staphylococcus aureus and Methicillin Resistant Staphylococcus aureus (MRSA). Furthermore, Cavicide Disinfectant is rated as being effective within 2 minutes for the following organisms:
- Hepatitis B Virus (HBV)
- Hepatitis C Virus (HCV)
- Herpes Simplex Virus Types 1 and 2
- Human Immunodeficiency Virus (HIV-1)
- Human Coronavirus (not associated with Severe Acute Respiratory Syndrome or SARS)
- Influenza A2 Virus
For faster, cleaner and more effective control, use Metrex Cavicide Disinfectant spray, or wipes.
Purell Professional Surface Disinfectant Spray Citrus Scent - 1 Gallon Refill
Purell has been one of America's most well-known household brands for years. Now in the healthcare niche, Purell professional surface disinfectant spray is an all-purpose cleaner that delivers both safety and powerful germ killing technology. The active ingredients are Ethyl Alcohol and Isopropyl Alcohol.
In other words, with no harsh fumes or chemicals, Purell Healthcare Surface Disinfectant is ideal for dental offices. Instead of unpleasant antiseptic odors, Purell disinfectant spray leaves only a fresh citrus scent. You get a rapid Germ Kill Time: (30-seconds) while maintaining hospital-grade disinfection for MRSA, VRE and Norovirus.
The professional surface disinfectant spray target makes it super easy and safe to use, with no precautionary statements; and no hand washing required. What's more, it has demonstrated proven multi-surface performance, across most hard and soft surfaces, making it the perfect product for dental practice environments.
Monarch Surface Disinfectant Spray (by Air Techniques)
Monarch Surface Disinfectant Spray saves time and money with its handy spray and wipe application. Pre-cleaning is therefore unnecessary, and you still get the fungicidal, bactericidal and virucidal effectiveness within 60 seconds or less. All you need to do is spray it on, and then wipe it off.
Active ingredients Ethyl alcohol as well as the quaternary ammonium formula means that you get a complete one-step disinfection on hard, non-porous surfaces. The EPA registers it as effective against TB, HIV, Hepatitis B & C, MRSA, S. aureus, E. coli, influenza and other clinically relevant organisms in just one minute.
Monarch is Ethanol based, with a bleach free formula, free of aldehydes, phenols and hormone disruptors. It is also fragrance-free, making it safe and environmentally suitable for a wide range of applications in any dental practice.
Rapicide OPA/28 High-Level Disinfectant 1 Gallon. Glutaraldehyde-free
Rapicide OPA/28 is a Glutaraldehyde-free, ortho-phthalaldehyde (OPA) based high-level disinfectant designed specifically for a wide range of semi-critical medical devices. It has a maximum reuse period of 28 days.
With only a 10-minute high-level disinfection time, Rapicide is faster than all other OPA disinfectants on the US market. The rapid manual disinfection time provides at least one extra disinfection cycle for every five instruments reprocessed – which is good news in a busy environment.
Rapicide OPA/28 effectively kills TB, HIV2, MRSA, VRE, and Hepatitis Viruses. It comes in a ready and easy to use one gallon bottle, with no mixing or activation required.
The shelf-life (unopened) is 2 years, and 75 days once opened. It is highly compatible with most materials, and it is non-corrosive to metal. The solution is colorless, and although it is not odorless, it has a mild and recognizable smell.
Metrex CaviWipes combine a handy cleaner and disinfectant into one uncomplicated product. These dental surface wipes pre-saturated with CaviCide solution, providing effective removal of dirt and quick broad-spectrum disinfection.
The active ingredients are Isopropyl Alcohol and Dimethyl Benzyl Ammonium Chlorides, and the wipes do not contain aldehydes, phenols, bleach, or other toxic chemicals. Therefore these handy disinfectant surface wipes act as a fungicidal, bactericidal, virucidal and tuberculocidal disinfection in only 3 minutes.
CaviWipes are recommended for use on a wide range of nonporous surfaces and fixtures. They are designed so that they won’t dry out too quickly, or bunch up when being used. Each CaviWipe comes in the form of a durable, non-woven fully saturated towelette, available both in flat packs and in canisters - select your purchase option here.
PDI bUosE Disinfectant Super Sani-Cloth Wipes - Large 160 Wipes Per Tub
Super Sani-Cloth® Germicidal Disposable Wipe are ideal for daily use in typically fast-paced dental environments. The cleaning and disinfectant properties require short contact times and provide broad coverage protection against microorganisms.
Super Sani-Cloth disinfecting wipes have a high alcohol (55%) content, making them effective in combating 30 microorganisms in around 2 minutes, including MDROs, blood borne pathogens and viruses: MRSA, VRE, HIV, HBV, HCV.
PDI Super Sani-Cloth wipes are EPA-registered as an intermediate level disinfectant, and they meet CDC, OSHA, and CMS Tag F441 guidelines. There are 160 wipes per canister, and the deep well lid provides ample space to store and access your next wipe.
Clorox Healthcare: VersaSure® Cleaner Disinfectant Wipes
Clorox VersaSure Cleaner and Disinfectant Wipes use an alcohol-free quat solution. The 1-step cleaning and disinfecting wipes are versatile enough to use on common healthcare surfaces with the assurance of broad-spectrum disinfection. They are EPA registered to kill 44 pathogens, including bacteria, viruses and fungi, in two minutes or less.
The unique low-residue formula enhances quat activity on surfaces and produces no fumes or unpleasant odors.
VersaSure Cleaner Disinfectant Wipes are durable, low-linting and textured for greater strength. Improved wetness properties in the design provides greater surface coverage compared with some competitors who use quat and quat-alcohol. This provides the assurance that treated surfaces will remain wet for the full contact time, giving you peace of mind.
The Right Disinfectant Ensures Client and Personnel Safety
Just as it’s important to “start at the top” when sweeping the steps, so it is important to choose your disinfecting and sterilizing product based on your top priorities. Each dentistry practice will have its own quirks and preferences based on what is more important - saving time, money, avoiding harm to the environment, or ensuring the highest possible level of safety.
This guide has highlighted the products that perform best in all of those spheres. Each of them, individually, has its perfect place - whether as a bulk liquid, or individual sanitary wipes, whether used in a high, medium or low risk area - your disinfecting and sterilizing needs are taken care of.
Shop all infection control products at better prices.