Cleaning dental instruments thoroughly and effectively is one of the most important facets of infection control in a healthcare environment. HTM 01-05 guidance specifies procedures in an effort to guide those responsible for this decontamination towards “essential quality” and ultimately “best practice”.
Dentistry is an increasingly “target-driven” profession and many practices (particularly those fulfilling an NHS contract) are under pressure to maintain a high throughput of patients. This has a knock-on effect which makes the efficiency of instrument reprocessing even more important, not only in terms of compliance, but also from a business point of view. The safety of staff and the increasing emphasis on the environmental impact of cleaning processes must also be considered. Insufficiently cleaned instruments will not be sterilized effectively even after a ‘successful’ cycle in the autoclave. This is where enzymatic detergents are increasing in popularity due to their efficient and effective cleaning action without the presence of other, harsher chemicals.
Historically, harsh chemicals that have the ability to break down the type of contamination found on dental instruments, such as dried blood and saliva, have been needed to achieve effective cleaning. However, as awareness about the advances made in cleaning technology has emerged, so users have come to question whether the possible detriment to both user and equipment, and their environmental impact makes them the most suitable cleaning substances in the long term.
The development of using multiple enzymes (amongst other ingredients) in detergents has effectively reduced the need for more aggressive chemical ingredients in instrument reprocessing, increasing user safety, reducing the environmental impact and providing a solution that has much wider material compatibility.
Enzymes are naturally occurring proteins and are responsible for many essential biochemical reactions in microorganisms, plants, animals and humans and as such are crucial to life processes, for example, their presence in digestive juices.
Enzymes catalyse specific reactions, which means they speed reactions up, while at the same time remaining themselves unchanged. One such reaction is breaking down proteins in blood on dental instruments. The presence of enzymes enables this cleaning to take place at lower temperatures, at neutral pH and reduces the need for aggressive chemical breakdown of the soil. This property makes enzyme cleaners ideal for use in manual or ultrasonic cleaning processes.
Enzymes are selective in terms of the reactions they carry out and will only work on a material if it is present. It is this selectivity that not only provides efficient and effective cleaning, but has enabled the formulation of cleaning products that have excellent material compatibility – a particularly important benefit when using in dental surgeries where many different types of surfaces and materials are found. are also fully biodegradable and their regular use fulfills the demands of practices by using the power of nature to create the effective cleaning agents required in a healthcare setting.
Enzyme types that might be found in dental instrument cleaning products include:
- Protease, which breaks down proteins
- Amylase, which breaks down carbohydrates and starch
- Lipase, which breaks down lipids (fats)
So, as practices continue to get busier, we are demanding more from our decontamination processes in terms of efficiency and effectiveness whilst keeping one eye on how we can contribute to a safer, more sustainable environment for all. The use of enzyme-based cleaning products in conjunction with pre-cleaning treatments (such as immediate reprocessing or the use of an instrument foam to prevent the contaminants from drying out), can form part of this collective movement and be part of a highly effective instrument reprocessing regime.
Laura Yates BSC, CChem, MRSC is Technical Manager at Dentisan
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