Instrument cleaning

Ensuring compliance with HTM01-05 has now become an essential part of the job of practice managers and principals. The adherence to protocols that ensure safe and effective cleaning and sterilisation is important but so too is a thorough understanding of why certain procedures should be followed. This understanding enables a better appreciation of how decontamination procedures serve to reduce the potential for the transmission of infections and provides a framework for practices to comply with essential quality standards.

HTM01-05 references research that indicates that a 'low level of prion contamination may theoretically be present on some instruments following contact with dental tissues' and that the risk of prion transmission exists through protein contamination of instruments.

Prion contamination is important in the face of recent evidence that suggests the prion disease marker PrPsc can accumulate in peripheral tissue, for both the variant and sporadic Creutzfeldt-Jakob Disease strains. This evidence, and the reports linking prion disease transmission through blood transfusions, has led to a rise in concern over the possibility of large numbers of sub-clinical, asymptomatic carriers of the disease being present within the standard population. Any transmission risk is compounded by the ability of the prion infectious agent to remain viable after traditional inactivation regimes such as autoclaving (121°C, 30 minutes) or the use of chemical solutions.