The perfect cleaning and maintenance of dental handpieces represent a challenge even for experienced and skilled dental staff. The internal cleaning of handpieces is especially challenging because the design incorporates a series of very small lumens and gears. The cleaning of instruments is important in order to avoid cross-contamination, and as proper instrument maintenance carried out according to manufacturer's specification, this also plays an important part in ensuring longevity of the dental handpieces.
According to the HTM01-05, the cleaning and sterilising of handpieces must take place after every use. Doing this manually will place a heavy workload on the clinic staff, whereas the processes carried out with the aid of a semi- or fully-automated system, can optimise the workflow in the dental surgery.
HTM01-05 states that the use of manual cleaning “presents particular problems […] [because […] it is not possible to fully validate the process”. Additionally, the recommendation is to replace manual cleaning with automated cleaning where possible. According to HTM01-05 manual cleaning is only recommended to be carried out if advised by the manufacturer and if it lives up to the essential quality requirements. It is recommended to move towards the best practice. The recommendation is to carry the cleaning out automatically “[…] because it offers the best option for the control and reproducibility of cleaning”.
There are three different methods for instrument cleaning, namely manual, semi-automatic, and full-automatic. The manual cleaning is where the operator washes the handpieces by hand, sprays oil through every instrument, and finally sterilises them in an autoclave. In the semi-automatic process, the handpieces are cleaned in a thermo-disinfector; the dental assistant moves the instruments to the lubricator and finally places them in the autoclave for sterilisation. This procedure may vary. The fully-automatic method is the so-called all-in-one method where a device first cleans the instruments internally, then lubricates them, cleans externally and finally sterilises them. The DAC Universal is able to clean, lubricate, and sterilise in one fully automatic cycle.
To check the combined process, the following steps should be observed. According to HTM01-05 it is recommended that all instruments are inspected for visible soiling after cleaning. The DAC Universal sterilisation is checked with a Class 5 chemical indicator placed in the chamber during the cycle and this combined with a printout of the process contributes to the daily routine control.
Some AEDs (authorising engineers decontamination) have already observed the validation of a DAC Universal and accepted the process that takes place. This means that equipment is able to be validated on site after installation and annually thereafter. Leading dental handpiece manufacturers, such as KaVo, W&H, EMS, Sirona and BA International, have recognised the process that takes place in the DAC Universal. They have approved the use of the unit for preparation of their instruments.
According to the HTM01-05, products should always be handled and maintained according to manufacturer specifications, and it states that the manufacturer must supply information on how to care for and maintain its products. This means that there are requirements for both the manufacturer and the user of the instruments. It is undoubtedly advantageous for a dental clinic and its patients to use a machine that can clean, lubricate, and sterilise in one cycle.