Best practices for instruments disinfection and decontamination

28 May 2023

A look at the steps for safe sterilisation.  

The National Standard of Healthcare Cleanliness (NSoHC) outlines that healthcare cleaning services should work towards delivering high standards of hygiene and cleanliness to protect patients, staff and the public better. For dental surgeries, part of this process includes the disinfection and decontamination of instruments to prevent the risk of infection and avoid cross-contamination.

Current guidance from the NSoHC recommends that clinical staff must understand what cleaning is required and ensure protocols are in place to make sure cleaning is thorough and effective, and the necessary standards are reached. However, different levels of disinfection and decontamination can vary depending on the type of work being done, the instruments being used and the size of practice.

Understand the decontamination process

Decontamination (also known as reprocessing) is the process where reusable items are made safe for future use. It is a complex process that involves multiple stages, including cleaning, the removal of debris and soling; disinfection, using heat/chemicals to reduce harmful organisms; inspection, a visual process using a magnification lamp to detect debris or instrument damage; and sterilisation, removing and killing microbes such as fungi, bacteria, and viruses. It’s essential that all parts of the decontamination cycle are carried out correctly by staff.

Identify a safe area for decontamination

Many dental practices have a separate decontamination room but sometimes this is not possible due to lack of space or building regulations, meaning decontamination will need to take place in the dental treatment room. If the latter, the CQC expect steps to be taken to reduce risks.

It is important to make sure that the decontamination room has a single run of sealed and easily cleaned worktops, including an area for dirty instruments, washing and rinsing sinks, space for inspecting cleaned instruments prior to sterilisation, an appropriate place to accommodate an autoclave, an area for packaging instruments, and a separate handwashing sink. A dirty-to-clean workflow must always be maintained to prevent cross-contamination.

Adhere to quality requirements  

Complying with essential quality requirements is a must. According to the Health Technical Memorandum 01-05 (HTM 01-05), all instruments should be reprocessed using a validated decontamination process; an auditing tool should be used to ensure the ongoing maintenance of requirements; and every practice is expected to produce a statement of plans for future improvements.

In addition, there are a number of other elements needed to support the decontamination process. Examples include an infection control policy with detailed instructions on how to clean instruments; a nominated member of staff to oversee the decontamination cycle; clear procedures around the management of single-use and reusable instruments; instrument storage and wrapping recommendations; and guidance around the use of dedicated equipment for specific instruments.

Invest in suitable cleaning equipment

Reusable dental instruments can be cleaned using a washer disinfector, manual washing combined with ultrasonic cleaning, and manually (when governed by appropriate protocol). While all methods of cleaning are acceptable within the essential quality requirements framework, manual cleaning is not usually best practice and should only be considered when a tool is not compatible with automated processes.

Miele has developed a range of equipment to help dental practices ensure they are meeting the guidance outlined by the NSoHC and CQC.

Its solutions for instrument reprocessing provide better cleaning performance, improved process security, and greater convenience. Miele has a wide range of solutions to meet your requirements and will work closely with its partner Eschmann to help you achieve optimum level hygiene.


For more information visit Solutions for dentists (