Cleanability of dental instruments – implications of residual protein and risks from Creutzfeldt-Jakob disease
J. T. Walker1, J. Dickinson2, J. M. Sutton3, N. D. H. Raven4 & P. D. Marsh5
Dental instruments such as endodontic reamers that are difficult to clean and should be considered as single use.
Manual cleaning of dental instruments has a risk of puncture wounds, lacerations and cuts.
Ultrasonic cleaners clean well, but the ultrasonic solution can become contaminated with debris.
Washer disinfectors provide fully automated and validated cleaning but have yet to be taken up in large numbers of dental practices.
Detailed cleaning instructions are required from instrument and washer disinfector manufacturers.
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AbstractCleaning of dental instruments is the first line of control in reducing the adherent bioburden. The threat of vCJD and the difficulty in removing prion protein has provided a new challenge for cleaning surgical and dental instruments. Prion proteins are also more resistant to many disinfection and sterilisation techniques. A number of different methods are currently available in primary care for cleaning instruments including manual washing, ultrasonic cleaners and washer disinfectors. Manual cleaning of dental instruments is time-consuming, introduces operator error and the risk of puncture wounds, is not reproducible and does not completely remove debris from instruments. Ultrasonic baths are significantly more effective than hand cleaning alone and are currently used by the majority of dental surgeries (often as an adjunct to manual cleaning). Automated washer-disinfectors appear to provide a validated, reliable and reproducible procedure for disinfection and sterilisation of dental instruments to ensure both the safety of patients and dental staff. Dental instruments that are difficult to clean are frequently contaminated with tissue debris after routine reprocessing and cannot be excluded as a potential transmission risk for infectious agents, including prions. The transmission of vCJD via dentistry is considered to be low risk, however, the Department of Health (DoH) has recently advised dentists to ensure that endodontic reamers and files are treated as single-use as a precautionary basis in order to further reduce any risk of vCJD transmission.
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HPA Centre for Emergency Preparedness and Response, Porton Down, Salisbury, SP4 0JG
HPA Centre for Emergency Preparedness and Response, Porton Down, Salisbury, SP4 0JG
HPA Centre for Emergency Preparedness and Response, Porton Down, Salisbury, SP4 0JG
HPA Centre for Emergency Preparedness and Response, Porton Down, Salisbury, SP4 0JG
HPA Centre for Emergency Preparedness and Response, Porton Down, Salisbury, SP4 0JG; Leeds Dental Institute, Leeds, LS2 9LU
Correspondence to: J. T. Walker1 e-mail:
jimmy.walker@hpa.org.uk
http://www.nature.com/bdj/journal/v2....2007.893.html
***PLEASE NOTE IN USA CJD UPDATE AS AT JUNE 2007, please note steady
increase in ''TYPE UNKNOWN''. ...TSS
1 Acquired in the United Kingdom; 2 Acquired in Saudi Arabia; 3 Includes 17
inconclusive and 9 pending (1 from 2006, 8 from 2007); 4 Includes 17
non-vCJD type unknown
(2 from 1996, 2 from 1997, 1 from 2001, 1 from 2003, 4 from 2004, 3 from
2005, 4 from 2006)
and 36 type pending (2 from 2005, 8 from 2006, 26 from 2007)
http://www.cjdsurveillance.com/pdf/case-table.pdf
USA NVCJD BLOOD RECALLS ONLY ;
http://www.google.com/search?hl=en&q...SS&btnG=Search
vCJD case study highlights blood transfusion risk
http://vcjdblood.blogspot.com/
CREUTZFELDT JAKOB DISEASE MAD COW BASE, CWD, SCRAPIE UPDATE OCT 2007
http://cjdmadcowbaseoct2007.blogspot.com/
NOR-98 ATYPICAL SCRAPIE USA UPDATE AS AT OCT 2007
Tuesday, October 9, 2007
NOR-98 SCRAPIE UPDATE AUGUST 31, 2007 RISES TO 5 DOCUMENTED CASES
http://nor-98.blogspot.com/
CREUTZFELDT JAKOB DISEASE MAD COW h-BASE UPDATE USA
http://cjdmadcowbaseoct2007.blogspot.com/
ABSTRACTS SPORADIC CJD AND H BASE MAD COW ALABAMA AND TEXAS SEPTEMBER 2007
Date: Mon, 24 Sep 2007 21:31:55 -0500
I suggest that you all read the data out about h-BASE and sporadic CJD, GSS,
blood, and some of the other abstracts from the PRION2007. ...
http://lists.ifas.ufl.edu/cgi-bin/wa...&F=&S=&P=19744
*** PLEASE READ AND UNDERSTAND THE RAMIFICATIONS OF THIS !!! THE PRICE OF
POKER INDEED GOES UP. ...TSS
USA BASE CASE, (ATYPICAL BSE), AND OR TSE (whatever they are calling it
today), please note that both the ALABAMA COW, AND THE TEXAS COW, both were
''H-TYPE'', personal communication Detwiler et al Wednesday, August 22, 2007
11:52 PM. ...TSS
http://lists.ifas.ufl.edu/cgi-bin/wa...mg&T=0&P=19779
TSS