Disinfection and cleaning plan, including skin-protection for dentists

what object to be maintained

how type of maintenance

with what working materials (e.g. disinfection solution, VAH/DGHM listed),

preparation, dosage, working time

when point of time, interval, sequence

of the hygienic measures

who name and signature

of the person responsible

Simply logical, simply safe

Instruments and aids for ▪ general, preventive, restorative and

orthodontic treatments such as impression trays, trays, cassettes, tablets, glasses, suction cannulas and detachable suction couplings

▪ surgical, periodontal and endodontic treatments; for example syringes, forceps, levers

Rotating or oscillating instruments for ▪ general, preventive, restorative and

orthodontic treatments; for example polishers, drills, milling tools, grinders, finishing burs

▪ surgical, periodontal and endodontic treatments; for example endodontic/periodontal instruments and surgically rotating instruments

Instrument preparation:

1. Contamination-proof transport to processing site 2. Removal of coarse organic soiling with chemical pulp 3. Disinfection and cleaning 3.1 Wet-chemical: ▪ Soaking of disconnected instruments or with joints opened,

bubble-free, fully immersed by disinfection and cleaning solution (if needed ultrasound bath)

▪ Cleaning, rinsing after reaction time with running water, drying 3.2 Mechanical: ▪ In cleaning and disinfection device, disinfect, clean and dry

according to manufacturer instructions 4. Check for cleanliness, integrity, if needed repeat Step 3 5. Identifi cation 6. Care and maintenance 7. Function check 8. Labelling (according to requirement) 9. Steam pressure sterilisation with eff ective and validated

procedure: 9.1 Non-critical instruments*; steam-pressure sterilisation not required 9.2 Semi-critical instruments**; unpacked on trays, sieve trays, tablets,

stands, bowls, etc. or packed in sterile packaging in accordance with EN 868

9.3 Critical instruments***; packed in sterile packaging in accordance with EN 868

10. Documented release for use of medical devices 11. Contamination-proof storage, storage time in accordance

with EN 868

For general and surgical instruments: ID 212, ID 212 forte, ID 213

For rotating instruments: ID 220, Undiluted

Cleaning and disinfection device:

Programme: Temperature/Reaction time:

Steam pressure steriliser: autoclave

Programme: Temperature/Reaction time:

Preparation is done directly after the treatment while observing the risk assessment and evaluation of the medical devices:

In RDG drier before the disinfection, not over 6 hrs.

Transmission instruments for general, preventive, restorative, orthodontic, surgical, periodontal and endodontic treatments; for example turbine, hand and angle pieces

Auxiliary devices with/without leakage of fl uids and/or air and particles; for example dental clearance equipment, powder jet equipment, intraoral camera, etc.

Preparation is done as per the procedure for instruments outlined above (steps 3 and 9 according to manufacturer‘s documents)

Externally: wipe disinfection and cleaning

Interior: Cleaning Care (lubrication of interior parts)

Automatic preparation: Disinfection/Cleaning e.g.in RDG (Cleaning and disinfection device) Internal cleaning and maintenance for internal parts

FD multi-wipes (single-use wipes): FD 322, undiluted, 15 sec. FD 333, undiluted, 1 min. FD 366 sensitive, undiluted, 1 min.

FD 333 wipes, undiluted, 1 min. FD 350 disinfection towels, undiluted, 15 sec.

Preparation, device:

Device: Programme: Temperature/Reaction time:

After every treatment and after contamination

Surfaces

Surfaces and fl oors in examination and treatment rooms (e.g. treatment unit, devices, cabinets)

Disinfect and clean surfaces with a suitable disinfectant (using an appropriate wet wiping method). No rinsing or wiping dry before the end of the reaction time. Re-use the surfaces when they are visibly dry

FD 300, 1 % (10 ml/l water) 15 min. FD 312, 1 % (10 ml/l water) 15 min. FD 370 surgery cleaner, 1 %(10 ml/l water) with FD multi-wipes, single-use wipes and hygienically prepared towels, multi-use wipe cloths

FD 300 top wipes, undiluted 2 min. FD 312 wet wipes, undiluted, 15 min.

Every working day (e.g. at the end of the treatment day), additionally as required

Auxilliary staff

Objects and small surfaces in patient vicinity that have been contaminated and cannot be disinfected thermally or by soaking in solutions (e.g. treatment unit, devices, work surfaces, furnishings, X-ray equipment, lamp handles, intraoral fi lm rolls)

Washing with quick disinfectants Limit spray disinfection to areas that cannot be reached by wipe disinfection

Ensure complete coverage, heed application time, allow to dry

Cleaning and maintenance (such as dentist‘s chair)

FD multi-wipes (single-use wipes): FD 322, undiluted, 15 sec. FD 333, undiluted, 1 min. FD 366 sensitive, undiluted, 1 min.

FD 300 top wipes, undiluted, 2 min. FD 333 wipes, undiluted, 1 min. FD 350 disinfection towels, undiluted,15 sec. FD 360 imitation leather cleaner, Undiluted

In the treatment area after every treatment and after contamination

As required

Skin protection plan An easily accessible hand-washing station with running water (warm and cold), direct dispensers with washing lotion that is gentle on the skin, hand disinfectant and appropriate skin care products as well as single-use tissues are required. No jewellery, watches, rings may be worn on the hands and forearms. Skin & hands

Skin, when aff ected by ▪ water-soluble working material such

as disinfectants, cleaning solutions, X-ray development chemicals

▪ materials that are not water-soluble, such as organic solvents, petroleum ether

▪ Accumulation of moisture and softening skin (maceration), e.g. when wearing gloves

Cleaning of hands: Under running water with liquid soap that is gentle on the skin from a dispenser, dry with single use tissue

Gentle liquid washing preparations: HD 425 or HD 435 from single-use wipe dispenser

Before starting work, after fi nishing work, in case of visible soiling, before meals, following every visit to the toilet, after sneezing, blowing one‘s nose or coughing

All staff

Skin protection and care: Apply carefully between fi ngers, paying special attention to fi ngernail folds and the back of the hands

HD 440 or protection emulsion W/O All staff

Skin, for non-physiological colonisation with e.g. bacteria, fungi, viruses

Hygienic disinfection of hands: Hand disinfection in accordance with the procedure outlined in CEN/EN 1500, rub until dry (15 sec.). Hands must be air-dry before putting on the medical single-use gloves.

Surgical disinfection of hands: 1 min. wash hands and forearms to elbows, if needed brush fi ngernails and nail folds. Completely wet hands and forearms by rubbing (in accordance with the procedure outlined in CEN/EN 12791) with hand disinfection solution in portions and keep moist during the advised lenght of time (1.5 min.). Hands must be air-dry before putting on the sterile medical single-use gloves.

HD 410, min. 3 ml, 15 sec. HD 412 essential, min. 3 ml, 30 sec.

HD 410, min. 10 ml, 1.5 min. HD 412 essential, min. 5 ml, 5 min.

Before preparing for work, before and after each treatment, when inter-ruptions in treatment occur, after work-station maintenance, before putting on or taking off gloves

Before extensive dental/oral-surgery, before all dental/oral-surgery on patients with increased risk of infection

All staff

Instruments

Suction unit, suction hoses (interior)

Spittoon (internal)

Cleaning by suctioning of water-air mix, especially when blood has been suctioned

Cold water (1/2 litres minimum) After every treatment

a) Disinfection: slow suction of a mix of air and disinfection/cleaning solution

b) Cleaning: removal of deposits (calcium, bacterial contamination, salts from jet-stream equipment)

Disinfecting and cleaning the spittoon

Concentrate in the care system OroCup mix and suction

a) Orotol® plus, 2 % (20 ml/l water), 60 min.

b) MD 555 cleaner, 5 % (50 ml/l water), 30–120 min.

FD 550, undiluted

a) Once or twice per day, minimum at end of working day

b) Once or twice per week, prior to lunch

Additionally as required

Filter

Amalgam Separator

Filter-change or cleaning according to manufacturer‘s specifi cations

Change/draining the collector vessel and disposal of the separated material according to manufacturer‘s instructions

Use gloves

Do not touch contaminated pieces ofthe separator, use gloves

Use of gloves if needed

As required

Suction hoses (exterior) etc.

Mouth rinse basin (inside and outside)

Disinfection and cleaning through wiping FD multi-wipes (single-use wipes): FD 322, undiluted, 15 sec. FD 333, undiluted, 1 min. FD 366 sensitive, undiluted, 1 min.

FD 300 top wipes, undiluted, 2 min. FD 333 wipes, undiluted, 1 min. FD 350 disinfection towels, undiluted, 15 sec.

A fter every treatment

Impressions e.g. alginates, silicones, polyether rubber, hydrocolloids, polysulphides, etc. as well as

Tools and equipment e.g. prosthesis, bridges, etc., plaster models, bite registration and bite plates of wax, shellac or plastics, as well as articulators, occludators, fi xators, face bows and more.

Disinfection and cleaning with mechanical procedure: according to manufacturer instructions

Wet-chemical procedures: Disinfection and cleaning by soaking in solution, after the advised amount of time rinse with running water and air dry if needed

Make of the Device: Hygojet preparation: MD 520, undiluted, 10 min.

MD 520, undiluted, 5 min.

After removal from mouth Prior to transport to dental laboratory After receiving from dental laboratory

Objects with acid-soluble coatings such as cement, dental tartar, oxide fi lm, fl ux residues

Cleaning (e.g. in ultrasound bath)

MD 530, Undiluted As required

Objects with fi lm of plaster or alginate

cleaning (e.g. in ultrasound bath)

MD 535, Undiluted As required

Other

Oral antiseptics Rinse the mouth or immerse the swab with antiseptic to reduce the patients oral micro-organisms and help prevent the risk of cross infection to the dental professional

Preparation and dosage: OD 600, undiluted (20 ml), 1 min.

Before surgical operations for patients with an increased risk of infection

Patient

Clothing Protective clothing in accordance withDIN 66 083, OP-clothes, especiallyOP-cloths, OP-area clothing, professionalapparel

OP clothing and OP-area clothing, protective clothing and textile materials with patient contact, are to be cleaned internally or outsourced with an accredited disinfection wash process (disinfecting washing machine in accordance with EN 13795-1) OP-clothing is then to be sterilised with a suitable steam sterilisation process. Professional apparel is to becollected in suffi ciently resistant and thick containers/sacks and must be prepared with thermal or chemical-thermal disinfection procedures

Make of the Device:

Washing programme:

Preparation, dosage:

After use

After contamination

Operator

Waste Waste from treatment and examination rooms

Pointed, sharp, fragile objects, body parts (e.g. teeth, tissue) with blood, waste contaminated with secretions (e.g. saliva ejector, cotton wool rolls, swabs or similar), as well as waste infected with agents of certifi able diseases must promptly and at the site of their occurrence be collected in puncture-proof, tear-proof and moisture-resistant and sealed containers and without transfering or sorting be incinerated in sealed containers. Lead foils, waste coatings, fi xing baths, developers, mercury-containing residues, waste pharmaceuticals, batteries must be disposed of by waste management companies. Household-like waste is collected in waste bags and separated and disposed of according to the local guidelines.

* Non-critical medicinal devices: medical device that only come into contact with unbroken skin ** Semi-critical medicinal devices: medical device that comes into contact with mucosa or pathologically altered skin *** Critical medicinal devices: medical device that penetrate mucosa or skin and come into contact with blood, interior tissue and organs (incl. wounds) and MP for applying blood, blood products incl. sterile medicinal products Patients suffering from or thought to suffer from a clinical condition of a transmittable spongiform encephalopathy (CJK, vCJK etc.) are to be treated in institutions that are sufficiently equipped to prevent infection. The preparation of the re-usable instruments and materials may be carried out only in institutions with an externally certified quality management according to DIN EN ISO 13485/13488.

Stamp of the surgery/date/signature of the operator

This disinfection and cleaning plan was provided by DÜRR DENTAL AG · Höpfigheimer Strasse 1774321 Bietigheim-Bissingen · Germany · www.duerrdental.comTelephone +49 (0) 71 42/705-0 · Fax +49 (0) 71 42/705-500

P007

-033

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LOD

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1.5/

01/F

02 Ev

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nd p

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lean

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with

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acc.

to V

AH

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DG

HM

incl

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In u

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bath

in u

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incl

. Tb

ID 212

ID 212 forte

ID 213

2 % / 5 min. 2 % / 60 min. 2 % / 2 min.

2 % / 60 min.

4 % / 30 min.

2 % / 30 min.

ID 220 100 % / 1 min. 100 % / 0.5 min.

In accordance with the German Employer‘s Liability Insurance Association for safety and health at work BGV A1, BGR 250/TRBA 250, BGI 775 and Section 36 Infectious Diseases Protection Act

Disinfection and cleaning plan, including skin-protection for dentists

what object to be maintained

how type of maintenance

with what working materials (e.g. disinfection solution, VAH/DGHM listed),

preparation, dosage, working time

when point of time, interval, sequence

of the hygienic measures

who name and signature

of the person responsible

Simply logical, simply safe

Instruments and aids for ▪ general, preventive, restorative and

orthodontic treatments such as impression trays, trays, cassettes, tablets, glasses, suction cannulas and detachable suction couplings

▪ surgical, periodontal and endodontic treatments; for example syringes, forceps, levers

Rotating or oscillating instruments for ▪ general, preventive, restorative and

orthodontic treatments; for example polishers, drills, milling tools, grinders, finishing burs

▪ surgical, periodontal and endodontic treatments; for example endodontic/periodontal instruments and surgically rotating instruments

Instrument preparation:

1. Contamination-proof transport to processing site 2. Removal of coarse organic soiling with chemical pulp 3. Disinfection and cleaning 3.1 Wet-chemical: ▪ Soaking of disconnected instruments or with joints opened,

bubble-free, fully immersed by disinfection and cleaning solution (if needed ultrasound bath)

▪ Cleaning, rinsing after reaction time with running water, drying 3.2 Mechanical: ▪ In cleaning and disinfection device, disinfect, clean and dry

according to manufacturer instructions 4. Check for cleanliness, integrity, if needed repeat Step 3 5. Identifi cation 6. Care and maintenance 7. Function check 8. Labelling (according to requirement) 9. Steam pressure sterilisation with eff ective and validated

procedure: 9.1 Non-critical instruments*; steam-pressure sterilisation not required 9.2 Semi-critical instruments**; unpacked on trays, sieve trays, tablets,

stands, bowls, etc. or packed in sterile packaging in accordance with EN 868

9.3 Critical instruments***; packed in sterile packaging in accordance with EN 868

10. Documented release for use of medical devices 11. Contamination-proof storage, storage time in accordance

with EN 868

For general and surgical instruments:

For rotating instruments:

Cleaning and disinfection device:

Programme: Temperature/Reaction time:

Stem-pressure sterilisation: autoclave

Programme: Temperature/Reaction time:

Cabinet, drawer (dust protection)

Preparation is done directly after the treatment while observing the risk assessment and evaluation of the medical devices:

In RDG drier before the disinfection, not over 6 hrs.

Transmission instruments for general, preventive, restorative, orthodontic, surgical, periodontal and endodontic treatments; for example turbine, hand and angle pieces

Auxiliary devices with/without leakage of fl uids and/or air and particles; for example dental clearance equipment, powder jet equipment, intraoral camera, etc.

Preparation is done as per the procedure for instruments outlined above (steps 3 and 9 according to manufacturer‘s documents)

Externally: wipe disinfection and cleaning

Interior: Cleaning Care (lubrication of interior parts)

Automatic preparation: Disinfection/Cleaning e.g.in RDG (Cleaning and disinfection device) Internal cleaning and maintenance for internal parts

Preparation, device:

Device: Programme: Temperature/Reaction time:

After every treatment and after contamination

Surfaces

Surfaces and fl oors in examination and treatment rooms (e.g. treatment unit, devices, cabinets)

Disinfect and clean surfaces with a suitable disinfectiant (using an appropriate wet wiping method). No rinsing or wiping dry before the end of the reaction time. Re-use the surfaces when they are visibly dry

With single-use wipes or hygienically prepared wipes, multi-use wiping cloths

Every working day (e.g. at the end of the treatment day), additionally as required

Auxilliary staff

Objects and small surfaces in patient vicinity that have been contaminated and cannot be disinfected thermally or by soaking in solutions (e.g. treatment unit, devices, work surfaces, furnishings, X-ray equipment, lamp handles, intraoral fi lm rolls)

Washing with quick disinfectants Limit spray disinfection to areas that cannot be reached by wipe disinfection

Ensure complete coverage, heed application time, allow to dry

Cleaning and maintenance (such as dentist‘s chair)

In the treatment area after every treatment and after contamination

As required

Skin protection plan An easily accessible hand-washing station with running water (warm and cold), direct dispensers with washing lotion that is gentle on the skin, hand disinfectant and appropriate skin care products as well as single-use tissues are required. No jewellery, watches, rings may be worn on the hands and forearms. Skin & hands

Skin, when aff ected by ▪ water-soluble working material such

as disinfectants, cleaning solutions, X-ray development chemicals

▪ materials that are not water-soluble, such as organic solvents, petroleum ether

▪ Accumulation of moisture and softening skin (maceration), e.g. when wearing gloves

Cleaning of hands: Under running water with liquid soap that is gentle on the skin from a dispenser, dry with single use tissue

Gentle liquid washing preparations: single use tissue

Protection emulsion W/O preparation:

Before starting work, after fi nishing work, in case of visible soiling, before meals, following every visit to the toilet, after sneezing, blowing one‘s nose or coughing

All staff

Skin protection and care: Apply carefully between fi ngers, paying special attention to fi ngernail folds and the back of the hands

All staff

Skin, for non-physiological colonisation with e.g. bacteria, fungi, viruses

Hygienic disinfection of hands: Hand disinfection in accordance with the procedure outlined in CEN/EN 1500, rub until dry (15 sec.). Hands must be air-dry before putting on the medical single-use gloves.

Surgical disinfection of hands: 1 min. wash hands and forearms to elbows, if needed brush fi ngernails and nail folds. Completely wet hands and forearms by rubbing (in accordance with the procedure outlined in CEN/EN 12791) with hand disinfection solution in portions and keep moist during the advised lenght of time (1.5 min.). Hands must be air-dry before putting on the sterile medical single-use gloves.

Before preparing for work, before and after each treatment, when inter-ruptions in treatment occur, after work-station maintenance, before putting on or taking off gloves

Before extensive dental/oral-surgery, before all dental/oral-surgery on patients with increased risk of infection

All staff

Instruments

Suction unit, suction hoses(interior)

Spittoon (internal)

Cleaning by suctioning of water-air mix, especially when blood has been suctioned

Cold water (min. 1/2 litre) After every treatment

a) Disinfection: slow suction of a mix of air and disinfection/cleaning solution

b) Cleaning: removal of deposits (calcium, bacterial contamination, salts from jet-stream equipment)

Disinfecting and cleaning the spittoon

a) Once or twice per day, minimum at end of working day

b) Once or twice per week, prior to lunch

Additionally as required

Filter

Amalgam Separator

Filter-change or cleaning according to manufacturer‘s specifi cations

Change/draining the collector vessel and disposal of the separated material according to manufacturer‘s instructions

Use gloves

Do not touch contaminated parts of separator, use gloves

Use of gloves if needed

As required

Suction hoses (exterior) etc.

Mouth rinse basin (inside and outside)

Disinfection and cleaning through wiping A fter every treatment

Impressions e.g. alginates, silicones, polyether rubber, hydrocolloids, polysulphides, etc. as well as

Tools and equipment e.g. prosthesis, bridges, etc., plaster models, bite registration and bite plates of wax, shellac or plastics, as well as articulators, occludators, fi xators, face bows and more.

Disinfection and cleaning with mechanical procedure: according to manufacturer instructions

Wet-chemical procedures: Disinfection and cleaning by soaking in solution, after the advised amount of time rinse with running water and air dry if needed

Make of the Device: After removal from mouth Prior to transport to dental laboratory After receiving from dental laboratory

Objects with acid-soluble coatings such as cement, dental tartar, oxide fi lm, fl ux residues

Cleaning (e.g. in ultrasound bath)

As required

Objects with fi lm of plaster or alginate

cleaning (e.g. in ultrasound bath)

As required

Other

Oral antiseptics Rinse the mouth or immerse the swab with antiseptic to reduce the patients oral micro-organisms and help prevent the risk of cross infection to the dental professional

Preparation: Patient

Clothing Protective clothing in accordance withDIN 66 083, OP-clothes, especiallyOP-cloths, OP-area clothing, professionalapparel

OP clothing and OP-area clothing, protective clothing and textile materials with patient contact, are to be cleaned internally or outsourced with an accredited disinfection wash process (disinfecting washing machine in accordance with EN 13795-1) OP-clothing is then to be sterilised with a suitable steam sterilisation process. Professional apparel is to becollected in suffi ciently resistant and thick containers/sacks and must be prepared with thermal or chemical-thermal disinfection procedures

Make of the Device:

Washing programme:

Preparation, dosage:

Operator

Waste Waste from treatment and examination rooms

Pointed, sharp, fragile objects, body parts (e.g. teeth, tissue) with blood, waste contaminated with secretions (e.g. saliva ejector, cotton wool rolls, swabs or similar), as well as waste infected with agents of certifi able diseases must promptly and at the site of their occurrence be collected in puncture-proof, tear-proof and moisture-resistant and sealed containers and without transfering or sorting be incinerated in sealed containers. Lead foils, waste coatings, fi xing baths, developers, mercury-containing residues, waste pharmaceuticals, batteries must be disposed of by waste management companies. Household-like waste is collected in waste bags and separated and disposed of according to the local guidelines.

* Non-critical medicinal devices: medical device that only come into contact with unbroken skin ** Semi-critical medicinal devices: medical device that comes into contact with mucosa or pathologically altered skin *** Critical medicinal devices: medical device that penetrate mucosa or skin and come into contact with blood, interior tissue and organs (incl. wounds) and MP for applying blood, blood products incl. sterile medicinal products Patients suffering from or thought to suffer from a clinical condition of a transmittable spongiform encephalopathy (CJK, vCJK etc.) are to be treated in institutions that are sufficiently equipped to prevent infection. The preparation of the re-usable instruments and materials may be carried out only in institutions with an externally certified quality management according to DIN EN ISO 13485/13488.

Stamp of the surgery/date/signature of the operator

This disinfection and cleaning plan was provided by DÜRR DENTAL AG · Höpfigheimer Strasse 1774321 Bietigheim-Bissingen · Germany · www.duerrdental.comTelephone +49 (0) 71 42/705-0 · Fax +49 (0) 71 42/705-500

P007

-033

-02/

LOD

-St/

1.5/

01/F

02 Ev

en a

nd p

erfe

ct c

lean

ing

with

Hyg

oson

ic

In accordance with the German Employer‘s Liability Insurance Association for safety and health at work BGV A1, BGR 250/TRBA 250, BGI 775 and Section 36 Infectious Diseases Protection Act