I had a very nice gentleman in my chair the other day, who also happens to be a fairly famous actor. He has appeared in well known films and television programmes but Nichola, who edits this blog for me, says I may not mention his name...

He had just finished his treatment, but hesitated before leaving. He looked a little embarrassed and said “Do you mind if I ask you a question?”” Not at all” I said. Then he proceeded to ask me something that I have often felt many others would like to ask but somehow cannot pop the question before leaving.

“Well, you see all those instruments on your bracket table” he said waving his hand across the room at the confusing array of mouth mirrors, probes, tweezers and other unmentionables. “What do you do with them after I have gone? I know that you use them again on someone else, but how do you clean them? And those gloves that you have on. What happens to them? Do you clean them? Wash them…….? Or what? I hope you don’t mind me asking” he said “I am sure you have it all worked out, but I would just like to know”

I was not offended at all. My first reaction was to demonstrate that we follow the cross infection control guidelines set down by the British Dental Association which are posted on the wall of each surgery, and we are regularly inspected by NHS and Denplan officials. All our nurses are qualified and registered with the General Dental Council and we all receive at least two hours training with updates every year along with regular audits. But this man is a practical sort of guy and I realised that all he wanted to know was: “What do you actually do?”

I showed him the ultrasonic cleaning machine that was buzzing away on a worktop. “All equipment goes into this machine which is filled with disinfectant.” I said, lifting the lid so he could see inside. “It vibrates ultrasonically so that anything stuck to the instruments is loosened off. Then the instruments are scrubbed under running water by the nurse and placed into this autoclave. An autoclave is a large pressure cooker that raises the temperature of the instruments to 134’C for four minutes. This kills all bugs” I said. “My autoclave is fitted with a printer so that I have a record of each sterilization cycle so that I can monitor that the correct temperature is achieved for the correct period of time.” My friend was beginning to look impressed.

“What happens to the instruments after that?” He asked. “They are stored in metal sterile trays with lids. We have two sides of our work bench. We isolate one side for dirty instruments and one side for clean instruments.” I don’t think he had thought about that but he got the point.” All work tops are sprayed with disinfectant after each patient.”

“Now we use disposable non latex gloves. A new pair is used for each patient. Of course that is after I have washed my hands” He looked relieved. I then went on to explain that we use many other disposable pieces of equipment such as plastic cups, saliva ejection tips, suction tips, bibs, three in one tips, hand towels, face masks, visors. He was beginning to look bored so I explained that root-filling files and reamers are also thrown away after each patient, along with steal burrs, even though some of them cost £30, because it is impossible to clean them properly. My actor friend was beginning to move towards the door. “That’s fine” he said “can I bring my wife and children next time I come?” “Of course you can” I said.

I wanted to tell him about how we flush out the hand piece drills with sterile oil and then autoclave them. I wanted to explain about Sterilox which disinfects the water that sprays though all my instruments; I wanted to tell him about the special clinical waste bins we use and how much it costs to have them incinerated. And of course we use a new needle for each patient!  But he had gone. Well he did ask!  Peter Haynes 24th January 2009