Recommendation for NHSScotland

• Dental practices should have a rigorous cleaning process in place for all reusable dental instruments.
• Whilst there is some laboratory-type evidence that dental handpieces are not reliably sterilised using non-vacuum sterilisers there is no direct evidence to assess whether the provision of benchtop vacuum sterilisers to dental practices in Scotland would provide benefit in terms of increased patient safety to justify the additional cost.
• Manufacturers’ instructions should be followed for all instruments and decontamination equipment. 

NHSScotland is required to consider the Scottish Health Technologies Group (SHTG) advice.

What were we asked to look at?

Would the provision of benchtop vacuum sterilisers to dental practices in Scotland provide sufficient benefit in terms of increased patient safety to justify
the financial outlay and ongoing revenue costs?

Why is this important?

Two main types of benchtop steam sterilisers are in use. Sterilisers which deliver a type ‘N’ cycle use passive displacement to remove air from the chamber to allow steam to come into contact with instruments. These are indicated for solid instruments. In steam sterilisers delivering type ‘B’ cycles, air removal is facilitated by a vacuum stage. This allows steam to come into contact with internal surfaces of instruments, such as dental handpieces, which have hollow components.

No information on current practice was identified. In a survey of Scottish dental practices conducted in 2004, 89% of practices which participated (n=179) had type N sterilisers, whilst 11% had type B sterilisers. The proportion of practices with a type B steriliser is likely to have increased.

Referred by

Scottish Dental Clinical Effectiveness Programme.