With HTM105 covering so many decontamination issues within the practice – it could leave you wondering which system you should improve on next. One thing in the memorandum I would like to mention is the quality of purified water that you should be using in your sterilisers, the fact that when I read the article it prompted more questions than answers surely means it’s worth discussing.

HTM105 itself does not actually list the specific contents or upper limits for elements contained within the purified water. The memo requires your purified water to conform to BS-EN 13060, which – within the industry is not a particularly recognised standard when compared to other standards such as British Pharmacopeia (BP) and European Pharmacopeia (EP).

Unless you are willing to part with this amount of money BS13060 is not an easy specification to get your hands on. BP and EP is the specification we would normally be required to manufacture and until recently BS13060 was a standard that we didn’t even analytically test to. BS13060 actually requires more testing and analysing than BP and EP, within the specific elements dissolved in the purified water.

Essentially if you use Crystal Medic purified water, its one less thing to worry about – because we have rigorous in house and outsourced testing. Every bottle you purchase is guaranteed to achieve the specification required by HTM105. We can supply certificates to prove this which helps you show you have took due diligence in choosing the correct purified water for successful decontamination.

The purpose of Health Technical Memorandum 01-05 is to progressively raise the quality of decontamination in dental surgeries and facilities using methods highlighted in HTM 01-05, obviously leading to less risk of disease and contamination throughout the work environment. This Progress towards achieving best practice could be seen as almost a never-ending process of development with the discovery of new and often more adequate sterilization techniques.

Some of the key issues or areas concerned with the misuse of purified water and neglect of a could-be contaminated work place and instruments include the following:

• Improve separation of decontamination processes from other activities and enhance the distinction between clean and dirty workflows around the workplace.
• Provide and develop suitable storage for instruments that have been sterilized with purified water, which inevitably reduces exposure to air and a possible risk of pathogenic contamination. The system should be focused on safe and orderly storage of instruments. This will ensure that instrument storage is well protected in the appropriate clean room against the possibility of exposure of stored instruments to contaminated aerosols.
• Install a modern validated washer-disinfector of adequate capacity to remove the need for manual washing with purified water. If this isn’t possible, workers should take every measure to ensure that decontamination tasks are done separately, or using another form of sterilization to avoid the risk of contamination.
• Dental hand pieces should be cleaned and sterilized with purified water and other sterilization products after each patient has been examined or treated.

When it comes to clients choosing a dental facility, there comes ample choice- I want to talk about why they could choose one practice over another. This applies to those in the private or NHS sector who invest in reliable contractors to provide them with professional services such as autoclaves engineers, tooling supplies, dental water, or purified water. This is only my point of view from someone in the industry having seen it all – visiting and providing di water to hundreds of different setup practices all over the country.

From a clients perspective there are so many different dental surgeries to choose from. How do you choose the right dental surgery for you? Is it a question of prices (both privately and NHS run surgeries)? Or are their certain elements to look for in a good quality, reliable dental surgery?

Just having friendly staff, a great customer service ethic, with nicely decorated rooms is the norm now, however a lot of clients will look deeper into your surgery, particularly those who have previously had bad experiences with unhygienic dental practices. Showing your clients you run up to date and consistent decontamination procedures is something to think about remembering ro water or dental water is only a small part – but key part to the process. Important key issues or attention to detail like these not only make and form impressions with the customer but could be vital for the safety of your clients.

In Summary one way you can separate yourself from the competition is to sell the fact that you have raised the quality of decontamination in your facility by remembering to document and promote your processes like the dental water you use is pure water to a recognised standard. I think when a client knows how seriously you take sterilisation and customer safety they are more comfortable and happy to remain a good customer for years to come.

Investment in modern dental instruments and tools are expensive but sensible decisions for the future of your practice, putting bacteria and viral issues aside it also makes good sense to protect these investments by checking the decontamination procedures are not causing damage to your instruments. Often the damage will occur before your sterlisation process, it pays to look closely at your washing and disinfection stage. Some dentists are now using washer disinfectors connected to the mains water supply without the supply of ro water, these are great at getting consistent results removing debris very effectively – keep a close eye of scale build up on your instruments internally and externally, as this can cause damage to your instruments as well as the washer itself. Many practice’s still use the manual methods, scrubbing down instruments first, washing away debris and then a final rinse with dental water like Crystal Medic. This serves to reduce bacteria and virals, the purified water also conditions the instruments before they enter the sterilizer.

Dental instruments are made of high-quality materials designed to minimise corrosion, this resistance is based on their alloy composition and structure, forming a protective passivation layer on the surface. Instruments resist corrosion differently depending on the quality and thickness of this layer. It is important to avoid damage to this passivation layer during cleaning by using the correct when sterilising. Methods such as the use of wire brushes, which may give rise to surface abrasion, should be avoided. Any instruments that have rust spots should be removed. Always use detergents and process water specifically formulated for cleaning of instruments, and when using manual methods the detergent should be designed for the manual cleaning of dental instruments to perform correctly and avoid instrument degradation including discoloration, staining, corrosion and pitting. Another issue when manually cleaning is to remember to measure the correct volume of  process water and detergent to achieve the concentration specified by the detergent manufacturer. Once your washing is complete, lubricate any relevant items prior to sterilization with a non-oil-based lubricant.

The performance of your sterliser is affected by the quality of the purified water you use. Using Crystal Medic with the correct decontamination systems will not only achieve complete sterilization, but will help protect expensive steriliser components reducing maintenance and running costs long term.