Find out which Dentisan products comply with the relevant sections in the HTM01-05 guidelines.
Choose a product application below:
Instrument hygiene
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Product application
HTM 01-05 References
HTM 01-05 Reference 2.15
Instruments for decontamination should be transferred as soon as possible after use to the decontamination area in order to avoid the risk of drying. Prompt decontamination is appropriate. Potable or RO (reverse osmosis) water immersion or the use of commercial gels/sprays may be considered. These measures reduce the absorption of proteins to the instrument surfaces and makes cleaning easier.
HTM 01-05 Reference 3.14
Rinse – removes detergent used during the cleaning process. This stage can contain several sub-stages. The quality of water to be used for this stage is an important consideration in terms of ensuring a clean, unmarked product after sterilization. Recent evidence review makes clear that the previous limits on endotoxin levels set for rinse water, which effectively ruled out the use of potable water, should no longer be applied. Studies demonstrate that much of the potable water supply in England exhibits satisfactorily low endotoxin concentrations (below 30 EU/mL), which are unlikely to harm health in this application. Accordingly, potable water may be used at this stage provided that the local water adviser (undertaker) indicates that the endotoxin level given above, hardness (less than 50 mg/L), pH and salt burdens are satisfactory for the purpose. Changes in water quality mean that you should seek this advice not less than once per annum. However, where the local potable water is unsatisfactory or spotting is observed on instruments, then final stage RO water rinsing is recommended.
Instrument decontamination
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Product application
HTM 01-05 References
HTM 01-05 Reference 3.1
The principle methods of cleaning reusable dental instruments currently available are: cleaning using a washer-disinfector; manual combined with ultrasonic cleaning; manual.
HTM 01-05 Reference 3.14
Rinse – removes detergent used during the cleaning process. This stage can contain several sub-stages. The quality of water to be used for this stage is an important consideration in terms of ensuring a clean, unmarked product after sterilization. Recent evidence review makes clear that the previous limits on endotoxin levels set for rinse water, which effectively ruled out the use of potable water, should no longer be applied. Studies demonstrate that much of the potable water supply in England exhibits satisfactorily low endotoxin concentrations (below 30 EU/mL), which are unlikely to harm health in this application. Accordingly, potable water may be used at this stage provided that the local water adviser (undertaker) indicates that the endotoxin level given above, hardness (less than 50 mg/L), pH and salt burdens are satisfactory for the purpose. Changes in water quality mean that you should seek this advice not less than once per annum. However, where the local potable water is unsatisfactory or spotting is observed on instruments, then final stage RO water rinsing is recommended.
HTM 01-05 Reference 3.1
The principle methods of cleaning reusable dental instruments currently available are: cleaning using a washer-disinfector; manual combined with ultrasonic cleaning; manual.
HTM 01-05 Reference 3.30
Place instruments in a suspended basket and fully immerse in the cleaning solution, ensuring that all surfaces are in contact with the solution. The solution should be made up in accordance with the manufacturer's instructions.
HTM 01-05 Reference 3.1
The principle methods of cleaning reusable dental instruments currently available are: cleaning using a washer-disinfector; manual combined with ultrasonic cleaning; manual.
HTM 01-05 Reference 3.33
In principle, manual cleaning is the simplest method to set up, but it is difficult to validate because it is difficult to ensure that it is carried out effectively on each occasion.
Hand hygiene
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Product application
HTM 01-05 References
HTM 01-05 Reference 6.6
Mild soap should be used when washing hands. Bar soap should not be used. Apply the liquid soap to west hands to reduce the risk of irritation, and perform hand-washing under running water.
Ordinarily, the hand-wash rubbing action should be maintained for about 15 seconds. After the exercise, the hands should be visibly clean.
HTM 01-05 Reference 6.8
Hand cream, preferably water-based, should be used to avoid chapped or cracking skin. Communal jars of hand cream are not desirable as the contents may become contaminated and subsequently become an infection risk. Ideally, wall-mounted hand-cream dispensers with disposable cartridges should be used. Any staff that develop eczema, dermatitis or any other skin condition should seek advice from their occupational health department or general practitioner (GP) as soon as possible.
HTM 01-05 Reference 6.12
Wall-mounted liquid hand-wash dispensers with disposable cartridges should be used. It should be ensured that the nozzle is kept clean. Refillable hand-wash containers should not be used as bacteria can multiply within many of these products and are therefore a potential source of contamination.
Multi surface treatment
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Product application
HTM 01-05 References
HTM 01-05 Reference 6.57
Evidence suggests that the use of commercial bacterial cleaning agents and wipes is helpful in maintaining cleanliness and may also reduce viral contamination of surfaces. Care should be taken in the use of alcohol wipes, which - though effective against viruses on clean surfaces - may fix protein and biofilm. However, the careful use of water with suitable detergents, including those CE-marked for clinical use, is satisfactory provided the surface is dried after such cleaning.
HTM 01-05 Reference 6.62
Areas and items of equipment local to the dental chair that need to be cleaned between each patient include:
- Local work surfaces
- Dental chairs
- Curing lamps
- Inspection lights and handles
- Hand controls including replacement of covers
- Trolleys/delivery units
- Spittoons
- Aspirators
- X-ray units
HTM 01-05 Reference 6.63
Areas and items of equipment that need to be cleaned after each session include:
- taps;
- drainage points;
- splashbacks;
- sinks.
In addition, cupboard doors, other exposed surfaces (such as dental inspection light fittings) and floor surfaces, including those distant from the dental chair, should be cleaned daily.
HTM 01-05 Reference 6.74
For blood spillages, care should be taken to observe a protocol that ensures protection against infection. The use of 1% sodium hydrochloride is recommended with a yield of at least 1000 ppm free chlorine (unless PCT policy suggests otherwise). Contact times should be reasonably prolonged (not less than five minutes). A higher free chlorine yield of up to 10,000 ppm is useful, particularly for splash contamination. The process should be initiated quickly and care should be taken to avoid corrosive damage to metal fittings etc. The use of alcohol within the same decontamination process is not advised.
Impressions, prosthese and orthodontic appliance
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Product application
HTM 01-05 References
HTM 01-05 Reference 7.1
Decontamination of these devices is a multi-step process to be conducted in accord with the device or material manufacturer’s instructions. In general terms, the procedure will be as follows:
a. Immediately after removal from the mouth, any device should be rinsed under clean running water. This process should continue until the device is visibly clean.
b. All devices should receive disinfection according to the manufacturer's instructions. This will involve the use of specific cleaning materials noted in the CE-marking instructions. After disinfection, the device should again be thoroughly washed. This process should occur before and after any device is placed in a patient's mouth.
c. If the device is to be returned to a supplier/ laboratory or in some other fashion sent out of the practice, a label to indicate that a decontamination process has been used should be affixed to the package.
Water quality
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Product application
HTM 01-05 References
HTM 01-05 Reference 6.79
Where monitoring is undertaken, the TVC should be expected to lie in the range 100 to 200 colony forming units per millilitre (cfu/ml). In general, this work will be conducted at 22oC. These measurements can be carried out by local microbiological services or by the Health Protection Agency. In the first instance, PCTs will be able to advise. (Some commercial water-purification services offer microbiological control such that TVC values may be maintained below 10 cfu/ml.)
HTM 01-05 Reference 6.86
Disinfection of DUWLs should be carried out periodically. In all cases, the manufacturer’s instructions should be consulted. Sodium hypochlorite and isopropanol and a number of other agents have been shown to be effective in the removal of biofilm as well as the reduction of microbacterial contamination. However, these agents should only be used where recommended by manufacturers. If they are used, care should be taken to ensure that DUWLs are thoroughly flushed after disinfection and before being returned to clinical use.
