Autoclave monitoring and packaging in Bangkok dental offices, Thailand

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Pannaporn Thanakitprapa
Apisada Jaratrasamee
Praewpat Pachimsawat


Objectives: To examine the regular practice of autoclave monitoring and autoclave dental packaging in Bangkok dental offices, Thailand.

Method and Materials: A preliminary questionnaire interview was performed in 52 private clinics in 2006 and a postal questionnaire was sent out to 629 hospital and private clinics in 2013. Questions included practices on 3 modes of sterilization monitoring: mechanical, chemical, and biological, as well as the types of packaging used.

Results: The response rate of the 2013 survey was 18% (n=113). We found improved formal education in infection control but understanding in the significance of autoclave performance monitoring was still low. Mechanical monitoring was performed the most (90.2%) compared with other types of monitoring. External and internal chemical monitoring were applied in 75% and 33% of all clinics, respectively. Biological monitoring was done in 17.9% of clinics surveyed. Only 2% performed all types of monitoring. The disposable paper/plastic pouch was the main packaging material (92.9%) for autoclave, among these 78.1% reused the pouch. Each paper/plastic pouch was reused most frequently 3 times before disposal. Hospital clinics performed better monitoring in all aspects and reused the pouch less than in private clinics.

Conclusion: Sterilization monitoring of an autoclave machine was inadequate among Bangkok dental offices and knowledge could be the contributing factor to poor practices as formal education was low. Reuse of a paper/plastic pouch was a routine practice but its impact was unknown. There is a need of better education on infection control and further study on the validity of pouch reuse.


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Thanakitprapa P, Jaratrasamee A, Pachimsawat P. Autoclave monitoring and packaging in Bangkok dental offices, Thailand. M Dent J [Internet]. 2020 Oct. 21 [cited 2023 Dec. 2];37(2):173-82. Available from:
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1. Neiburger EJ. Cross-contamination with dental equipment. Lancet 1993; 341: 181.
2. Oosthuysen J, Potgieter E, Fossey A. Compliance with infection prevention and control in oral health-care facilities: a global perspective. Int Dent J 2014; 64: 297-311.
3. AlNegrish A, Al Momani AS, Al Sharafat F. Compliance of Jordanian dentists with infection control strategies. Int Dent J 2008; 58: 231-236.
4. Acosta-Gio AE, Mata-Portuguez VH, Herrero-Farias A, Sanchez Perez L. Biologic monitoring of dental office sterilizers in Mexico. Am J Infect Control 2002; 30: 153-157.
5. van Doornmalen JP, Dankert J. A validation survey of 197 hospital steam sterilizers in The Netherlands in 2001 and 2002. J Hosp Infect 2005; 59: 126-130.
6. Kearns HP, Burke FJ, Cheung SW. Cross-infection control in dental practice in the Republic of Ireland. Int Dent J 2001; 51: 17-22.
7. Kohn WG, Collins AS, Cleveland JL, Harte JA, Eklund KJ, Malvitz DM, Centers for Disease C, Prevention. Guidelines for infection control in dental health-care settings--2003. MMWR Recomm Rep 2003; 52: 1-61.
8. Spry C. Understanding current steam sterilization recommendations and guidelines. AORN J 2008; 88: 537-550; quiz 551-534.
9. Centers for Disease C. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. 2008; Accessed 10 October 2016.
10. Association of periOperative Registered Nurses. Recommended practices for selection and use of packaging systems for sterilization. AORN J 2007; 85: 801-812.
11. Reichert M, Young JH. Sterilization Technology for the Health Care Facility. 2 ed: Jones & Bartlett Learning; 1997.
12. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013; 310: 2191-2194.
13. Krejcie RV, Morgan DW. Determining Sample Size for Research Activities. Educ Psychol Meas 1970; 30: 607-610.
14. Coulter WA, Chew-Graham CA, Cheung SW, Burke FJ. Autoclave performance and operator knowledge of autoclave use in primary care: a survey of UK practices. J Hosp Infect 2001; 48: 180-185.
15. Healy CM, Kearns HP, Coulter WA, Stevenson M, Burke FJ. Autoclave use in dental practice in the Republic of Ireland. Int Dent J 2004; 54: 182-186.
16. Wood PJ. Infection control practices of Rhode Island dental hygienists and certified dental assistants. J Dent Hyg 1995; 69: 212-222.
17. King TB, Muzzin KB. A national survey of dental hygienists' infection control attitudes and practices. J Dent Hyg 2005; 79: 8.
18. Su J, Deng XH, Sun Z. A 10-year survey of compliance with recommended procedures for infection control by dentists in Beijing. Int Dent J 2012; 62: 148-153.
19. McCarthy GM, Koval JJ, John MA, MacDonald JK. Infection control practices across Canada: do dentists follow the recommendations? J Can Dent Assoc 1999; 65: 506-511.
20. Matsuda JK, Grinbaum RS, Davidowicz H. The assessment of infection control in dental practices in the municipality of Sao Paulo. Braz J Infect Dis 2011; 15: 45-51.
21. Elkarim IA, Abdulla ZA, Yahia NA, Al Qudah A, Ibrahim YE. Basic infection control procedures in dental practice in Khartoum-Sudan. Int Dent J 2004; 54: 413-417.
22. Burke FJ, Coulter WA, Cheung SW, Palenik CJ. Autoclave performance and practitioner knowledge of autoclave use: a survey of selected UK practices. Quintessence Int 1998; 29: 231-238.
23. Smith AJ, Bagg J, Hurrell D, McHugh S. Sterilization of re-usable instruments in general dental practice. Br Dent J 2007; 203: E16.
24. Monarca S, Grottolo M, Renzi D, Paganelli C, Sapelli P, Zerbini I, Nardi G. Evaluation of environmental bacterial contamination and procedures to control cross infection in a sample of Italian dental surgeries. Occup Environ Med 2000; 57: 721-726.
25. Bancescu AA, Ciufecu C, Skaug N, Palenik CJ. Infection control practices and compliance to national recommendations among dentists in Romania. Int Dent J 1999; 49: 260-268.
26. Skaug N, Lingaas E, Nielsen O, Palenik CJ. Biological monitoring of sterilizers and sterilization failures in Norwegian dental offices in 1985 and 1996. Acta Odontol Scand 1999; 57: 175-180.
27. Scheutz F, Reinholdt J. Outcome of sterilization by steam autoclaves in Danish dental offices. Scand J Dent Res 1988; 96: 167-170.
28. McErlane B, Rosebush WJ, Waterfield JD. Assessment of the effectiveness of dental sterilizers using biological monitors. J Can Dent Assoc 1992; 58: 481-483.