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July 31, 2012
It’s hard to believe it’s been four years. Way back in issue #1 we stated that the goal of Practice Tips was to help dentists and staff increase their independence, reduce down time, and get the most out of their equipment.
Here we are, four years later, and that is precisely what we’ve done!
Thousands of practitioners have saved time and money by learning how to install basic replacement parts such as toggles, air/water syringes, and quick disconnects. We’ve covered the basics of pneumatics and introduced you to the junction box.
We’ve had several issues devoted to sterilizers including “decoding” the Statim sterilizer errors to help you trouble-shoot even if you don’t perform the repair yourself.
But it’s not just about repairs, we’ve also had many issues devoted to maintenance!
The first step in reducing down time and repair costs is reducing the frequency of break downs. The BEST way to do this is to have a good system of routine maintenance in place. We’ve also created a printable poster showing routine maintenance of your sterilizer- post it in your sterilization room to help staff keep your sterilizer running well. We’ve had issues dedicated to specific equipment as well as more general information to cover everything in the office!
We’ve also increased your knowledge with in-depth discussions of the design and function of equipment. Each issue has been replete with detailed descriptions, photographs, illustrations, and diagrams to convey as much information as possible. For further clarification, we’ve had a number of video issues as well.
Our YouTube channel has had tens of thousands of views! Unlike many “dental corporate” videos, we don’t just post a series of commercials for the latest new product. Our videos feature real information that you can put to use immediately in your office to save time and money.
Many of our videos have been made to compliment previous text-and-photo issues of Practice Tips by showing the things we’ve discussed being done in real time. And, they’ve been made by the hard-working tech support staff who take your calls every day. These guys know what real practitioners need to know and are asking us about every day.
We’d like to take this opportunity to thank each and every one of you that take the time to read PracticeTips every month. Whether you receive it in your inbox, read it in our blog, or read other online postings, THANK YOU for following us. Please share Practice Tips with your colleagues too. Point them to our blog, or have them send an e-mail to firstname.lastname@example.org to subscribe for free!
Finally, we would really like to hear from YOU. We are interested in your feedback and we invite your topic suggestions so that we can continue to fulfill our mission of presenting you with useful content. What piece of equipment can we help demystify? Do you need help installing something? Please e-mail your ideas, feedback and suggestions to Techtips@amerdental.com!
In the future we’ll continue to provide you with helpful information, diagrams and videos to help you get the most out of your practice. Send us your ideas so we can incorporate them as well.
Bookmark our archives as a handy reference you can use every day!
May 31, 2012
Water quality is important to proper function of your sterilizer.
Why? You'll find out why, because this month in Practice Tips, we’ll look at the principles of autoclave sterilization.
The sterilizer is one of the most important pieces of equipment in the office. If you don’t have sterile instruments, you can’t work. But, how do these vital pieces of machinery function?
First, we’ll review a little history.
Most dental offices have what are classified as “table top” sterilizers as they are quite compact and small – small enough to fit on a table top (or counter top, more often).
Table top sterilizers were originally designed as “flash” sterilizers for use in medical operating rooms. They were intended for quick “flash” sterilization of instruments whose sterility was somehow compromised in the operatory (most commonly by being dropped). Their (comparatively) short cycle times and small size makes these sterilizers ideal for the dental office as well.
Now that we know a little background, we can move on to matters of function:
Taken at the most basic level, an autoclave is really just a boiling tank. You have water in a reservoir which is drained (or pumped) into the chamber at the beginning of the cycle. The chamber heats up causing the water to boil. The chamber continues to heat, super-heating the steam which then builds up pressure so that the steam permeates all items in the chamber. According to CDC guidelines, most items require 3-7 minutes of exposure to this superheated pressurized steam to be rendered sterile. The specific time will vary depending on the nature of the item and how it is packaged.
Once sterilization has been achieved, the pressurized steam is vented from the chamber and the heating elements turn off allowing the chamber and contents to cool. The vented steam is sometimes exhausted out a drain, or sometimes vented back into the reservoir where there is a condensation coil to facilitate cooling of the steam returning it to a liquid. Finally, the contents of the chamber are allowed to dry (the specific method of drying will vary widely from one make and model of autoclave to another).
As you can see, water (or steam created from this water) is integral to the function of an autoclave. For this reason, it is very important that you only use distilled water or water that has been treated for use in a sterilizer (typically, de-ionized). Properly treated water will have a very low Total Dissolved Solids (TDS) level- 5ppm or less. Distillation or de-ionization are normally the only way to achieve such low TDS levels. Other methods of water treatment (for example, reverse osmosis) are not normally adequate to achieve such low TDS levels.
The water and steam flows through a variety of small pipes and valves many of which can become clogged from the various minerals and additives that may be in untreated (i.e. tap) water. Poor or low water flow can lead to overheating (damaging expensive instruments), failure to achieve pressure (which is required for sterilization to be achieved), as well as damaging components of your autoclave. Naturally, damage to components of the autoclave can lead to malfunction, costly downtime, and expensive repairs.
As an additional safeguard, autoclaves have filters on the water line to catch any debris before the water enters the chamber. Check your filters regularly as part of your routine maintenance. Two examples of fill line filters are pictured below:
This sintered bronze filter is used on Pelton & Crane Sterilizers:
A mesh filter is used on Tuttnauer and Midmark sterilizers:
Many sterilizers will also have a filter in the reservoir- be sure to check it frequently as well. If you notice debris in the reservoir of your autoclave, be sure to clean it out thoroughly using your suction to remove any debris or dirty water.
Water quality is so important that some autoclaves (e.g. the Statim cassette sterilizers) have a built-in water quality sensor that will prevent function if the water is not of suitable purity. Of course, sometimes the sensor can be damaged or get dirty, so make certain to keep it clean & inspect it as part of your regular maintenance.
The water quality sensor also brings to mind a common problem with self-distilled water. Most counter top water distillers are manufactured and marketed for home use so they include carbon filters. The carbon filter is included to improve the taste of the water for drinking. However, they will actually introduce carbon into the water, so remove the carbon filter if distilling water for your sterilizer. The carbon from these filters will often trigger the water quality sensor of the Statim and could impede the function of this and other sterilizers.
As you can see, water quality can play a significant role in the daily use of your autoclave so make certain to only use appropriately prepared water in yours to keep it working well and maintain the vital sterility of your instruments.
March 28, 2012
This month in Practice Tips we’ve got a video showing diagnosis and repair of a Statim sterilizer with a steam leak. When diagnosing any problems, it’s best to start with a physical inspection of the components to look for obvious signs of trouble as our techs do here. You can see the methodical step-wise approach to take whenever trouble shooting.
As it turns out, the problem was simply a worn, bad, or improperly installed cassette seal. Our techs were unable to make a definitive determination but replacing the seal did correct the problem. The simplest things are often a great starting point if using process of elimination to diagnose (sometimes, all one can do).
This demonstration shows the proper method of replacing a Statim cassette seal as well as the importance of lubricating the seal when installing. It may have simply been lack of lubrication that lead to the failure of the original seal (our techs were never able to make a definitive conclusion- but this is something to keep in mind).
Lubricating the cassette seal or door gasket of your sterilizer (as applicable) should be part of your routine maintenance. See previous issues of Practice Tips for more information on trouble shooting and repairing the Statim or other sterilizers.
Can’t see the video? You can also view this video on our blog or Youtube.