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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 5  |  Issue : 2  |  Page : 5-6

Assessment of sterilization practices among orthodontists


1 PG Student, Department of Orthodontics and Dentofacial Orthopaedic, ACPM Dental College and Hospital, Dhule, Maharashtra, India
2 Professor, Department of Orthodontics and Dentofacial Orthopaedic, ACPM Dental College and Hospital, Dhule, Maharashtra, India
3 Professor and HOD, Department of Orthodontics and Dentofacial Orthopaedic, ACPM Dental College and Hospital, Dhule, Maharashtra, India
4 Reader, Department of Orthodontics and Dentofacial Orthopaedic, ACPM Dental College and Hospital, Dhule, Maharashtra, India

Date of Submission14-Oct-2020
Date of Acceptance17-Nov-2020
Date of Web Publication29-Jan-2021

Correspondence Address:
Dr. Prasad Anil Borole
Department of Orthodontics and Dentofacial Orthopaedic, ACPM Dental College and Hospital, Dhule, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmo.ijmo_4_20

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  Abstract 


Background: Orthodontists do not perform surgical procedures, nevertheless they are obliged to practice appropriate sterilization techniques to prevent cross-infection. This is also important from an ethical and legal point of view. The aim of the present study is to evacuate the compliance of orthodontists to infection control procedures in Khandesh region, Maharashtra. Methodology: A questionnaire with 20 items was delivered by E-mail to a total of 271 orthodontists/residents from Khandesh region, Maharashtra. The data collected from the survey was analyzed using IBM SPSS statistics 22 software. Results: Nearly 93.4% of the responders believed that autoclave is the best method of sterilization, 59% of the responders think that dry heat is the best for sterilization, while 50.9% of the responders think about cold chemical and 60.5% about ethylene oxide. Many responders preferred the multiple options. Conclusion: Infection control procedures in the field of orthodontics must be improved in India. Training on compliance with the infection control principles should be included in education programs and these programs should be repeated on a regular basis.

Keywords: Cold chemical sterilization, disinfection, heat sterilization, infection control procedure, orthodontics, sterilization


How to cite this article:
Borole PA, Maheshwari A, Kerudi V, Aley M, Saxena S, Phalak Y. Assessment of sterilization practices among orthodontists. Int J Med Oral Res 2020;5:5-6

How to cite this URL:
Borole PA, Maheshwari A, Kerudi V, Aley M, Saxena S, Phalak Y. Assessment of sterilization practices among orthodontists. Int J Med Oral Res [serial online] 2020 [cited 2021 Feb 25];5:5-6. Available from: http://www.ijmorweb.com/text.asp?2020/5/2/5/308276




  Introduction Top


Infection control is crucial for orthodontists and for patient health. Orthodontists usually do not perform comprehensive surgical procedures, but they are obliged to use appropriate sterilization techniques to prevent cross-infection in daily practice. This is also important from an ethical and legal point of view.[1],[2] However, studies have found that orthodontists have lower compliance to infection control procedures than dentists. The main reasons for this include they work on pediatric cases, they do not perform procedures in deep tissues, sterilization procedures result in the loss of time and money, and sterilization procedures cause corrosion in orthodontic pliers. In literature, several studies have documented the effects of sterilization on orthodontic archwires, pliers, brackets, bands, and elastic ligatures and evaluated infection control procedures to be followed in the practice of orthodontics and the compliance of orthodontists to these procedures.[1],[3],[4] However, no comprehensive research evaluating the compliance of the Khandesh orthodontists to the infection control procedures is available. In the present study, we aimed to evaluate sterilization and disinfection methods employed in the practice of orthodontics in Khandesh region and the compliance of orthodontists to these methods.


  Methodology Top


Postgraduate orthodontic students, faculties, and private practitioners from Khandesh region in Maharashtra were decided as a population for the present study. In the present study, we had constructed a questionnaire containing twenty questions regarding sterilization and cross-infection, approach toward the sterilization procedures in clinics, and their working place. The last section of questionnaire inquires whether or not they are following all the protocols. This questionnaire was distributed among the postgraduate students and faculties of orthodontics departments of dental colleges in Khandesh region, Maharashtra, and private practitioners in the form of physical copies where possible. However, electronic media (in the form of Google Form) was also used to generate maximum data. Hence, within 4 weeks, reply was received from 271 orthodontists out of the 450 contacted orthodontists. Hence, we reduced the confidence level and decided to use confidence level of 90% and a sample size of 271 was considered for the results.


  Results Top


The sample of the present study comprised a total of 271 responders, in which 60.5% were male and 39.5% were female. According to 85.2% of the responders, vaccination is compulsory for orthodontists, 5.9% are not sure, and 8.9% of the responders are confused about it. Most of the responders, that is, 39.9%, strongly agreed with the fact that frequent sterilization can cause rusting and wearing of orthodontic pliers, 18.1% agreed with this, 27.3% were neutral, while 14% disagreed and 0.7% strongly disagreed. Among the orthodontic practitioners, 55.4% sterilize their diagnostic instruments and pliers daily, 11.4% sterilize instruments thrice in a week, 17.7% of the responders go with twice-a-week sterilization, and 15.1% of the responders sterilize their instruments only once in a week. Most of the responders, that is, 86.7% of the responders, are servicing their pliers, but 7.4% are not servicing. Almost 65.7% of the responders used disinfectant for hand piece sterilization, while 93 responders (34.4%) used to autoclave their hand pieces [Figure 1]. According to 93.4% of the responders, autoclave is the best method of sterilization; 59% of the responders think that dry heat is the best for sterilization while 50.9% of the responders think about cold chemical and 60.5% about ethylene oxide. Many responders preferred multiple options [Figure 2].
Figure 1: Method of sterilizing hand piece

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Figure 2: Best sterilization method in orthodontics

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  Discussion Top


Survey conducted at California in the year 1977, showed that the orthodontists used barrier protection as well as followed all sterilization/disinfection procedures and environmental disinfection programs. In this survey, it was found that 94% of the responders relied solely on disinfection.[5],[6],[7] In contrast, the article published in the year 1986 revealed that 80% of mid-Atlantic orthodontists used American Dental Association (ADA) approved sterilization procedures. The purpose of the 1987 and 1988 survey conducted in Georgia among orthodontists was to document the risk factors associated with infectious disease, existing sterilization and disinfection procedures, compliance with ADA/Centers for Disease Control and Prevention (CDC) recommendations, and the perceptions of adequacy of sterilization and disinfection procedure.[8],[9] The purpose of the 1988 survey conducted in Georgia was to document the trends among orthodontists with regard to risk factors, current sterilization and disinfection procedures, compliance with ADA/CDC recommendations, and the perceptions of adequacy of sterilization and disinfection procedure.


  Conclusion Top


The present study concludes that most of the orthodontists sterilize themselves as well as instruments, pliers, and hand pieces, but few of them do not sterilize or take care to protect themselves as well as their patients. The study strongly recommends that all orthodontists should provide the best possible methods of infection control both to themselves and to their patients as suggested by the Indian Dental Association and the Dental Council of India.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Mazzocchi AR, Paganelli C, Morandini C. Effects of 3 types of sterilization on orthodontic pliers. J Clin Orthod 1994;28:644-7.  Back to cited text no. 1
    
2.
Johnston MW, Moore WC, Rodu B. Comparison of convection heat sterilization units for the orthodontic office. Am J Orthod Dentofacial Orthop 1991;99:57-63.  Back to cited text no. 2
    
3.
Carcao G. Comparison of 3 dry heat convection sterilizers. J Clin Orthod 1993;27:259-63.  Back to cited text no. 3
    
4.
Mazzocchi A. Orthodontic pliers and sterilization procedures. Questions and Answeers Virtual Journal of Orthodontics. 1996;3.  Back to cited text no. 4
    
5.
Wichelhaus A, Brauchle G, Mertmann M, Sander FG. Corrosion of orthodontic pliers using different sterilization procedures. J Orofac Orthop 2004;65:501-11.  Back to cited text no. 5
    
6.
Angelillo IF, Villari P, D'Errico MM, Grasso GM, Ricciardi G, Pavia M. Dentists and AIDS: A survey of knowledge, attitudes, and behavior in Italy. J Public Health Dent 1994;54:145-52.  Back to cited text no. 6
    
7.
Guidelines for infection control in the dental office and the commercial dental laboratory. Council on dental therapeutics. Council on prosthetic services and dental laboratory relations. J Am Dent Assoc 1985;110:969-72.  Back to cited text no. 7
    
8.
Council on Dental Therapeutics. Accepted Dental Therapeutics. 40th ed. Chicago: American Dental Association; 1984.  Back to cited text no. 8
    
9.
Matlack RE. Instrument sterilization in orthodontic offices. Angle Orthod 1979;49:205-11.  Back to cited text no. 9
    


    Figures

  [Figure 1], [Figure 2]



 

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