1. Although the oral cavity is contaminated with pathogenic bacteria, it is important that we exercise measures of disinfection of our hands, the field of operation, and the instruments we use for oral surgical procedures in an effort to prevent cross-infections and the introduction of extraneous bacteria to which surgically traumatized tissues may respond unfavorably.
2. An effort was made in this discussion to provide some fundamental bacteriologic facts on which the practical techniques of sterilization and disinfection could be based.
3. Since moist heat has been shown to be the most efficient means of destroying bacteria, it was emphasized that steam under pressure and boiling water should be the methods of choice for sterilization of instruments.
4. Chemical disinfectants should be used only when moist heat might be decidedly injurious to delicate, cutting-edged instruments.
5. Pathogenic sporulating organisms which are found in the mouth are few in number and infrequent in occurrence. Under ordinary circumstances, the dentist would rarely treat patients harboring spore-forming organisms and thus he would be unlikely to spread infections caused by these bacteria.
6. Asporogenic bacteria are eliminated after five minutes’ exposure to boiling water, although ten minutes’ exposure would be safer and more advisable. Spores succumb after ten to ninety minutes’ exposure, depending on the type of bacteria.
7. The autoclave can provide complete sterilization in a relatively short period of time.
8. Chemical disinfectants are bactericidal for most nonsporulating organisms after fifteen minute’s exposure, but are ineffective against spores and unreliably effective against the viruses which apparently are responsible for infectious hepatitis and homologous serum jaundice. This latter evidence, plus the constant threat of deep needle infections, indicates that chemical solutions should not be used for disinfecting needles for injection. Studies have shown that these virus diseases definitely can be transferred from one patient to another due to a careless technique of sterilization of needles and syringes.
9. After the instruments have been disinfected carefully, they should be stored between clean, or preferably autoclaved, towels in cabinets that are as dust-free as possible. Those instruments not used frequently should be removed from the storage cabinet and disinfected at regular intervals.
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