(a) Sterilization is required for all surgical and other instruments that may be used intraorally or extraorally, where these instruments may be used invasively or in contact with or penetration of soft tissue, bone or other hard tissue. Other nonsurgical instruments, such as plastic instruments, that may come into contact with tissue must be disinfected with an American Dental Association-registered solution that is tuberculocidal.

(b) All instruments subject to sterilization must undergo at least one of the following procedures:

(1) Steam autoclave

(2) Chemical Vapor

(3) Dry-heat oven

(4) Ethylene oxide

(5) Chemical sterilant (used in dilution amounts and time periods according to manufacturer's recommendations or accepted OSHA standards). Sterilization equipment and its adequacy shall be tested and verified in accord with American Dental Association (ADA) recommendations.

(c) Following a dental procedure, all instruments and operatory equipment that may have become contaminated with blood, saliva, or tissue debris must be, at a minimum, disinfected and preferably sterilized by a CDC or ADA-approved method before utilization again for patient care.

(d) Prior to sterilization, all instruments must be free of any visible debris and must be either scrubbed thoroughly with a detergent and water solution or debrided in an ultrasonic device containing cleaning solution.

(e) Oral prosthetic appliances and devices from a dental laboratory must be washed with a detergent and water solution, rinsed, disinfected, and rinsed before the appliance or device is placed into patient's mouth.

(f) Disposable (non-resterilizable) items, including but not limited to gloves, needles, intravenous fluids, intravenous administration tubing, intravenous catheters/needles, and like items, shall not be used in the treatment of more than one patient.

(g) All items contaminated by body fluids during patient care must be treated as biohazardous material. Before extracted teeth are returned to a patient or other party, the teeth must be rendered non-biohazardous. All contaminated single-use items must be disposed of through established OSHA guidelines for such disposal. Teeth or tissue fragments to be used for microscopic, testing, or educational purposes must be sterilized prior to use. Such tissues must be handled and stored as biohazardous material until sterilization is performed.

(h) When it is necessary to send items (including but not limited to impressions, bites, working casts, prosthetic appliances or devices) to a dental laboratory for fabrication on repair, those items that are contaminated by body fluids must be considered biohazardous. Before such items are delivered to the dental laboratory or technician, they must be rendered non-biohazardous according to established OSHA guidelines.

(i) When it is necessary to return items (including but not limited to impressions, bites, working casts, prosthetic appliances or devices) to a dental office from a dental laboratory which item has been fabricated or repaired, those items that have been potentially contaminated shall be rendered non-biohazardous. Before return to the dentist by the dental laboratory or technician, the item must be rendered non-biohazardous according to established OSHA guidelines.

Source Note: The provisions of this §108.24 adopted to be effective February 20, 2001, 26 TexReg 1494