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GovtDentalClinicsPhasingOutBoiling871001
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Govt dental clinics phasing out boiling

Sterilisation being done by other means

MORE government and school dental clinics are sterilising instruments with high-pressure steam, chemicals or hot-air ovens instead of with boiling water.

The change has been taking place daring the past year under a Health Ministry programme to ensure that dental instruments are totally germ tree. The programme is expected to be completed soon.

Private dental clinics, on the other hand, have been slow to change.

Dr Myra Elliot, who spoke at a meeting of dental surgeons over the weekend, said it is believed that almost half of all dental surgeons still boil their instruments.

The risk in not autoclaving, or using hot air ovens with temperatures up lo 180 deg C, is that some Hepatitis B or Aids virus may not be destroyed. Some spores are resistant to heat and sometimes boiling does not destroy them.

With about 140,000 Hepatitis B carriers in Singapore, or 5.5 per cent of the population, dentists could become agents of infection if they use poorly sterilised instruments.

Hepatitis B is an infection of the liver and can lead to complications such as cancer of the liver. The virus is found in the body fluids and secretions of a carrier and can be passed on through sexual contact and contaminated blood.

The dental clinic at the National University Hospital has already fully converted to autoclaving and the hot air method.

As a further precaution against infection, many disposable items are used, like needles, cups, salivary ejectors (to drain out saliva during treatment), and suction tips.

Private dentists who are slow to change cite two reasons - practicality and cost.

A dentist in private practice said: "In autoclaving, or sterilising with high-pressure steam, the instruments must be able to withstand the pressure and temperature. Over time, these could damage the delicate hand pieces.

"It is also difficult to recover the cost spent on these units because we want to keep our fees low."

Another said: "Boiling of instruments is still practical for non-surgical operations, such as filling teeth, where the likelihood of contamination is not great.

"But when it comes to surgeries, the instruments will have to be 100 per cent sterile."

Two others said the switch to autoclaving cannot be done overnight because of the cost.

However, one dental surgeon with a clinic in town felt that in terms of hygiene for himself and his patients, buying an autoclave and hot air oven was worthwhile.

He bought them a few years ago for about $4,500 but then had to raise his fees by between 2 and 5 per cent.

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This article was written by Roy Tan.