Equipment Re-start & Maintenance Information

In the event your surgery has closed due to COVID-19 we have, in consultation with our suppliers, put together this handy guide on how to prepare and protect your equipment in the best possible way.

Below you will find:

Information on re-starting equipment after a long shut-down
Maintenance documents
Cleaning protocols

for our Equipment Brands supplied into the New Zealand market.

If you have any questions, or concerns, please email us and one of our Specialists will be in contact as soon as they can.

A-dec

Below are the recommendations for re-starting A-dec equipment, and hygiene procedures for waterline maintenance.

A-dec Chairs A-dec delivery systems GEOSIL DS. Dental Unit Biofilm Removal (Quick Guide) DUWL shock treatment procedure Waterline Treatment Guide

A-dec Chairs

There are no special requirements for re-starting A-dec Chairs.

A-dec delivery systems

If they are not used for longer than a week, empty the water bottles and purge the system of water (do not leave the water lines empty as this would encourage bacteria and biofilm growth).

You can either use the syringe or the handpiece flush to purge the system until you no longer see water.
Once you are ready to begin using the systems again, perform a shock treatment to make sure the waterlines are cleaned and ready for use.

For shock treatment, Ivoclar Vivadent recommends:

GeoSIL DS (DUWL Quick Guide.pdf

New DUWL Shock treatment procedure 15102018_.pdf

GEOSIL DS. Dental Unit Biofilm Removal (Quick Guide)

Method of Use:

1. Remove all couplings, handpieces, motors, syringe tips, attachments etc in order to prevent blockages.

2. Remove and empty all water from the bottle and dental chair. (run all lines with empty water bottle in place)

3. Flush & clean the water bottle with 200ml of Geosil DS then discard the liquid. Replace the water bottle pickup tube if it is contaminated.

4. Fill the water bottle with 800ml of Geosil DS & run the fluid through the chairs lines periodically over 30 min. (4x 20 second fluid flush for each line)

5. Empty & clean out the water bottle, flush 400ml of clean water through all lines. Repeat this flush a second time.

6. For further in-depth info regarding steps, please refer to the DUWL shock treatment/sanitisation procedure full guide

GEOSIL DS Dental Unit Biofilm Removal (Quick Guide).pdf

DUWL Shock Treatment Procedure.pdf

DUWL shock treatment procedure

This shock treatment is principally intended for the DUWL of a Dental chair/unit clean water bottle system (CWBS) - intended for dental patient treatment procedures. This procedure is intended for DUWL/CWBS that has been supplied by Ivoclar Vivadent, it may however be cross-applicable to other dental chair brands, but please ensure prior manufacturer/supplier approval is gained.

It is recommended that any dental treatment water is supplied from a separate, independent clean water bottle system (CWBS) - that can be easily maintained, quality assured and shocked treated when needed. The CWBS will principally supply water for the air/water syringe, handpieces, motor, scaler, (lines) or other equipment requiring water for patient treatment.

These lines should be in regular use and flowing (not broken down or not used – this may “back contaminate” other lines) with the correctly dosed "Adec ICX tablet" treated water in each bottle of water.

The spittoon rinse and cup fill is generally supplied from the mains water supply - include these in the shock treatment procedure only if they are connected to the CWBS

Any faulty line should be repaired as quickly as practical or physically disconnected from the CWBS circuit - to prevent possible flow-back contamination.

Dental Unit WaterLine (DUWL) Shock Treatment/Sanitisation procedure: using Ivosil/Geosil.

When the CFU count is above 200CFU- via a MHPC Test sampler.
If any bio-film or algae is blocking handpiece couplings, or observed in treatment water or observed inside the DUWL bottle or pickup straw.
If the dental chair/unit is not used for more than 2 weeks.
If suspicion of a DUWL related patient infection has occurred post treatment.
If a DUWL test was last competed 1, 3 or more months ago.

Required components

1. Ivosil/Geosil DS (IGDS) 5L Shock treatment liquid.

2. Safety glasses and exam gloves.

3. Optional - water bottle pick-up tube.

4. Cap or bung.

5. Clear, 2L, plastic jug with gradations of 100ml. (1-4 available from Ivoclar Vivadent NZ Ltd)

Recommended shock treatment procedure:

While Ivosil/Geosil DS liquid (IGDS) is a much safer alternative to use than the more problematic bleach solutions. We recommend that the user wears safety glasses and exam gloves during this process. (Bleach is not recommended for safety and equipment damage reasons)
Confirm that the overleaf conditions are met and check the "water pickup tube" in the water bottle is clean and not discoloured.
Replace the pickup tube before proceeding if it is dirty or discoloured – available from Ivoclar Vivadent (IV) Ltd by specifying the Adec/Anthos chair model/bottle size.
Ensure that you have the correct screw-on water bottle cap or bung - available from IV by specifying the chair model/bottle size.
Remove all handpieces, motors, couplings, scalers, syringe tips, etc. Wipe the exposed tubing ends with an alcohol wipe.
Remove the water bottle and discard any water and place back onto the chair empty. Run all available lines until streaming water is removed from the DUWL circuit.
Fill the water bottle with 200ml of IGDS and firmly fit the cap/bung.
Carefully shake the sealed bottle for 20 seconds- with the cap/bung being held, ensure the liquid contacts all surfaces.
Discard all liquid - but do not rinse.
Refill the water-bottle with 800ml of fresh IGDS and fit to the chair.
Run the IGDS through all lines (gather in all handpieces/scaler/motor tubing and use the delivery systems flush toggle) for at least 20 seconds each, including each syringe and any other tubing that maybe connected to the CWBS.
Repeat this procedure 2 more times with a 10 minute break/hold time in between. The procedure should take around 35 minutes to treat all the lines.
You can collect all expelled liquids into the plastic jug then discard – observe if any biofilm is expelled.
Remove the bottle, apply the cap/bung, shake the bottle, discard remaining IGDS.
Refit the empty bottle and run all available lines until streaming water is removed from the DUWL circuit.
Half fill the bottle with clean water, apply the cap or bung and carefully shake it for 20 seconds- then discard the water.
Repeat the rinse once more. Wipe dry any liquid from the bottle pickup tube (would be chair attached if the pickup tube is exposed).
Fill the water bottle with 400ml of fresh water. Run all lines until this fresh water is emptied into the 2L jug.
Check for any bio-film in the expelled water then discard. Repeat the clean water flush a second time or until no Bio-film is noticed in the expelled water.
Repeat the MHPC Test in one month, if the test comes in at under 200CFU for 3 consecutive months- you can reduce testing to once every 3 months per chair.
Use ICX in every water bottle fill for any ADEC chair going forward—this ICX treated water should remain in the water bottle and chairs lines (remains active for 2 weeks) at all times to maintain a healthy DUWL system.

Final Important Note: Active & living bio film in your dental lines will cause blockages during normal dental chair use. During a shock treatment some biofilm will be killed & may be removed during the flushing procedure. Please be aware that follow up shock treatments may be required for heavy contamination. Please be aware that some biofilm may be dislodged during normal use after any shock treatment—system flushing as in procedure 10 should be repeated in these heavy contamination cases.

DUWL Shock Treatment Procedure.pdf

Waterline Treatment Guide

In the Waterline Maintenance Guide (Waterline Maintenance Guide.pdf), Adec recommends using CFU/ml as a way to ensure that waterlines have been adequately cleaned and are safe to use.

Ivoclar Vivadent Ltd sells the test kits to check water quality.
These are shown in IVOTEST waterline maintenance Flyer May2020.pdf.

There is also a direction page included
(Science Made Simple MHPC Test.pdf)

A record of the test results should also be kept and there is a spreadsheet attached which dental practices can use
(Dental Unit Waterline Register.pdf)

A-dec Downloads

GEOSIL DS. Dental Unit Biofilm Removal (Quick guide)

NEW DUWL shock treatment procedure 15102018

Dental Unit Waterline Register

Science Made Simple MHPC Test

Waterline Maintenance Guide

IVOTEST waterline maintenance Flyer

Stern Weber

Hygiene regulations and specific tasks to be performed to ensure the surgery is operationally efficient after a prolonged period of closure.

The main hygiene regulations What happens when a surgery or clinic has to be closed for a prolonged period? Basic tasks needed to ensure safe closure Tasks to be performed when reopening the clinic

The main hygiene regulations

Before a prolonged period of closure it is good practice to perform a specific set of pre-closure tasks. If, for whatever reason, they have not already been performed, it is recommended that they be carried out, in any case, before re-opening the surgery.

As you are aware, the goal of surgery hygiene is to prevent the transmission of infectious diseases from one patient to another, to surgery/dental lab staff, and vice versa.

These suggestions aim to make this goal as achievable as possible by ensuring the workplace is, upon reopening (when a further set of tasks is performed), ready and efficient from day one.

The main goal of these few tasks is to empty the tubing, making sure no water is left inside dental units and circuits.
Doing so prevents the formation of biofilm in the internal circuits of the equipment, thus limiting any proliferation of bacteria.

What happens when a surgery or clinic has to be closed for a prolonged period?

Dental surgeries are considered biohazardous workplaces.

Numerous studies have demonstrated that dental unit water hoses/pipes are microbial agent (biofilm) reservoirs. The dental unit and its water system must therefore undergo several operations designed to reduce bacterial load, especially before prolonged periods of inactivity.

For these reasons, preventing contamination of the water in dental units and preventing any formation of biofilm in them is particularly important; this is equally true for autoclaves, which must therefore have their tanks emptied.

The goal is the same: to prevent proliferation of bacterial flora inside machines as much as possible, especially before prolonged periods of closure.

Basic tasks needed to ensure safe closure

10-Step Plan For Safeguarding Stern Weber Equipment

1 Where dental units have automatic, semi-automatic or manual sanitization/disinfection systems, carry out the respective cycles as indicated in the user's manual. If the dental unit is equipped with an independent spray feed tank (i.e. not connected to the mains water supply), it is recommended that it be emptied completely at the end of any cycle. https://www.sternweber.it/it/downloads/

2 Perform all the cleaning and maintenance tasks usually performed in the surgery at the end of the day; make sure all surfaces are disinfected properly. As for the dental unit, always use products that comply with the manufacturer's instructions and ensure they are used correctly as per the instructions in the user's manual.

It is essential to respect the contact time shown on the disinfectant package and, once this time has elapsed, remove the disinfectant with a clean damp cloth before drying. This minimises any potential on-surface aggression by the product, especially in the event of prolonged interruption of work, while ensuring effective sanitisation.

3 Clean the suction filters and, using the product recommended by the manufacturer, flush the suction circuit abundantly with lukewarm water by drawing from the “bucket” container.

Where there is an automatic cannulae flush system it is advisable - after completing the previous tasks - to empty the specific liquid from the tank, replace it with water and proceed with an additional flush cycle. Once the cycle is over, empty the tank.

4 Lastly, run dental unit surgical suction for at least 3 minutes to completely drain and dry the suction system.

5 Bring the patient chair to a position high enough to allow easy floor cleaning and assist discharge of the liquids in the internal dental unit tubing.

6 Switch off the osmosis system and drain it completely, if present. It is important to completely empty the storage tank and disinfectant tank (if the system is equipped with them).

7 Close the water shut-off tap for the individual surgery, if present:

Run all the dynamic instruments and syringes to drain the water in the pipes/hoses until there is none left.
Activate delivery of water to the cup until there is none left.
Activate delivery of water to the cuspidor bowl until there is none left. Then pour in the water-liquid solution for surgical suction, diluted as per the manufacturer's instructions; this is to reduce the bacterial load in the discharge pipes inside the dental unit.

8 Close the main water tap.

9 Drain the water system by opening all the basin taps in individual treatment rooms and/or ancillary rooms.

10 Turn off the ELECTRICAL panel for each individual room. It is advisable to leave the main surgery panel on to ensure operation of any other devices you wish to leave on (e.g. fridges for storage of compounds and medicines).

Tasks to be performed when reopening the clinic

How should I return water to the ducts and proceed with disinfection? We can answer this by applying the 5 minute rule.

Disinfection must cover the following aspects:

Bear in mind that the dental unit water system could be contaminated by oral bacteria or germs in the water (generally known as pseudomonas aeruginosa or legionella pneumophila).

The germ population, already held in check by the tasks performed prior to closure, can be reduced further. How? Let water flow from all taps for at least 5 minutes.

Let's now go into more detail and look at the sequence of tasks to be performed at the reopening phase after a prolonged period of closure.

SURGERY AND DENTAL UNITS

1 Turn on the main electrical panel in each surgery.

2 Switch on the compressors control unit.

3 Switch on the suction devices control unit.

4 Open the main water tap and individual surgery taps (if any).

5 If there is a centralised osmosis system, after turning it on and filling the tank with disinfectant (if it is part of the system), run water from the cuspidor bowls of all the units simultaneously for at least 5 minutes. Then proceed with reopening of the storage tank.

6 Run plenty of water into the basins.

7 Switch on each dental unit again and operate the cuspidor bowl and cup fountain, letting the water run abundantly.

8 Operate all dynamic instruments and syringes so fresh water arrives from the tubing.

9 Where the dental unit has automatic, semi-automatic or manual sanitization/disinfection systems, empty the tanks of their respective liquids, fill the tanks with fresh liquid and activate the processes as per the instructions in the use and maintenance manual.

AUTOCLAVES

1 Oil the hinges of the autoclave doors and fill the tank with clean water. If there is no water inlet treatment system, fill the tank with water having a conductivity of less than 15 μS/cm.

2 Check the door seal is not worn.

3 Perform a Vacuum Test cycle, an Elix Test cycle and a Bowie & Dick cycle, in compliance with local regulations.

4 Check that the expiry date (shown on the labels attached to the instrument pouches after the sterilization cycle is still valid.

INTRAORAL X-RAY UNITS

1 After prolonged non-use of the equipment, it is recommended that you carry out, on first start-up, a series of brief emissions (0.01-0.02 seconds) and, subsequently, take some X-rays with longer emission times of 0.1 second.

Doing so helps improve stabilisation of the X-ray tube before routine use.

Stern Weber Downloads

Stern Weber - Equipment Re-start Manual

Dürr Dental – Equipment

Practice break – what do I need to do? Checklist.

An increasing number of surgeries are having to shut down temporarily due to the spread of coronavirus. If surgeries do have to close, the following checklist is designed to provide you with all the information you will need to prepare the DÜRR DENTAL units you are using in the best possible way. The steps we recommend taking range from thorough cleaning and disinfection to depressurising compressors and checking settings on X-ray units. And if you have service or maintenance work pending or are waiting for a replacement unit, we can offer you a variety of options.

As a reliable partner DÜRR DENTAL will always remain at your side. Our absolute priority is to ensure that all products are in perfect working order when your surgery reopens.

Equipment Diagnostic Imaging

Equipment

Suction System

Clean the suction system with MD 555 cleaner (note the specifications for concentration and reaction time, rinse with water after cleaning)
Disinfect the suction system with Orotol® plus (note the specifications for concentration and reaction time, DO NOT rinse with water after disinfecting)
Press the cleaning button on the spittoon valve and clean the yellow coarse filter (replace if necessary)
Change the yellow disposable filters on the hose manifolds
Switch off the water supply to the rinsing unit, drain the water
Clean the yellow filter on the suction unit inlet (wet suction systems only)
Change the amalgam collecting container on the amalgam separator (if you have an amalgam separator)
Remove all suction handpieces from the hose manifold to start up the suction unit. Run the suction unit for at least 30 minutes to dry the suction pipes.
Remove all suction handpieces from the suction hoses; clean and disinfect the handpieces according to the manufacturer information.

Compressor

Switch on the unit and wait until the cut-off pressure is reached
While the compressor unit is running, open the condensate drain valve on the membrane drying unit. Once all of the condensation water has escaped, close the condensate drain valve. Open the condensate drain valve. Once the start-up pressure has been reached, the compressor will switch on.
With the compressor switched on and the condensate drain valve open, wait until no more condensation water emerges
Close the condensate drain valve when no more air escapes
Disconnect all power from the unit
Disconnect the compressed air connection from the quick release coupling

Diagnostic Imaging

Image plate scanner VistaScan

Cover the scanner with a hood to protect against dust
Monthly consistency check (in countries where a consistency check is mandatory)
If image plates have been kept for longer than a week, delete prior to use
Inspect image plates for damage. Guided automated checks can be carried out with VistaSoft Inspect AI (artificial intelligence)

Intraoral camera VistaCam

Clean and disinfect the surface as described in the operating instructions

Dürr Dental Equipment Downloads

Durr Equipment Re-start Checklist

Dürr Dental – Cleaning Products

Dūrr Cleaning Products stocked by Ivoclar COVID-19 Exposure Times

Dūrr Cleaning Products stocked by Ivoclar

Code/Location	SAP Code	Description	UOM	Used for
FD312	727733	Surface Disnfection	2.5L	Alcohol-free concentrate for disinfecting surfaces of non-invasive medical devices, medical fixture and floors.
FD322	727734	Quick-acting Disinfection	2.5L	Fast-acting, ready-to-use solution for disinfecting and cleaning surfaces of medical devices and fixtures.
FD350	727735	Disinfection Wipes	EACH	Alcohol-based, quick-acting disinfection and cleaning wipes for smaller surfaces of medical devices.
FD 360	716434	Cleaning & Care of Vinyl Upholstery	EACH	Cleaning fluid for deep cleaning and care of vinyl upholstery.
FD Multi Wipes Compact	758666	Multi Wipes Compact 29 x 30cm	Tub of 60	Universal dry wipes, can be soaked in disinfectant and cleaning agents.
FD Multi Wipes Compact	758667	Multi Wipes Compact 29 x 30cm	8 x Tubs of 60	Universal dry wipes, can be soaked in disinfectant and cleaning agents.
HD 410	727738	Hand Disinfection	500ml	Alcoholic rub-in preparation for hygienic and surgical hand disinfection.
HD 435	727739	Hand Washing Lotion	2.5L	Mild washing solution for hands.
MD 520	716442	Impression Disinfection	2.5L	Fully virucidal ready-to-use solution for effective and gentle disinfection and cleaning of impression, prosthetic work, etc.
MD 530	727741	Cement Remover & Prosthesis Cleaner	2.5L	Ready-to-use solution for the removal of cement, calculus, smoking stains, oxide layers etc. from dentures, bridges, crowns, spatulas, glass, etc.
MD 535	716430	Plaster Remover	2.5L	Ready-to-use solution for the removal of plaster and alginates from impression trays and other aids.
MD 555	716441	Special Detergent for Suction Units - Weekly Cleaner	2.5L	Foam-free cleaning concentrate for all types of suction systems and amalgam separators.
Orotol Plus	716448	Suction System Disinfection - Daily Cleaner	2.5L	Foam-free liquid concentrate for similtaneous disinfection, deodorisation, and care of all suction systems and amalgam separators.
Orotol Ultra	733482	Suction System Disinfection	500g	Powder concentrate for similtaneous cleaning, disinfection, deodorisation and care of dental suction systems, amalgam separators.
Orocup	704711	Orocup Care System	Each	User-friendly, closed care system for disinfection and cleaning of suction systems and amalgam separators.
Orotol Ultra Starter Kit	733480	Suction System Disinfection	Kit	Powder concentrate for similtaneous cleaning, disinfection, deodorisation and care of dental suction systems, amalgam separators.
FD 366 Sensitive Surfaces	716447	Sensitive Surface Disinfection	2.5L	Alcohol-reduced, ready-to-use solution for disinfecting and cleaning especially sensitive surfaces of medical devices.
FD 366 Sensitive Wipes	759506	Sensitive Top Wipes	Pkt of 50	Ready-to-use disinfection and cleaning wipes for sensitive surfaces of medical devices.
FD 366 Sensitive Wipes	737693	Sensitive Surface Disinfection Wipes	Tub of 100	Practical disinfecting wipes for fast-acting disinfection of sensitive surfaces on invasive and non-invasive medical devices in hospitals, private practices and laboratories.
FD366 Sensitive Wipes	737694	Sensitive Surface Disinfection Wipes	4 x Pkts of 100	Practical disinfecting wipes for fast-acting disinfection of sensitive surfaces on invasive and non-invasive medical devices in hospitals, private practices and laboratories.

COVID-19 Exposure Times

Dürr Dental Cleaning Products Downloads (pdf)

FD 366 Sensitive Wipes

HD 410

HD 435

HD 440

MyRay

Detailed step by step list for possible checks on the MyRay X-ray imaging devices.

RXDC Hyperion (Pan, Ceph and 3D units)

RXDC

Do a physical/ visual check on the unit ---check battery if needed, mechanical , check Head Actuators and LED (Hypersphere)
Make sure power is available for the unit before start-up (check UPS / AVR)
Power ON the unit and leave it ON for a few minutes
For the first X-ray exposures ---choose a low parameter or short exposure time (CHILD + Incisal tooth)
Do it for 3-5 times with intervals of 1 min each

Hyperion (Pan, Ceph and 3D units)

Do a physical/ visual check on the unit ---check cables, check PC
Make sure power is available for the unit before start-up (check UPS / AVR)
Power ON the unit and leave it ON for a few minutes
For the first X-ray exposures ---choose PANORAMIC >>>Child , the idea is to have low parameter + short exposure time (CHILD + Quick Pan)
Do it for 3 times for Panoramic (intervals of 3 mins. each)
You can also do this if you have the Cephalometric unit (intervals of 3 mins. each)
After these, you can perform the Daily Check for the 3D.

W&H Dental

Follow the step-by-step video guide through the hygiene workflow in your practice to interrupt the chain of infection… this ensures best practice reprocessing and your personal protection.

The video covers Used Instruments, Cleaning & Disinfection, Inspection & Lubrication, Packaging, Sterilization and Storage.

EMS

Below are two download links to brochures for:

Hibernating your AIRFLOW device
Re-booting your AIRFLOW device

ems-save-our-smiles-guided-biofilm-therapy

EMS AIRFLOW Products Downloads (pdf)

8 Easy Steps to Hibernate Your AIRFLOW Device

10 Easy Steps to Reboot Your AIRFLOW Device