We know Dentists have to make a lot of choices. During each procedure they choose the equipment, tools and the right products to use. Long before this, they choose what products to keep on hand for all possible scenarios. More choices are made for cleaning, sterilising and disinfection. While we can’t take away all these decision-making responsibilities, we can help with one – DISINFECTION.
In the Dental world, hygiene is key, but never so much as now with the Coronavirus as an added risk. Thorough disinfection has never been more vital. And, with so many to choose from, yet another decision needs to be made.
So, which disinfectant is most suitable for Dentists?
Skip ahead to the end of the article for the short answer, or stay with us while we take you through the “why?”.
We have extracted this disinfection comparison table from the SADA Dental Clinical Protocols in Response to the Covid-19 Pandemic (click the link to view the full draft).
|Characteristics||Hydrogen Peroxide (H2O2)||Hypochlorous acid (HOCl)||Bleach (NaOCl)||Isopropyl alcohol|
|Suggested effective concentration||3% Hydrogen peroxide for disinfectant, 1% pre-procedural mouth rinse, 6% to 25% as chemical sterilant||80–200 ppm||500–1000 ppm||Concentrations of 60% – 80% is a potent virucidal agent|
|pH (disinfection efficacy is determined by pH)||4- 5.5 (weak acid)||8 to 9 (alkaline)||Neutral|
|Effectiveness (killing power)||Bactericidal, virucidal, sporicidal and fungicidal properties||80–100 x more effective than NaOCl + Faster|
|Contact time||0.5% Accelerated hydrogen peroxide demonstrated bactericidal and virucidal activity in 1 minute and mycobactericidal and fungicidal activity in 5 minutes||Immediate effect||10-30 minutes||2-5 minutes|
|Safety||Toxic and irritant to skin, serious eye irritant (use protective eyewear)||Safe and non-toxic and non-irritant to skin and eyes||Toxic and irritant to skin and eyes||Toxic and irritant to skin and eyes|
|Odour||Odour not significant||Odourless||Strong odour||Strong odour|
|Physical characteristics||Leaves residue||Does not evaporate and leaves no residue||Leaves residue||Evaporates quickly|
|Disadvantages||Materials compatibility concerns (lead, brass, copper, zinc) both cosmetic and functional. Limited clinical experience. Potential for eye and skin damage|
|Corrosiveness||Oxidising||None||Corrosive||Corrosion of metal|
|Discolouration||Cosmetic changes e.g. discolouration of black anodised metal finishes||None||Discolouration of fabrics and plastic surfaces||Prolonged use—discolouration and cracking of rubber and plastics|
|Other||FDA approved||Non-FDA cleared|
|Ease of use||Rinsing, Spray and wipe||Spray and Foggers||Spray and wipe||Spray and wipe|
And here is their assessment for these 4 list below (for the complete list see the full SADA draft).
ASSESSMENT OF THE DISINFECTION COMPARISON
|Alcohol||As an environmental surface disinfectant, it is no longer recommended. Apart from the fact that it fixates protein, such as blood and saliva on hard surfaces, it is, furthermore, volatile and inflammable.|
|Hypochlorous Acid (HOCl)||Clean, deodorise and intermediate disinfectant effective against viruses similar to COVID-19 on hard, non-porous surfaces. Also applied for wound healing.|
|Hydrogen peroxide||High-level disinfection, compatible with plastic surfaces but not metal surfaces. Serious eye damage with contact.|
|Sodium hypochlorite (bleach)||Intermediate-level disinfection, inexpensive but corrosive, damages plastics, vinyl fabrics and irritating to skin and eyes|
What’s the take home from this?
- Alcohol as a surface disinfectant is not recommended because it fixates protein and also due to its volatility and flammability
- NaOCl (bleach) is inexpensive but not compatible with plastics and fabrics. It is, furthermore, corrosive and may cause irritation of eyes and skin (intermediate-level disinfectant).
- HOCl (hypochlorous acid): is moderately expensive, compatible with fabrics, plastics and metals (high-level disinfectant
- H2O2 (Hydrogen peroxide): Compatible with plastics and elastomers but poor metal compatibility and serious eye damage with contact (high-level disinfectant).
Considering efficacy (virucidal and bactericidal), ease of use, cost, compatibility with plastics and metals, and safety – HOCl comes out with most boxes ticked!
And as promised, this is the one less choice Dentists have to make
Eco-Lyte (NTL), with its active ingredient HOCl, is the right disinfectant product choice for Dentist.