Guide for dental office managers · United States
Which CDC sterilization guidance applies to a dental office?
The daily sterilization work in a dental office follows CDC’s dental texts — the 2003 dental infection-control guidelines and their 2016 summary — and CDC’s current dental page also points to the 2008 disinfection and sterilization guideline (CDC, sterilization monitoring page for dental settings, 2024).
Where the 2003 and 2008 texts say different things — the air-removal test and requalification after a failed spore test — this page sets the two wordings side by side, and then shows which CDC text each state’s dental board has adopted.
Three CDC texts, one daily job
One text is the dental guideline: the Guidelines for Infection Control in Dental Health-Care Settings — 2003. Its sterilization monitoring recommendations sit on pages 24–25 of that guideline (CDC, sterilization monitoring page for dental settings, 2024).
One text is the dental summary: the Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care, published in 2016 (CDC, Summary of Infection Prevention Practices in Dental Settings, 2016).
One text is a hospital guideline: the Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 (CDC/HICPAC, 2008 disinfection and sterilization guideline). CDC’s own dental page names it alongside the dental guideline:
“CDC provides recommendations for sterilization monitoring in the Guideline for Disinfection and Sterilization in Healthcare Facilities (2008) as well as on page 24–25 of the Guidelines for Infection Control in Dental Health-Care Settings (2003)” (CDC, sterilization monitoring page for dental settings, 2024).
So the dental texts guide the office every day, and the 2008 guideline matters wherever it is pulled in — by CDC’s dental pages, or by a state rule.
Where they differ: the air-removal test
The 2003 dental guideline leaves the schedule to the manufacturer of the machine: “Prevacuum sterilizers should be tested periodically for adequate air removal, as recommended by the manufacturer” (CDC, 2003 dental infection-control guidelines).
The 2008 guideline sets the schedule itself: “An air-removal test (Bowie-Dick Test) must be performed daily in an empty dynamic-air-removal sterilizer (e.g., prevacuum steam sterilizer) to ensure air removal” (CDC/HICPAC, 2008 disinfection and sterilization guideline).
| CDC, 2003 dental infection-control guidelines | CDC/HICPAC, 2008 disinfection and sterilization guideline |
|---|---|
| “Prevacuum sterilizers should be tested periodically for adequate air removal, as recommended by the manufacturer.” C03-13 |
“An air-removal test (Bowie-Dick Test) must be performed daily in an empty dynamic-air-removal sterilizer (e.g., prevacuum steam sterilizer) to ensure air removal.” D08-4 |
| “If a sterilizer fails the air removal test, it should not be used until inspected by sterilizer maintenance personnel and it passes the test” C03-13 |
Not addressed in this row |
Both wordings are about one kind of machine: a pre-vacuum, or dynamic-air-removal, steam sterilizer (CDC, 2003 dental infection-control guidelines; CDC/HICPAC, 2008 disinfection and sterilization guideline). A gravity steam sterilizer does not run an air-removal test, and nothing on this page applies one to it (CDC/HICPAC, 2008 disinfection and sterilization guideline).
The two texts disagree on how often the test runs, and this page says so instead of hiding it: periodically, as the manufacturer recommends, or daily (our sources pack, conflict K3).
What Dental Logbook does with the disagreement. Dental Logbook will schedule an air-removal test on every pre-vacuum unit for every day of use, before the first load, and record the test the manufacturer specifies. A failed test puts the unit out of service until it is inspected and passes.
If the air-removal test is new to your office, the guide to which dental sterilizers need the Bowie-Dick test, and how often covers the test itself.
Where they differ: requalification after a failed spore test
When a spore test fails and the cause has been found and corrected, the 2003 dental guideline asks the office to “rechallenge the sterilizer with biological indicator tests in three consecutive empty chamber sterilization cycles” (CDC, 2003 dental infection-control guidelines).
The 2008 guideline adds detail to the same test: “Three consecutive empty steam cycles are run with a biological and chemical indicator in an appropriate test package or tray”, and “Each type of steam cycle used for sterilization (e.g., vacuum-assisted, gravity) is tested separately. In a prevacuum steam sterilizer three consecutive empty cycles are also run with a Bowie-Dick test” (CDC/HICPAC, 2008 disinfection and sterilization guideline).
| CDC, 2003 dental infection-control guidelines | CDC/HICPAC, 2008 disinfection and sterilization guideline |
|---|---|
| “rechallenge the sterilizer with biological indicator tests in three consecutive empty chamber sterilization cycles after the cause of the sterilizer failure has been determined and corrected” C03-19 |
“Three consecutive empty steam cycles are run with a biological and chemical indicator in an appropriate test package or tray. Each type of steam cycle used for sterilization (e.g., vacuum-assisted, gravity) is tested separately. In a prevacuum steam sterilizer three consecutive empty cycles are also run with a Bowie-Dick test.” D08-5 |
Here the sources disagree in the open. The 2003 dental guideline and the 2008 guideline both say empty chamber, while our sources record that CDC’s current dental page asks for three consecutive fully loaded chamber sterilization cycles instead (our sources pack, conflict K1). This page does not pick a side.
Dental Logbook will record the chamber state used in each requalification cycle and show the three results together, so the office follows whichever text governs it and can show which one it followed.
Which CDC text your state has adopted
What binds a dental office is its state board’s rule. Some state rules make CDC guidance binding; one of the five states in our sources is silent (our sources pack, conflict K4).
| State | What the rule does | Source |
|---|---|---|
| New Jersey | Names “Centers for Disease Control and Prevention (CDC) Recommended Infection Control Practices for Dentistry, incorporated herein by reference, as amended and supplemented”. | NJ-1 · New Jersey rule 13:30-8.5 |
| Pennsylvania | Makes “Failing to follow current infection-control recommendations issued by the Federal Centers for Disease Control” unprofessional conduct. | PA-1 · Pennsylvania Code 49 Pa. Code §33.211 |
| Georgia | Treats “current recommendations of the Centers for Disease Control and Prevention” as “minimum standards of acceptable and prevailing dental practice”. | GA-1 · Georgia Board of Dentistry rule 150-8-.01 |
| Florida | Defines “CDC Guidelines” as “the Center for Disease Control’s Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008, adopted and incorporated by reference”, and uses that definition in rule 64B5-25.003 subsections (2)(c), (5) and (8), not in (9). | FL-3 · Florida rule 64B5-25.002 |
| New York | Silent. No New York text in our sources adopts CDC guidance. | K4 · our sources pack |
Read Florida narrowly: the 2008 guideline is written into its rules for named subsections only, and the subsection that sets spore-test intervals is not one of them (Florida rule 64B5-25.002).
New York is the silent one: none of the New York texts behind this page adopts CDC guidance, and this page will not say that one does (our sources pack, conflict K4).
What to record
The 2008 guideline is also the text that names what a record holds: “For each sterilization cycle, record the type of sterilizer and cycle used; the load identification number; the load contents; the exposure parameters (e.g., time and temperature); the operator’s name or initials; and the results of mechanical, chemical, and biological monitoring” (CDC/HICPAC, 2008 disinfection and sterilization guideline).
- The type of sterilizer and the cycle used
- The load identification number
- The load contents
- The exposure parameters (e.g., time and temperature)
- The operator’s name or initials
- The results of mechanical, chemical and biological monitoring
Dental Logbook will give each of those its own field, fill in the load number and the operator, and keep the entry with the load. Whichever CDC text governs your office, those six items are the record list the 2008 guideline carries.
Related guides
Two guides on this site follow on from this one:
- The Bowie-Dick test: which dental sterilizers need it, and how often — the air-removal test in detail.
- Does OSHA require spore testing in dental offices? — the other half of who requires what.
This page is not legal advice; check your state board's current rules.