Guide for dental office managers · United States
When a chemical indicator or sterilizer reading fails
When a mechanical reading or a chemical indicator indicates inadequate processing, the instrument packs from that load are not used until they are reprocessed (CDC, 2003 dental infection-control guidelines; CDC, Infection Prevention Checklist for Dental Settings).
The rows behind that answer stop the packs and do not stop the machine: the remove-from-service step in these sources belongs to the procedure that starts after a failed spore test (CDC, 2003 dental infection-control guidelines).
What counts as a failed reading or indicator here
Two kinds of check carry the decision: mechanical indicators, for example time, temperature and pressure, and chemical indicators (CDC, Infection Prevention Checklist for Dental Settings). This page is about the moment either one indicates inadequate processing (CDC, Infection Prevention Checklist for Dental Settings).
The rows quoted below name internal and external chemical indicators. Where each one belongs in the pack, and what a failed one looks like before anything is used, is covered in the guide to chemical indicators inside and outside the pack.
The readings themselves are the other half of the check: what to look at on every load, and how to note it, is covered in checking time, temperature and pressure on every load.
The packs from that load are not used until they are reprocessed
The rule is short: do not use instrument packs if mechanical or chemical indicators indicate inadequate processing (CDC, 2003 dental infection-control guidelines).
It covers the whole load, not only the pack that caught your eye. If either mechanical indicators or internal or external chemical indicators indicate inadequate processing, items in the load should not be used until reprocessed (CDC, 2003 dental infection-control guidelines).
The dental checklist states the same rule in checkable form: instrument packs are not used if mechanical (e.g., time, temperature, pressure) or chemical indicators indicate inadequate processing (CDC, Infection Prevention Checklist for Dental Settings).
The rows, side by side
Two rows carry this rule, and they say it in different words. Both are quoted here exactly.
| What the source says | Source | What it means for this load |
|---|---|---|
| “Do not use instrument packs if mechanical or chemical indicators indicate inadequate processing” | C03-10 · CDC, 2003 dental infection-control guidelines | The packs stop as soon as a check reads badly. Nothing in the load is used. |
| “If either mechanical indicators or internal or external chemical indicators indicate inadequate processing, items in the load should not be used until reprocessed” | C03-10 · CDC, 2003 dental infection-control guidelines | One bad check is enough. The hold sits on the load’s items, and it ends at reprocessing. |
| “Instrument packs are not used if mechanical (e.g., time, temperature, pressure) or chemical indicators indicate inadequate processing” | CHK-3 · CDC, Infection Prevention Checklist for Dental Settings | The checklist form of the same rule, with the mechanical examples kept. |
Review the procedures and look for operator error
The review step in these sources reads: remove the sterilizer from service and review sterilization procedures (e.g., work practices and use of mechanical and chemical indicators) to determine whether operator error could be responsible (CDC, 2003 dental infection-control guidelines).
Two things sit in that sentence: a review of the sterilization procedures, and one question to answer, whether operator error could be responsible (CDC, 2003 dental infection-control guidelines). The examples in the middle are the source’s own, and they stay as written: work practices and the use of mechanical and chemical indicators (CDC, 2003 dental infection-control guidelines).
When the out-of-service flow starts
That remove-from-service step sits in the procedure that starts after a failed spore test (CDC, 2003 dental infection-control guidelines). For a failed chemical indicator or a failed reading on its own, the rows quoted on this page stop the packs and say nothing about stopping the sterilizer (CDC, 2003 dental infection-control guidelines; CDC, Infection Prevention Checklist for Dental Settings).
| The failure | What stops | What starts |
|---|---|---|
| A failed chemical indicator or mechanical reading | The packs from that load: items in the load should not be used until reprocessed (CDC, 2003 dental infection-control guidelines). | Reprocessing of the load, and an entry recording what happened (see what to record below). |
| A failed spore test | The sterilizer: remove the sterilizer from service and review sterilization procedures (e.g., work practices and use of mechanical and chemical indicators) to determine whether operator error could be responsible (CDC, 2003 dental infection-control guidelines). | The out-of-service flow in these sources, which begins at that step (CDC, 2003 dental infection-control guidelines). |
The full flow after a failed spore test — the repeat test, the loads to recall, and the return to service — is laid out in what to do when a dental sterilizer fails a spore test.
What to record
None of this reaches a record unless someone writes it down. A good log keeps the failure next to the load it came from:
- The outcome of the load: released, held for a spore test, or failed and reprocess, with notes required.
- Which check failed: the mechanical reading or an indicator, whether internal or external, and how many indicators failed.
- When the decision was made and who made it.
- What the procedures review found: loading, packaging, operator error.
- How many packs from the load were reprocessed.
Dental Logbook will ask for each of these on the load’s own entry, and it will not mark a load released until the readings and the indicator results are in the entry. A photo of the cycle printout is one optional field in that entry.
What the rows on this page do not say
Where the pack is silent, this page says so instead of filling the gap. None of the rows quoted above covers:
- Who carries out the procedures review, or how soon after the failure it must happen.
- The numbers a mechanical reading has to meet to count as a pass.
- Telling anyone outside the office about a failed indicator or reading.
- How long the record of the failure is kept.
This page is not legal advice; check your state board's current rules.