From lab to lectures
When it comes to dental decontamination knowledge, students at the University of Glasgow’s Dental School not only have the UK’s best equipped decontamination teaching laboratory, they’ve also got a lecturer with more than 20 years’ industry experience under his belt.
George McDonagh, who joined as a full-time lecturer in Decontamination Sciences in 2008, has spent much of his working life as a validation test engineer checking the quality of decontamination equipment within the central sterile services units of hospitals in the west of Scotland.
George teaches third, fourth and final-year dental students and gives them sufficient knowledge and practical hands-on skills to allow them to manage the local decontamination unit within a dental practice.
He described the new role as a great opportunity: “I’d been a engineer for more than 20 years repairing and validating every type of decontamination machine you can imagine, so I was happy to hang up my tools and join the school as a lecturer so that students could benefit from my experience.”
George’s appointment, which is financed by NES, came at a time when dental decontamination came under the spotlight regarding the potential transference of Variant CJD (Creutzfeldt-Jakob disease) during dental surgery. Research showed that the prions comprising the disease were able to survive traditional decontamination techniques.
He explained the importance of his role in teaching good decontamination procedures: “You have to remember that, before 2007, there was no formal training for dental students and their only experience of instrument decontamination was what they picked up on the clinics, from others who had very little or no training themselves.
“At the University of Glasgow, with support from the Chief Dental Officer for Scotland, Greater Glasgow Health Board and NES, we are leading the way in the teaching of instrument decontamination for others to follow.”
Final-year students are given a two-week intensive course, which includes practical work in the use of manual washing, ultrasonic cleaning, automatic washer disinfector and benchtop steam sterilisers, both vacuum and non-vacuum.
And helping make the teaching as real as possible is one of the best-equipped decontamination labs in the UK.
On one wall of the demonstration lab is a bench comprising the traditional equipment found in a dental surgery such as a wash sink, ultrasonic bath, rinse station and non-vacuum steam steriliser. The other houses the more modern units, including a washer disinfector and a vacuum steriliser.
George said the traditional equipment is fine for decontamination as long as it is used properly, for example ensuring the sonic bath is changed regularly otherwise you’ll end up with ’soup’ at the end of the day!
However, George says the traditional sterilisers are not suitable for sophisticated three-dimensional instruments like handpieces. “The steam is unable to properly penetrate the internal structure of canulated or lumend instruments such as handpieces. For these, you really need a washer disinfector to clean the internal structure and then finish with a vacuum steriliser.
George often gets asked why dentists should use a vacuum steriliser rather than a non-vacuum unit. He explained: “A vacuum steriliser is preferable because it can sterilise through lumened devices such as handpieces. It has the power to penetrate all surfaces whereas the non-vacuum steriliser is only capable of sterilising solid instruments.
And it also gives users the option of packaging the instruments on site thereby ensuring that they are definitely sterile at point of use,” he added.
Disinfectant washers and vacuum sterilisers are expensive pieces of equipment, but George said financial help was still available from NHS boards to provide funding for dental surgeries.
In addition to teaching best practice on the use of equipment and decontamination processes, George also takes his students through the validation process for this type of equipment so that they understand how to keep the units working as effectively as possible.
He said: “I can show students the process of validating the equipment so when an engineer calls they will be familiar with what they should be doing and can confirm the validation from the data presented on the engineers laptop.
“Validation is another cost for the dentist so it’s important that dental staff know they are getting value for money from their engineer.”
George enjoys being able to pass on his knowledge to students and is sometimes surprised by their enthusiasm for the subject. “I occasionally bump into old students in town and they’ll often tell me how they’ve tried to change or questioned decontamination procedures at the dental surgeries they are now working at – so I must have made some impression!”