Practice Tips #34: Dental Equipment Routine Maintenance

In previous issues of Practice Tips we’ve discussed the importance of routine maintenance to keep your dental equipment running well. We’ve had dedicated issues on handpieces, x-ray processors, and sterilizers.

This month, we’re going to run through everything in the office on a daily, weekly, monthly, quarterly, and annual basis to give you a master check-list for office-wide maintenance. Naturally, this list should not be considered all-inclusive and there will be variations depending on what equipment you use.

Daily:

At the beginning of the day:

• Turn on the compressor, vacuum, and main water lines (you should have a solenoid on your water).
• Check fluid levels in the sterilizer and x-ray processor (topping off if necessary) and turn them on.
• Run a cleaning sheet through your processor (if available).
• Turn on delivery systems and open oxygen and nitrous tanks (if you have a central system).
• Check the ultrasonic cleaner solution.
• If using self-contained water systems and air purging every night, run handpieces and depress water buttons on air/water syringes to establish water line pressure.
• Refill water bottles of self-contained systems.

At the end of the day:

• Clean the sterilizer door gasket with a soft cloth and mild (non-antibacterial) liquid soap.
• Clean out or change chairside vacuum traps and run vacuum system cleaner through all vacuum lines. Be certain to securely replace the lid of the trap, after checking the screen on the trap.
• Empty waste bottle/tank on sterilizers equipped with one.
• Turn off all equipment as above – delivery systems, oxygen and nitrous tanks, sterilizer, processor, compressor, vacuum, and main water line. If using a Dent-X processor, remove the cover and slide the covers of the solution trays to the side allowing vapors to escape.
• Dry water lines by purging with air (if using self-contained water systems).

Weekly:

• Clean interior and exterior of sterilizer(s), including reservoir. Check the autoclave safety valve by pulling on the ring with a pliers (it should spring back).
• Check sterilizer filters and perform a spore test.
• Verify sterilizer is level.
• Check chairside trap screens and lid o-rings for wear and replace if necessary. Be certain to securely replace the lid of the trap afterward.
• Check and replace or clean out central vacuum and main water line filters.
• Check the amalgam separator.
• Disassemble and lubricate vacuum valves (HVE and SE).
• Clean ultrasonic cleaner.
• Clean operating light reflectors and lens shields (make sure reflectors are cool first).
• Check oil on oil-lubricated compressors and drain compressor tank. An auto-drain can also be installed on your compressor to drain as needed automatically.
• Clean processor racks according to manufacturer’s instructions. You may need to let them dry over the weekend as well.
• Empty and clean out bottles of self-contained water systems.
• Clean boiling chamber of water distiller

Monthly:

• Perform extended cleaning of x-ray processor per manufacturer’s recommendations. A special cleaning solution may be required.
• Check/clean plaster trap
• Check emergency resuscitation equipment
• Lubricate joints in operating lights, sterilizer door hinges, air/water syringe buttons, and other similar items around the office.
• Clean Pan or Ceph x-ray screens with a screen cleaner.
• Using heat-resistant PPE, check the sterilizer safety valve while under pressure (see Sterilizer Maintenance) and check the door for plumb.
• Check air and water filters in junction boxes.

Quarterly:

• Check filters on the compressor and central vacuum.
• Check compressor oil (if oil lubricated)
• Check tubing on delivery systems, nitrous, and vacuum as well as handpiece gaskets and/or coupler o-rings for signs of wear.
• Clean model trimmer wheel and drain lines.
• Lubricate drive chain on Dent-X processors.
• Check the hydraulic fluid of the patient chair.
• Check the life of computer battery back-up (UPS).
• Test smoke alarms.
• Verify computer back-up by restoring from a back-up.

Annually:

• Change sterilizer door gasket, bellows, and fill filters.
• Change oil (if oil lubricated) of the compressor.
• Check power cords for all electronic equipment around the office and replace any that are frayed or worn.
• Have fire extinguisher(s) inspected.
• Observe a complete sterilization cycle looking for any signs of malfunction, such as a steam leak.
• Conduct staff OSHA training
• Review emergency procedures with staff. Know how to handle patient emergencies, as well as what to do in case of a fire etc.
• Have X-ray equipment inspected, calibrated, and certified. Requirements vary, may be as infrequently as once every 5 years.

In general:

• Be observant. Note any equipment that exhibits unusual behavior, such as loud or abnormal noises or an unusual appearance/discoloration.
• Keep owner’s manuals for all equipment in a secure place.
• Consult dental equipment manuals for manufacturer’s recommended routine maintenance and supplement the list above accordingly.
• Check with local authorities for your requirements. Some things (for example spore tests) may have a different frequency requirement in your area. We have attempted to list such things at the most common interval, but there can be wide variation.
• Be aware of seasonal tendencies for extremes of heat, cold, and humidity and the effect these extremes can have on specific pieces of equipment. For example, replacing compressor dryer desiccant is commonly required in the summer months.
• It may be helpful to have primary equipment wired to a master switch to simplify turning on in the morning and off at night (just one switch to throw).
• Be mindful of critical equipment and always have spares of the following on hand:

• Light bulbs for operating lights and curing lights
• Filters for air and water lines
• Replacement screens/traps for central vacuum
• Fuses for chairs, sterilizer, processor, etc.
• Hydraulic fluid (if you have hydraulic chairs)
• Compressor oil
• Have a back-up plan in case of failure of compressor, vacuum or sterilizer. Having a smaller secondary unit on hand that can be “hot-swapped” temporarily can keep you up and running.
• Have a contingency plan in case of computer issues.