Biological monitoring is best—it measures the entire process and the killing of microbes. The bacterial spores used for office spore testing are identical to those used by sterilizer manufacturers when they obtain clearance from the FDA for their steam, dry heat or unsaturated chemical vapor units. The FDA ascertains that the units actually sterilize and kill high levels of specific bacterial spores. Before the FDA clears a new sterilizer model for sale in the United States, the results from spore tests, chemical and mechanical monitoring and other tests, along with product labeling information and information about the manufacturer, are all submitted to the agency for review. To be cleared by the FDA, a new model of sterilizer must be shown to repeatedly kill a high level of spores in half the normal cycle time. This ultimately provides a considerable safety measure for the dental practice.

A common way to routinely spore test sterilizers is to use a mail-in spore testing service available commercially and through some dental schools. These services send appropriate materials, mailing envelopes and instructions to the dental office. After processing the spore tests, the practice sends them to the service for analysis and reporting. A practice usually purchases enough tests to cover 6 months to a year, but beware: Spore tests have expiration dates!

Monitoring the efficacy of your sterilization procedures helps protect patients from the threat of microbes such as hepatitis, HIV, herpes, influenza, TB, MRSA, and streptococci. Following the CDC’s guidelines on testing and using mechanical, chemical and biological monitors per manufacturer’s instructions can go a long way to ensure your asepsis methods are effective.