Chemical germicides must be approved by the FDA. Examples of these are glutaraldehyde, paracetic acid and hydrogen peroxide. While some of these chemicals have the capacity to destroy even resistant organisms they do have several limitations:
1. Items should completely be immersed for approximately 10 to 12 hours.
2. They are highly corrosive.
3. They are highly toxic.
4. They are very costly.
5. Medical gloves lack chemical resistance to glutaraldehyde.
For this reason certain post-sterilization becomes important. Items need to be:
1. Rinsed with sterile water after removal to remove toxic or irritating residues.
2. Handled using sterile gloves and dried with sterile towels.
3. Delivered to the point of use is an aseptic manner.
For all these reasons, the use liquid chemical germicides is discouraged. Heat tolerant or disposable alternatives are instead suggested. These chemicals may have a better use as high level disinfectants. While these agents may be used for high-level disinfection, they must be used only for purposes indicated on their label.
Gas Sterilization using ethylene oxide (ETO) has been used in large healthcare facilities. they are however impractical for dental clinic settings. ETO can not effectively sterilize handpieces because of their decreased ability to penetrate the small lumen of the instrument.
Bead sterilizers have been in dentistry to sterilize small metallic instruments (eg, endodontic files). FDA has determined that a risk of infection exists with these devices because of their potential failure to sterilize dental instruments and has required their commercial distribution to cease unless the manufacturer files a premarket approval application. If a bead sterilizer is employed, the DHCP assumes the risk of employing a dental device FDA has deemed neither safe nor effective.