The Swiss Good Practice for Medical Device Reprocessing (GPA 2022) sets out the sterilization chain as: clean → disinfect → dry → pack → sterilize → check load → store. Each step is unidirectional — no backtracking, no shortcuts. Validation of the sterilization process, cycle parameter checks, and load verification are documented at each cycle. The SSO Quality Guidelines on Practice Hygiene (2018) summarize the requirements for members of the Swiss Dental Society. This guide details the chain in full for Swiss dental practices preparing for cantonal inspection.
The reprocessing chain is the fundamental concept of sterilization in dental practices: instruments always progress from contaminated to clean, then from clean to sterile, without ever going back. This unidirectional flow prevents the recontamination of instruments already processed. The dental sterilization chain in Switzerland follows the GPA 2022 (Swiss Good Practice for Medical Device Reprocessing): pre-cleaning → cleaning → disinfection → drying → packaging → sterilization → load verification → storage. The SSO Quality Guidelines on Practice Hygiene (2018) summarize the requirements for members of the Swiss Dental Society. Instrument risk classification follows the Spaulding system (critical / semi-critical / non-critical) — the reference schema in Swiss practice, complementary to MePV / ODim Art. 71 and 72 (SR 812.213).
Immediately after use, instruments are immersed in a decontamination bath (enzymatic or detergent-disinfectant solution). This step reduces the initial microbial load and protects staff during subsequent handling. Soaking time varies depending on the product used (typically 15 to 30 minutes). Rotary instruments (turbines, contra-angles) follow manufacturer instructions — some require lubrication before cleaning.
Pre-cleaning must not be delayed: organic residues (blood, saliva) that dry on the instrument are much harder to remove during cleaning and can shield microorganisms during sterilization.
Cleaning removes organic residue (blood, saliva, debris) that would prevent effective sterilization. In Swiss dental practices, the washer-disinfector (RDG) per SN EN ISO 15883 is state of the art — automated, reproducible, and recommended for practices with high instrument volume. The ultrasonic bath (cavitation cleaning, effective for hollow and articulated instruments) is an additional option. Manual brush cleaning remains acceptable but is less reproducible and carries a higher risk of sharps injuries.
After cleaning, instruments are rinsed with clean water (ideally purified or demineralized water to avoid limescale deposits) then thoroughly dried. Drying is an often-overlooked but essential step: wet instruments in a pouch compromise the sterility of the packaging. Drying can be done with medical-grade compressed air or a single-use lint-free cloth.
Each instrument is visually inspected (residual contamination, functional condition, corrosion) before packaging. Instruments are placed in sterilization pouches (heat-resistant paper/plastic per SN EN 868) appropriate to their size. Pouches are sealed by heat sealing. The sterilization date and batch number must appear on each pouch — this marks the beginning of traceability, as expected under MePV / ODim Art. 72 and the GPA 2022.
Pouches are placed in the autoclave following loading guidelines (do not overload, do not stack pouches). In Swiss dental practice, the Class B autoclave per SN EN 13060 is the de facto standard — the only class capable of sterilizing hollow instruments and wrapped loads. KIGAP 2010 (status 2017) and the SSO Quality Guidelines on Practice Hygiene (2018) recommend Class B. The standard cycle is 134°C / 5.5 min; for prion-relevant procedures, CJKV (SR 818.101.21) prescribes the 134°C / 18-minute cycle. Thermal validation follows SN EN ISO 17665-1. Before the first load of the day, a Bowie-Dick or Helix test validates proper autoclave function.
At the end of the cycle, the autoclave generates a report containing the recorded parameters (temperature, pressure, hold time). This report is the cornerstone of traceability — it proves that sterilization conditions were achieved. The GPA 2022 accepts electronic storage as equivalent to paper printout, provided integrity, completeness, and availability during inspection are guaranteed.
Dental turbines, contra-angle handpieces, and ultrasonic scaler tips are hollow instruments — steam must penetrate internal channels to ensure sterilization. This is why a Class B autoclave (with pre-vacuum cycle) is essential: Class N autoclaves do not reliably sterilize hollow instruments. The Spaulding classification places instruments with pulp contact (endodontic treatment, extraction) and oral surgery procedures (implantation, flap procedures) in the critical category — they require sterile packaging and rigorous validation. The GPA 2022 and KIGAP build on this risk classification.
Turbines require particular attention: lubrication per manufacturer's instructions before cleaning, use of the Helix test (not Bowie-Dick) to validate steam penetration into channels, and individual packaging in appropriately sized pouches. A failed Helix test means hollow instruments in the load are not sterilized — even if the autoclave report shows "cycle passed." For details on autoclave testing, see the biological controls guide.
After successful sterilization, the load is formally released by the designated reprocessing supervisor (formal release documented by signature or PIN code). Sterilized pouches are stored in a clean, dry space, away from dust and direct light. The use-by date depends on the packaging type and storage conditions — in practice, from 1 to 6 months depending on the packaging. Switzerland has no codified retention period in MePV; the GPA 2022 and KIGAP recommend alignment with SN EN 868 (packaging) and SN EN ISO 11607 (packaging validation). A pouch whose integrity is compromised (torn, opened, wet) must be repackaged and resterilized.
For details on calculating the use-by date, see our dedicated guide.
Traceability is the step most practices neglect — and the one inspectors from the Kantonsarztamt / Service du médecin cantonal check first during a reprocessing inspection under MePV / ODim Art. 71 and 72. Each batch must be documented: sterilizer make / type, sterilization process, date, batch number, start / end, efficacy documentation, release. The link between the patient, the instruments used, and the sterilization cycle must be established and verifiable — this is the expectation of the GPA 2022 and the SSO Quality Guidelines on Practice Hygiene (2018). Switzerland has no codified retention period; the recognized practice is long-term archival for civil-liability purposes.
This is precisely what SecuSteri does: the autoclave report is imported automatically, the operator selects the instruments in the load, signs with their PIN code, and the traceability record is generated. QR labels link each pouch to its cycle.
Skipping pre-cleaning (dried residue is much harder to remove during cleaning). Packaging instruments that are still wet. Overloading the autoclave (prevents steam from reaching all surfaces). Breaking the reprocessing chain (placing clean instruments on a contaminated surface). Not documenting cycles (a missing or incomplete register is the leading cause of findings during a Kantonsarztamt / Service du médecin cantonal inspection). Performing release without a designated responsible person. Confusing the standard 134°C / 5.5-min cycle with the prion-relevant 134°C / 18-minute cycle per CJKV (SR 818.101.21).
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