Ask Kara RDH: Do I really need to sterilize slow-speed handpieces after every patient?

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I read one of your articles regarding infection control. Do slow-speed handpieces really need to be sterilized after every patient when using a disposable prophy angles? We are currently sterilizing at the end of each workday.

Yes, slow-speed handpieces must be heat-sterilized in between every patient. Even though you use disposable prophy angles, and slow-speed handpieces are considered semi-critical devices, the Center for Disease Control and Prevention (CDC) explains they are an exception to the rule regarding disinfection and sterilization of semi-critical devices. The CDC states, “Studies have shown that handpieces can become contaminated internally with patient materials and the next patient may be exposed to potentially infectious materials1-4.” The CDC goes on to state handpieces “should always be heat sterilized after each patient1,4.” Due to the possible internal contamination of handpieces, barriers and surface disinfecting aren’t enough.

According to the CDC Guidelines for Infection Control in Dental Healthcare Settings, “Handpieces that cannot be heat sterilized should not be used4.” This applies to handpieces that cannot be removed from a dental unit.

Compliance with CDC recommendations is best achieved by purchasing multiple handpieces to allow time to heat sterilize each handpiece between every patient. Offices who are reluctant to invest in extra handpieces due to cost should remember that infection control and patient safety are top priorities, and buying multiple handpieces is the cost of doing business.

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  1. Centers for Disease Control and Prevention. (2016, March). Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care. Retrieved from
  2. Chin J.R., Miller C.H., Palenik, C.J. (2006). Internal contamination of air-driven low-speed handpieces and attached prophy angles. J Am Dent Assoc. 137(9):1275-80. Retrieved from
  3. Herd S., Chin J., Palenik C.J., Ofner S. (2007). The in vivo contamination of air-driven low-speed handpieces with prophylaxis angles. J Am Dent Assoc. 138(10):1360-5. Retrieved from
  4. Kohn, W.G., Collins, A.S., Cleveland, J.L., Harte, J.A., Eklunt, K.J., Malvitz, D.M. Center for Disease Control and Prevention. Guidelines for Infection Control in Dental Health-Care Settings – 2003. MMWR 2003; 52 (Report No. 17). Retrieved from
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Kara Vavrosky, RDHEP, is a Co-founder and the Chief Content Officer of Today’s RDH. Kara is a writer of popular articles that share practical advice and tips for hygienists, all in an informative and entertaining way. Beyond light-hearted content, Kara writes researched articles on topics in dental hygiene that educate hygienists on best practices and current protocols. A graduate of the Oregon Institute of Technology, Kara has a deep passion for spreading knowledge about the importance of oral health and how it relates to the entire body. Kara’s passion extends to helping other hygienists understand the latest protocols, products, and research — all with the goal to push the profession forward. Kara lives in Vancouver, Washington, with her fiancé Ben, and their rescued Chihuahua fur-babies, Bug & Ravioli. Beyond her love of dental hygiene, Kara enjoys spending time with her family, riding the Oregon dunes on her quads, and exploring the beautiful Pacific Northwest and all it has to offer.