Practice Start Up

Checklist for practice start-up

Last update: 23 April 2020

Water

Turn on the mains water supply as the first action of the start-up process. Listen and look for any water leaks.

Dental chair

Check the dental unit manufacturer’s instructions for the correct protocol for waterline treatment for chair start-up.
Check that any external water bottle attached to the dental chair is free of visible biofilm growth. Fill the bottle with water and add any required chemical treatment agents to the water that will feed into the chair.

Flush out each waterline for at least 2 minutes, holding them over the intake of the high-velocity evacuator one waterline at a time.

After this has been done, flush all the suction lines using the recommended agent, and then run several cupfuls of tap water down the suction hoses.

Other equipment containing water reservoirs

Fill the water storage bottles in operatory or laboratory equipment, including benchtop ultrasonic scalers with separate water bottles, CAD-CAM milling workstations (coolant for cutting burs), hard tissue lasers (water for cooling during cavity preparation), and the like, with the appropriate type of water, and include any required additives.

Suction system and compressor

Check whether any specific actions are needed for the compressor (e.g. closing off the drain of the compressed air reservoir, then restart the compressor. Check that compressed air pressure rises and there is no obvious leaking or malfunction.

Turn on the power to the suction system.

Ultrasonic cleaner

Turn on the unit at the mains power outlet.

Rinse the chamber thoroughly with tap water, and drain this out, before refilling with tap water. Add the required additive, then degas and perform the aluminium foil performance check. Ensure that there are perforations across the foil sheet(s). Then discard the chamber contents, rinse the chamber with water, refill the chamber, add fresh additive, then degas once more. The ultrasonic cleaner is now ready for use.

Washer disinfector

Ensure the chemical supply tanks are connected and have sufficient levels of chemicals, and that the water supply taps are turned back on. Then turn on the power. When the unit is used, include a soil test in every load and record the results (as part of normal performance testing procedures).  

Steam sterilizer

Make sure the unit has the data card (if appropriate) replaced.
Ensure that any deionized water reservoirs are filled with deionized water. Close off the drain control for the wastewater.  

Turn the power on. Watch as the sterilizer goes through its start-up procedure. If there is a date/time shown on the display, check that this is correct, and adjust as needed.

Check that the chamber is empty (other than for racks), and run a warm-up cycle. For a pre-vacuum sterilizer, now run the air leakage test, to check the integrity of the door seals.

Then run a suitable air removal test, e.g. a Bowie-Dick test, and record the results for this.

Electrical equipment

Check the status of the refrigerator (which should be running), and then the contents for medicines or supplies that are nearing or have passed their expiry date.

Turn on minor appliances in the staff area (e.g. electric jug, microwave oven).

Ensure arrangements have been made for re-setting phone diversion, mail collection, parcel delivery and the like.

Check that remote access to servers is working properly.

Scheduled medicines

Ensure that sufficient supplies of all required scheduled medicines (including local anaesthetic) are available, within the use-by date, and are kept securely away from patient/public access.