Your autoclave might be working perfectly. The question is whether you can prove it.
Most dental practices in South Africa own an autoclave and run it daily. But a surprisingly small number keep the sterilisation log the OHSC expects to find during an inspection. And when the inspector asks for it, "the nurse handles that" is not an answer that closes the finding.
What the inspector is actually looking for
The OHSC's inspection tool includes sterilisation records as a specific domain. Inspectors do not just check that your autoclave exists and appears to be functioning. They check whether it is being operated correctly, whether the results are being documented consistently, and whether you can demonstrate compliance over time.
A practice that runs its autoclave daily but keeps no log has no way to prove that any given instrument was properly sterilised. From an OHSC perspective, an undocumented sterilisation cycle did not happen.
What a proper sterilisation record contains
This is where most practices fall short. Many dental practices that do keep a log record only the date and whether the cycle "passed." That is not enough.
Each cycle entry needs to capture the specific cycle number, the time the cycle ran, the temperature reached, the pressure achieved during the cycle, whether the cycle passed or failed, and the name of the person who operated the machine. That last point matters more than practices often realise. If a patient outcome is ever connected to instrument sterilisation, the question is not just whether you have a log, but whether the log can tell you exactly what happened on a specific date, in a specific cycle, run by a specific person.
A log with missing fields, irregular entries, or dates that do not match your appointment schedule is a finding. An inspector who sees gaps in a sterilisation log draws the obvious conclusion.
The biological indicator requirement most practices have never heard of
Running the autoclave and recording the cycle results is one layer of sterilisation compliance. There is another layer that most dental practices in South Africa have never implemented.
The HPCSA's infection control guidelines require that biological indicators, commonly called spore tests, be used to verify that your autoclave is actually killing microorganisms at the required level. A spore test uses a vial or strip containing bacterial spores that correct sterilisation should destroy. The test is run inside a regular cycle, sent for processing, and the result confirms whether your machine is functioning as it should.
Spore tests are not optional. They exist because an autoclave can appear to complete a cycle successfully while not actually achieving the conditions necessary for sterilisation. A machine with a faulty seal, a failing heating element, or a compromised chamber can produce a "passed" reading while failing to sterilise instruments properly. Spore testing catches this where the machine's own sensors cannot.
When did your practice last run a biological indicator (spore) test on your autoclave?
This is a compliance gap.
Biological indicator testing is required under HPCSA infection control guidelines. Operating an autoclave without periodic spore testing means you cannot verify that your sterilisation process is actually effective. A free compliance evaluation will show you exactly where your infection control records stand.
Occasional testing is not sufficient.
Without a documented schedule and results on file, you cannot demonstrate compliance during an OHSC inspection. Intermittent spore testing with no records is treated the same as no testing at all. Get a proper system in place before your next inspection.
Good. That puts you ahead of most practices.
Make sure your full cycle log, including temperature, pressure, cycle number and operator name, is equally complete. Spore testing alone won't close a finding if the daily log has gaps.
Who is responsible for the log
The short answer is the practice principal. Section 8(1) of the OHS Act 85 of 1993 places the duty of providing a safe working environment on the employer. In a dental practice, sterilisation failure is both an infection control risk and an occupational health exposure.
The principal does not need to personally run every autoclave cycle. But the system for doing so, the training of the staff who operate the machine, and the records that prove it was done correctly, are the principal's responsibility. This is not something that can be delegated and forgotten.
What happens when the log cannot be produced
The OHSC inspector will ask to see your sterilisation records. Not a recent sample. They want evidence of an ongoing, systematic log demonstrating that your practice operates its sterilisation equipment correctly over time.
A log that exists but has gaps is a finding. A log that exists but does not contain the required fields is a finding. A log that does not exist is a serious finding, one that speaks directly to whether your practice is operating as a clinical safety environment. Under the National Health Act 61 of 2003, the OHSC has the authority to issue improvement notices and, in serious cases, to recommend suspension of a health establishment's certificate of compliance.
Your autoclave is not the problem. The record of how you use it is.
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