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CJD Decontamination — MFDS Part 1 MCQ

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ModerateMicrobiologyCJD DecontaminationMFDS Part 1

A patient is known to be at increased risk of Creutzfeldt-Jakob disease but has no neurological symptoms. Following a routine composite restoration, reusable instruments have contacted only low-risk oral tissues; no endodontic files or reamers were used. According to UK guidance, how should these instruments be managed?

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Correct answer: E — Reprocess them according to best practice and return them to general use

The correct answer is E. Current UK guidance classifies routine dental procedures as involving low-risk tissues. Reusable instruments used on a patient with, or at increased risk of, CJD can therefore undergo the usual validated best-practice decontamination process and be returned to general use. CJD risk status alone does not require routine dental instruments to be quarantined, reserved for that patient or incinerated. Those measures apply principally when instruments contact high- or medium-infectivity tissues, including some procedures undertaken while a diagnosis is pending. Chemical disinfection without the required cleaning and steam-sterilisation process is inadequate. Endodontic files and reamers are a separate consideration because UK dental guidance requires them to be single use, but the stem explicitly excludes these instruments.

Reference: Advisory Committee on Dangerous Pathogens, Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection, Part 4, sections 4.70–4.73, revised 2015. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/209758/Part_4_-_Infection_Control.pdf