In an Ontario dental office, two regulators decide who is responsible for sterilization. The Royal College of Dental Surgeons of Ontario (RCDSO) licenses dentists, while the College of Dental Hygienists of Ontario (CDHO) licenses hygienists. Each college expects its members to own distinct duties, so the division matters.
Quick facts: RCDSO regulates the dentist — and through the dentist, the facility and its sterilizers. CDHO regulates the hygienist's own practice. In Ontario, the RCDSO requires a biological indicator for each sterilizer on every day that it is used — daily monitoring, not weekly. The weekly baseline is the CDC / AAMI ST79 standard in most US states.
Two regulators, one treatment room
The short version: the dentist owns the sterilizer; the hygienist owns how they practise around it. RCDSO practice standards hold the dentist responsible for the facility — equipment, water, maintenance, records — under the college's IPAC standard. CDHO standards hold the hygienist to the office's infection control protocols, accurate documentation, and speaking up when something looks wrong.
RCDSO: what the dentist owns
The dentist is the license holder on record, so sterilization compliance sits on their desk. That covers choosing compliant sterilizers, scheduling maintenance, confirming water quality, and training staff. The RCDSO IPAC standard adds a firm benchmark: a biological indicator for each sterilizer on every day it is used — daily, not weekly. A passing spore test proves the unit kills resistant microorganisms. Between biological tests, chemical monitors such as autoclave indicator tape on every pack flag a failed load the same day.
CDHO: what the hygienist must do
A hygienist does not hold a facility licence, and CDHO does not expect them to run the office's sterilization program. Its standards expect hygienists to follow the employer's IPAC protocols, handle instruments competently, and keep accurate records — including confirming a recent passing biological test before treating patients. If that confirmation is missing, the hygienist raises it with the dentist or office lead, in writing if the gap persists.
Daily biological monitoring: who runs it, who records it
RCDSO sets the daily testing requirement; it does not dictate who performs it. In small offices a hygienist or lead assistant often runs the spore test because they already manage the loads. Both colleges care that the test happens on every day the sterilizer is used and that the result is written down — date, sterilizer, cycle, outcome. An unrecorded test never happened.
| Area of practice | RCDSO — the dentist | CDHO — the hygienist |
|---|---|---|
| Facility and equipment | Owns sterilizer compliance and maintenance | Follows validated protocols; does not own the machine |
| Spore testing | Daily biological indicator testing per the RCDSO standard | Confirms a passing test before care; no separate frequency |
| Records | Load logs, spore results, maintenance history | Clinical notes and any infection control concerns raised |
When a test fails, speed matters. Many offices stock the CliniEco Medical Biological Indicator — 24h Rapid Readout, 25-Pack so a sterilizer can be cleared or pulled from service within a day instead of waiting on a lab.
What happens when a spore test fails
A failed spore test is an event with a script, not a crisis. The sterilizer comes out of service at once, and every load since the last passing test is recalled and reprocessed. The team hunts for the cause — an overloaded chamber, a pack placed on edge, weak steam, or deferred maintenance — and documents the fix beside the failed result. The unit returns to service only after it passes again.
How a compliant office divides the work
A written division of duties — even one page — turns sterilization into a checklist someone owns. A workable split:
- The dentist or owner sets IPAC policy, approves equipment and maintenance, and signs off on spore test results and corrective actions.
- The hygienist follows office protocols, packages instruments in Class 4 dual-indicator sterilization pouches, documents care, and reports concerns promptly.
- The sterilization lead runs the daily biological tests, keeps the load log, and restocks tape, pouches, and indicators before supplies run out.
- Records staff file spore results and maintenance history so they can be produced at inspection without delay.
CliniEco Medical supplies the consumables behind that checklist — pouches, indicator tape, biological monitors — from one familiar source.
FAQ
Does a hygienist need to run the spore test?
No CDHO standard requires a hygienist to run it personally. If assigned, the hygienist needs training on that sterilizer and indicator. The duty is to confirm a passing test before treating patients.
Who is accountable if the autoclave fails a biological test?
The dentist, as license holder for the facility, owns the corrective action — pulling the unit from service, recalling loads, and documenting follow-up. The hygienist follows the recall protocol and keeps the issue visible until the sterilizer passes again.
How often are biological tests required in Ontario?
In Ontario, the RCDSO requires a biological indicator for each sterilizer on every day that it is used — daily monitoring, not weekly. The weekly baseline is the CDC / AAMI ST79 standard in most US states.
Do both colleges do inspections?
Yes, in different lanes. RCDSO practice inspections review the facility and its sterilization records, while CDHO quality assurance reviews the member's own practice and documentation.
Can one person manage sterilization for a multi-chair office?
Yes, with the right systems. One lead can manage several chairs using written load schedules, a daily test calendar, clear packaging rules, and adequate supplies. The real risk is an undocumented handoff between shifts.
Related reading: explore our dental compliance hub for sterilization and infection control.
check RCDSO sterilization monitoring requirements in our compliance pillar guide.
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