Nobody can look at an instrument pouch and tell whether it is sterile. The only thing standing between a failed cycle and a patient is your monitoring, and the only thing that tells you which loads to recall after a failure is your log. This template gives you a per-load cycle log, a weekly spore test log, and a written failed spore test protocol that should be posted where the sterilizer is, not filed away.
How to use this template
- Print one cycle log page per sterilizer per week or month, depending on your volume. Never combine two sterilizers on one sheet.
- Number every load and write that load number on every package that comes out of it. That number is what makes a recall possible.
- The CDC calls for mechanical monitoring on every load, an internal chemical indicator in every package, and a biological (spore) test at least weekly for each sterilizer, plus every load containing an implantable device.
- Post the failed spore test action plan on the wall by the sterilizer so the response does not depend on who is working that day.
- Keep completed logs as long as your state requires; retention periods for sterilization records are set by state and local rules, not by the CDC.
Log header
| Field | Entry |
|---|---|
| Practice name | |
| Sterilizer ID (name or number) | |
| Brand, model, serial number | |
| Type (gravity, pre-vacuum, chemical vapor, dry heat) | |
| Month and year | |
| Infection control coordinator | |
| Internal chemical indicator type used (4, 5, or 6) | |
| Biological indicator brand, method, and lot | |
| Monitoring service (in-office incubator or mail-in lab) |
Cycle log: every load
Record every load. Mechanical result means the display, gauges, or printout met the manufacturer's parameters for time, temperature, and pressure. External CI is the tape or pouch ink. Internal CI is checked when the package is opened at chairside; record failures here.
| Load # | Date | Operator initials | Cycle type | Contents (cassettes, pouches, implant load?) | Temp | Time | Pressure | Mechanical pass? | External CI pass? | Internal CI checked? | BI run this load? | Notes / action |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Daily air removal test (pre-vacuum sterilizers)
| Date | Sterilizer | Test type | Result (pass/fail) | Operator | Action if failed |
|---|---|---|---|---|---|
Biological (spore) test log
At least weekly for each sterilizer, and with every load containing an implantable device. The control must show growth for the test to be valid.
| Date run | Sterilizer | Load # | BI lot # | BI expiration | Control result (growth expected) | Test result (no growth expected) | Date read / reported | Read by or lab | Pass / Fail | Action taken |
|---|---|---|---|---|---|---|---|---|---|---|
Chemical indicator failures
| Date | Load # | Package or cassette | Indicator type | What was observed | Action taken | Initials |
|---|---|---|---|---|---|---|
Failed spore test action plan (post by the sterilizer)
Steps in order
- Take the sterilizer out of service immediately. Tag it so no one loads it. Switch to the backup unit.
- Notify the infection control coordinator and the owner or doctor on site.
- Review procedure: loading and packaging density, cycle selected, indicator placement, whether the correct BI and a matching control from the same lot were used, and incubator temperature.
- Quarantine and recall implantable devices processed since the last negative spore test. Non-implantable items generally do not require recall after a single positive result unless the sterilizer is found to be malfunctioning.
- Repeat the spore test immediately, using the same cycle, with a new BI and matching control.
- If the repeat test is negative and the procedure review found no problems, the sterilizer may return to service.
- If the repeat test is positive, keep the sterilizer out of service until it has been inspected or repaired, then rechallenge it with spore tests in three consecutive, fully loaded chamber cycles, all negative, before returning it to patient use.
- Recall and reprocess suspect loads back to the last negative test, to the extent possible, using the load numbers on the packages.
- Document everything below: the failure, the review, the retest, the repair, the recall, and who did what.
- If a confirmed failure raises questions about patient notification, contact your professional liability carrier and a dental-specific attorney before acting.
| Field | Entry |
|---|---|
| Date and time failure identified | |
| Sterilizer and BI lot | |
| Last negative spore test (date, load #) | |
| Control result (valid test? Y/N) | |
| Sterilizer removed from service by / time | |
| Procedure review findings | |
| Implantable items processed since last negative test | |
| Loads recalled (load numbers) | |
| Immediate retest date and result | |
| Service call placed (company, date) | |
| Repair performed | |
| Three consecutive negative tests (dates) | |
| Returned to service (date, by whom) | |
| Counsel or carrier contacted? (Y/N, date) | |
| Signature of infection control coordinator |
Monthly records audit
Audit checks
- Every operating day has at least one logged load, or a note explaining why not
- Load numbers run in sequence with no gaps
- A spore test is logged for every sterilizer, every week
- Every spore test has a control result recorded
- Mail-in reports are filed and matched to log entries
- Implant loads flagged and BI results tied to them
- Chemical indicator failures recorded with the action taken
- Indicator and BI stock in date and stored per the label
- Sterilizer maintenance records current
- Failed test protocol still posted and legible
| Field | Entry |
|---|---|
| Audit date | |
| Audited by | |
| Gaps found | |
| Corrective action and due date |
How to run the log day to day
Assign the log a physical home directly on or beside the sterilizer, with a pen attached. The person who loads the sterilizer fills in the row when the cycle starts, and completes the mechanical result when it ends. That sequence matters: if the row is created at the start, an aborted cycle leaves an obvious unfinished line instead of disappearing.
Load numbering should be simple and continuous. Many practices use a sterilizer identifier plus a sequential number that resets each year, such as A-0417 for the four hundred seventeenth load in sterilizer A. Whatever you pick, every pouch and cassette that leaves the chamber gets the sterilizer ID, the load number, and the date written on it. This is the whole point. Without it, a confirmed sterilizer failure means reprocessing every package in the office back to the last negative spore test, because you cannot tell which came from where.
The internal chemical indicator column is checked at the chair, not in the sterilization area. The person opening the package confirms the internal indicator has fully changed before using the instruments. A package whose internal indicator has not changed does not get used; it goes back for reprocessing and the failure gets logged on the chemical indicator sheet. Build that into your chairside setup routine so it happens without anyone thinking about it.
How often, and who owns it
The CDC's monitoring guidance sets the floor: mechanical monitoring every load, an internal chemical indicator in every package plus an external one where the internal indicator is not visible, and a biological indicator at least weekly for each sterilizer, with every implant load tested as well. Pre-vacuum units also need the manufacturer's daily air removal test before the first load.
Your state may set a higher floor. Several states write spore test frequency and record retention into their own board rules, and the CDC explicitly defers to state and local requirements on how long to keep records. Check your board's rule and write the retention period into your policy rather than guessing.
Ownership should sit with one named infection control coordinator, which the CDC's basic expectations also call for: at least one person trained in infection prevention to coordinate the program. That person runs the weekly spore test (or assigns it), reads or receives the results, files the mail-in reports, and does the monthly audit. Everyone who processes instruments fills in the cycle log, but one person is accountable for the log being complete.
What good looks like
A good log is one an inspector could pick up cold and follow. Continuous load numbers. A spore test every week for every sterilizer, including the backup unit if it is used on patient instruments. Control results recorded, because a test with no growth in the control is invalid, not a pass. Mail-in reports stapled behind the sheets they correspond to. Any failure documented with what was done about it, in order.
Practices that do this well also run the monthly audit honestly and write down what they found. Missing weeks are the single most common finding in sterilization records, and they usually happen the same way: a busy week, the person who normally runs the test was out, and nobody noticed until the audit. Catching that in your own audit and fixing it is a functioning program. Discovering it during an inspection is not.
One more sign of a good program: the failed spore test protocol is posted and the team has read it. When a positive result comes back on a Tuesday afternoon, the response should be automatic rather than improvised.
Common mistakes
Not labeling packages with the load number. Everything else in this log is undermined by this one omission. Labeling takes seconds per package and is the difference between recalling one load and recalling three weeks of instruments.
Using the wrong internal indicator. Autoclave tape and pouch ink are Type 1 process indicators. They tell you an item went through a process, not that sterilizing conditions reached inside the package. Internal indicators should be multiparameter types (Type 4, 5, or 6) labeled for your method and cycle. The sterilization monitoring guide breaks down all six ISO types.
Skipping the control. An in-office biological indicator must be incubated alongside an unprocessed control from the same lot. If the control does not grow, the test is invalid and has to be repeated with a new pair.
Testing only the main sterilizer. Every sterilizer used on patient instruments gets its own weekly test, including the small backup unit that only runs when things get busy. There is no CDC carve-out for part-time sterilizers.
Waiting to remove a failed sterilizer from service. The unit comes out of service when the positive result is known, not when the owner gets back from lunch. Give the team explicit authority to do that.
Forgetting the test after service. A sterilizer that has been installed, moved, or significantly repaired should be spore tested before it goes back into patient use, following the manufacturer's instructions.
Related ChairsideSource resources
- Sterilization monitoring: spore tests, indicators, and record keeping
- Course lesson: monitoring, logs, and failed spore tests
- Compliance: OSHA, HIPAA, infection control, and more
- How to run an internal infection control audit
- Dental equipment maintenance log template
This template is educational and is not legal or clinical advice. Follow your sterilizer and indicator manufacturers' instructions and your state board's rules, which may be stricter than CDC recommendations.
This guide is educational content and does not constitute legal, financial, tax, or clinical advice. Laws and regulations vary by state and change over time. Consult your own dental-specific attorney, CPA, and state dental board before acting.