DENTAL WATER QUALITY

 DENTAL WATER QUALITY

Biofilm contamination of dental unit water lines (DUWLs), although not a new phenomenon, has received widespread attention from the media and scientific community. There are few current data on which to formulate recommendations to control biofilm accumulation or to establish safe levels of microorganisms in dental unit water used for nonsurgical (restorative) procedures. The American Dental Association released a statement recognizing the microbial levels in DUWLs and urging improvement of the am microbiologic quality of water through research, product development, and training. Other organizations, such as the CDC and Office Sterilization and Asepsis Procedures Research Foundation (OSAP), have issued guidelines for DUWLS. 

Some published reports suggest increased exposure of dental health care workers to legionellae from aerosolized dental unit water. DUWL water from an unmaintained dental unit may contain literally millions of bacteria and fungi per ml (many of them potential clinical pathogens); the lack of specific epidemiologic studies has prevented accurate assessment of the potential effect on public health. To date, however, a major public health problem has not been identified.

Current recommendations are to flush water lines for at least 3 minutes at the beginning of the clinic day and for at least 15—20 seconds between patients. This process does not remove all contamination, but it may transiently lower the levels of free-floating microorganisms  in the water. Removal of water line contamination requires a number of steps, such as chemical disinfection of the lines, a sterile water source, and a specific filtration system in the water line or a combination of these treatments. It has no effect whatsoever on biofllm contamination.

 

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