The Centre For Disease Control recommends that dental unit water lines utilised in non-surgical procedures must be less than or equal to five hundred colony forming units of bacteria (heterotrophic type) per ml of water, which is the environmental safety standard. Dentists must also use sterile saline or sterile water when carrying out treatment. They must also follow manufacturer guidelines for maintaining and monitoring the quality of their dental unit water.
Biofilm – this is a layer of micro-organisms can develop in dental unit waterlines. A waterline is the tube which connects instruments and high speed hand held instruments including air and water syringes and ultrasonic scalers. In order to deliver water which is optimally composed regular and correct maintenance is necessary. The water must meet microbiologic standards and microorganisms in the water lines cannot be cause for concern for a healthy patient.
Thankfully infections resulting from the microbial contamination in waterlines is rare, these units have been linked and proven to host a wide range of bacteria and microbes which can cause illness in patients. These bacteria form films which contaminates the water supply, leading to infection. Units must be adequately maintained and monitored according the manufacturer instructions. Water quality can be improved through filtering, chemical treatments, valves and water supply sources.
Bacteria can also be introduced via patients during treatments. Therefore any devices coming into contact with patients must be connected to the mains and flushed adequately. Temperatures should not be increased as this can lead to bacteria multiplying. Manufacturer guidelines must be strictly adhered to by dental teams and dental practices. Sterile solutions should also be used to ensure cleanliness and delivery of sterile water.
Your equipment manufacturer will be able to advise on cleaning procedures and water sources. Chemicals and filtration may be advised. A routine plan will then need to be followed by staff as per recommended time intervals. Testing of the water is the only method to determine the safety and cleanliness standards. Testing equipment is available that determines the sterility of the water. Testing kits include in surgery kits and lab kits which are mailed away for testing. Most manufacturers provide a schedule for monitoring and testing.
The care of water lines is vital to ensure infection control standards are met and adhered to on an ongoing basis, thereby not putting patient health at risk. This will ensure standards in your practice and prevent any insurance or liability claims against your practice, or action by regulatory organisations.
The use and function of water lines cannot be underestimated as they are needed for all appointments, whether just a checkup of a longer surgical procedure. The equipment is essential all the same. Dentists should contact their manufacturer for assistance and to ensure standards are adhered to.