Protect Your Patients and Your Practice by Protecting Your Dental Unit Waterlines

There are a lot of questions surrounding dental unit waterlines these days with the confirmed death of an elderly woman in Italy who died after contracting Legionnaires disease from a visit to her dentist. With the correct information you can make informed decisions about how best perform dental waterline testing and use a waterline cleaner.

The Issue
Dental unit waterlines provide a particularly well suited environment for biofilm to grow and flourish due to the very narrow bore tubing. Biofilm is a community of bacterial cells and other microbes that adhere to surfaces and form a protective slime layer that contain many types of bacteria as well as fungi, algae, protozoa, and nematodes. Individual organisms or even portions of the biofilm near the surface break off into flowing water. The result is output water that is often many times more contaminated than tap water.

Health Implications
Until recently no outbreaks of disease had been reported even though numerous studies have identified the presence of waterborne opportunistic pathogens in dental unit water. However, there is a recent report in the Lancet (Vol 379, February 18, 2012) about a woman in Italy who contacted Legionella pneumophilia from dental unit waterlines during routine dental treatment which raises cause for concern.

Guidelines for Infection Control in Dentistry
The CDC recommends that dental unit water meet the standard set for drinking water, which is a limit of 500 colony forming units of bacteria per milliliter of water. Dental Healthcare Professionals should be trained regarding water quality, biofilm formation, water treatment methods, and appropriate maintenance protocols for water delivery systems.

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