At your dental office, you clean and sterilize every tool you use to treat a patient – and ensure that you’re minimizing the risk of infection or transferring bacteria or any other microorganism between your patients. And that’s a great thing!
But there may be one part of your practice that you’re overlooking. Your dental unit waterlines. The waterlines that connect tools like dental handpieces and irrigation systems can become coated with bacteria – resulting in infections and poor patient outcomes. Without proper cleaning and disinfection of your waterlines, you could be putting your patients at risk. Learn more below!
Understanding Biofilm Waterline Contamination And What Causes It
The waterlines of your dental unit become contaminated because the water provided by your municipal water source is not sterile. It can contain some bacteria, fungi, and protozoans in small amounts. Typically, these levels of bacteria, fungus and other microorganisms are low enough that they are not harmful to patients during dental procedures.
However, if your dental unit is not cleaned and flushed regularly, these microorganisms will colonize the interior surface of the waterline contamination, creating a “biofilm.” Thanks to the water supply containing both bacteria and trace amounts of the nutrients required to support them, the biofilm will continue to grow.
When this happens, the number of free-floating microorganisms that will exit your waterlines will grow. In other words, biofilm leads to the release of more bacteria into the water supply you’re using for your patients.
While most healthy patients are not at risk from infection simply due to the presence of these microorganisms, elderly folks, younger patients and those with compromised immune systems may be at risk. And, in some cases, dental waterlines can contain deadly pathogens like Legionella, non tuberculosis Mycobacterium, and Pseudomonas– which pose threats to all patients.
In addition, if there is any backflow during a procedure, oral bacteria from one patient could be transferred to another, if the bacteria enter the handpiece and then enters the waterlines. This poses a further infection risk.
How Can I Address Waterline Contamination In My Dental Units?
Luckily, it’s easy to address the issue of waterline contamination in your dental units with just a few simple steps. Here are some best practices that you can use in your office to keep your waterlines clean, and minimize the risk of biofilm development and patient infection.
- Test your water regularly– There are a number of simple, inexpensive off-the-shelf tests that you can use to check for bacteria in your water. Test your water regularly to ensure that it is safe for use. It’s recommended by the CDC and EPA that you keep your water at a level of under 500 colony forming units of heterotrophic bacteria per milliliter (≤500 CFU/mL). If you find that your water tests for higher bacteria levels than this, you need to take action right away. Be sure that you are testing all water lines in the unit, the ones that are not used as often may be more likely to have bacterial buildup.
- Clean and flush your waterlines every day, and between each patient – Each individual manufacturer and dental tool will have a different procedure for cleaning the waterlines. We recommend that you consult your owner’s manual and documentation, and familiarize yourself with the process.
The best way to keep biofilm from developing is to deprive the bacteria of the nutrients and the critical mass of microorganisms required to form the biofilm. If you flush your waterlines out every day before work, in between each patient, and after you see your last patient, you’ll be able to help prevent excess bacteria from collecting in your units overnight. Flushing your units for at least 2 minutes in the morning can help eliminate many bacteria, according to clinical studies.
You should also flush your unit in-between each patient to eliminate the risk of spreading pathogens between their mouths. The CDC recommends that you flush your lines for at least 20 seconds between each patient to decrease the possibility of transfer of harmful pathogens.
- Use high-quality water in your lines – For surgical procedures, you’ll need to use sterilized water and single-use sterile tubing, of course. But even for non-surgical procedures, you may want to consider using a supply of distilled water – rather than simply hooking your dental unit up to the municipal water supply. You could also consider installing a filter that cleans up the water from your water supply before it’s sent to your dental waterlines. However, even if you use “cleaner” water, you still have to flush and test the water routinely.
- Use chemical treatments to destroy bacteria – If you do find that you have an elevated level of bacteria that could be harmful, it’s best to use a chemical treatment to flush the system and destroy the biofilm. The proper chemical treatment may vary based on your device and its manufacturer, so consult with the manufacturer to determine the proper germicidal treatment for your unit.
- Educate your staff about the importance of dental unit waterline safety– Unless all of your staff members take action – flushing their units properly, checking the water bacteria levels, and so on – you may not be able to eliminate the infection risk caused by contaminated lines. So make sure you address the importance of waterline safety regularly, and perform regular audits to make sure all of your staff members are complying with waterline safety best practices.
If you’re interested in learning more, this article from OSAPhas answers to some frequently asked questions and can help you get more details about the importance of maintaining sanitized, clean dental waterlines.
Understand The Importance Of Waterline Safety – Protect Your Patients!
Maintaining a clean, sanitized, and hygienic waterline system is important for safeguarding your patients and preventing oral infections. So follow the above tips to clean your waterlines more effectively, and ensure that you’re complying with ADA and CDC-recommended best practices.
For more information about dental compliance, or to learn more about this subject, contact Dental Office Compliance of New England right away. We’re experts on dental compliance and can explain this subject in further detail.