What you can’t see may harm your patients, your staff and your practice’s reputation!
Removal or inactivation of dental unit water line (DUWL) biofilms requires the use of chemical germicides, since the untreated procedural water in there is contaminated.
The challenge with DUWLs, put simply, is that stagnant water in the narrow tubing is the perfect environment for microbial colonisation and subsequent biofilm growth.
Even worse, if you are using an in-line water heater and your water exceeds 20 degrees celsius, you are promoting greater microorganism growth.
The biofilm problem in focus
If we go back to basics for one moment, biofilm is a complex matrix of bacteria, fungi and algae bound together in a sticky gel of polysaccharides that forms a microcolony. The microcolony attaches to a surface, such as the interior of dental unit waterline tubing.
Once colonies of microorganisms start surviving inside your waterlines, they begin to build a sticky matrix that creates visible biofilm. This sticky, slimy substance protects the biofilm community, allowing for further multiplication of microorganisms.
When left untreated, or improperly maintained, the water flowing through these contaminated DUWLs can potentially harm your patients, your staff and ultimately your practice’s reputation.
If you are a numbers person, consider that HTM 01-05 states that the total viable counts upon microbiological monitoring should be expected to lie in the range 100 to 200 colony forming units per millilitre (CFU/ml) and yet:
- Untreated waterlines can reach up to 1,000,000 CFU/ml3
- Microbial counts in newly installed dental waterline can reach as high as 200,000 CFU/ml within five days (Barbeau J et al, 1996).
The reality of DUWL contamination
Documented diseases and ailments caused by opportunistic waterline bacteria include:
- Legionnaires’ disease
- Pneumonia
- Respiratory and soft tissue infections.
Offering one example, a major infection control breach in 2016 at a Southern California paediatric dental clinic resulted in over 70 children being hospitalised and treated for Mycobacterium (NTM) infections following pulpotomies.
In terms of treating these children, it can have life-changing consequences:
- Most children require surgical treatment (Iversen RH, 2012)
- Surgery comes with risk of damage to the facial nerve and will always result in a scar (Iversen RH, 2012)
- Swelling, redness and pain around the infected tooth can occur, with the bacteria potentially spreading to the gum and jawbone. In those cases, stopping the infection often means removing part of the jaw itself, making it a long-term issue for these children
- IV antibiotic treatment frequently prescribed post-operatively (Iversen RH, 2012)
- Antibiotic treatment can last up to 24 months in some cases (Lindeboom JA et al, 2011)
- Comes with a risk of high-frequency hearing loss (Hatzenbuehler LA et al, 2017)
- Even if infections are diagnosed early, adequate treatment may be complicated by an inability to reduce immune suppression, antibiotic adverse reactions and patient allergy (Lindeboom JA et al, 2011).
As history has unfortunately taught us, this is no trivial matter.
The ideal preventive solution
There is an easy way to manage this challenge – one DentaPure Cartridge = 365 days of safe, compliant, dental unit water.*
How it works:
- The DentaPure Cartridge contains non-allergenic iodinated resin beads
- As water passes through, the resin releases 2-6 ppm of atomic isotopes of elemental iodine (I2) during a typical dental treatment
- The (I2) isotopes control the bacteria, keeping dental unit water safe for 365 days.*
It is simple:
- Installs in minutes
- Cost effective
- Compatible with bottle and municipal systems
- Can use either tap or distilled water
- Once the DentaPure Cartridge is installed, no monitoring or shocking protocol is required for the life of the cartridge (see note below).
It is reliable:
- Reduces the possibility of human error
- In independent ADA testing, the DPI365M DentaPure Cartridge effectively treated 645l of water
- Will not interfere with dental materials and bonding.
Plus, as an interesting aside for those readers who like fun facts, the DentaPure Cartridge uses the same technology developed for NASA to ensure that water consumed in space is safe from harmful levels of bacteria and many other detrimental organisms.
NB: While DentaPure Cartridges do not require monitoring, manufacturer Crosstex supports all recommended/required monitoring guidance. Follow DentaPure Cartridge IFU to ensure results are within an acceptable range. DO NOT shock through a live DentaPure Cartridge.
* Or 240l of water if usage records are kept.
References
- Barbeau J et al. Multiparametric analysis of waterline contamination in dental units. Amer Soc for Microbiology 1996; 62(11): 3954-3959
- Iversen RH, Illum P. Cervicofacial nontuberculous mycobacterial lymphadenitis in children. Danish Med J 2012; 59(1): 1-4
- Lindeboom JA et al. Clinical manifestations, diagnosis, and treatment of Mycobacterium haemophilum infections. Clin Microbiol Rev 2011; 24: 701-717
- Hatzenbuehler LA et al. Pediatric dental clinic-associated outbreak of Mycobacterium abscesses infection. Journal of the Pediatric Infectious Diseases Society 2017; 6(3): e116–e122.
Revolutionise your waterline maintenance with Dentapure and Quintess Denta
If you are looking to provide safe and compliant treatment, including ensuring that your practice meets or exceeds microbiological water quality standards, then look no further.
Distributor, Quintess Denta, has a special offer on the DentaPure 365 Day Independent Water Bottle Cartridge (DPI365B10):
- In sterling – £135 (versus the RRP of £225)
- In euros – €150 (versus the RRP of €250).
For more information on how DentaPure works, please view the informative video at www.quintessdenta.com/en-GB/eShop/products/1/24 or simply visit www.quintessdenta.com or email [email protected]
