Dental Water Quality can Pose Serious Infection Control Risks

By on 1:27 PM

What is the Risk of Exposure to Contaminated Water in the Dental Office?

One of the most seriously overlooked sources of potential outbreaks is water used during procedures at dentist offices. The water risk is certainly considerable, and proper dental infection control precautions need to be followed, although such dental infections tend to be relatively rare in terms of outbreaks, when they happen, it can affect hundreds of people or more.

A recent example occurred in Italy when an 82 year old woman died of Legionnaires’ disease that she was exposed to during a dental treatment. The water in the dentist’s office was tested positive for Legionnaires’ disease, with the actual source being the aerosolized water that came from high-speed turbine instruments.

Such infections can happen in the US as well. This is because the sources of infection can develop in water supplies that begin as relatively clean.

 Woman Contracts Legionnaires' Disease From Dental Water - ABC News

The Problems related to Dental Water Quality

Bacterial load found in dental water is usually considerably higher than found in standard municipal water sources. This indicates that water sources and use at dentist offices needs proper attention in order to minimize any potential infection.

The types of microorganisms that are found in dental water are mainly bacteria, protozoa and fungi. These microbes  are floating freely in the water or are microbes that are attached to the inner walls of the waterlines.

Biofilm is formed by slime producing bacteria on the inner surfaces of tubing where the water flow has stagnated or moves very slowly. The bacteria have a continuous source of nutrients and can release planktonic microorganisms into the water supply, presenting a danger to both patients and the dental office staff.

The Scientific and Public Media Reports about Contaminated Dental Water

There have been several reports in the media about contaminated water at dental facilities causing outbreaks of bacterial infections. The aforementioned case of Legionnaires’ disease is one of many that has happened over the years.

In 2003, the Centers for Disease Control and Prevention issued recommendations in their report about dental unit water.

Recommendations about Infection Control for Dental Water

In the 2003 CDC guidelines many different recommendations were published relating to the cleaning and treatment of water and these include:
-  Flushing out waterlines at the start of the day and between patient treatments
-  Using approved water filtration systems or cleaners to disinfect water lines and prevent biofilm from forming.
-  Testing the water to keep track of microbial count.

For surgical procedures, sterile water or saline must be used. In addition, appropriate equipment, proper sterilization measures and separate reservoirs of water must be established to minimize the potential for contamination.

Systems to Provide High Quality Dental Water

Simple flushing alone will not remove the buildup of biofilm. However, the use of disinfectants and germicidal treatments on the water reservoirs will significantly diminish the buildup of bacterial contaminants. For example, microbial filtration exists on ultrasonic devices and dental hand pieces which have been in use for decades. Such filtration devices will remove the free floating microbes

Reducing the instances of water infection at dentist offices can be achieved through diligent dental infection control adherence to CDC protocols, investing in the proper filtrations systems, and applying appropriate sterilization agents to ensure that the dental water risk is minimized.


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