dental waterlines rust

Nov. 8, 2011
All you need to know about DUWLs and the ADA guidelines
by Mike Rust
Question: What’s the ADA/CDC standard for clean water in dental unit water? (All answers are quotes from the ADA/CDC standard. ) Answer: “[T]he number of bacteria in water used for nonsurgical dental procedures should be <500 CFU/mL, the regulatory standard for safe drinking water established by EPA”Question: What do I have to do?Answer: 1. TRAIN: “DHCP should be trained regarding water quality, biofilm …and appropriate maintenance protocols for water delivery systems.” 2. DISINFECT “Removal or inactivation of dental waterline biofilms requires use of chemical germicides.” 3. MONITOR: “Clinical monitoring of water quality ensure[s] that procedures are correctly performed. Dentists should consult with the manufacturer of their dental unit or water delivery system to determine the recommended frequency of monitoring”. 4. USE STERILE DEVICES FOR SURGERY: “Delivery devices (e.g., bulb syringe) should be used to deliver sterile water.”Question: Why? My water is good. Answer: “Studies have demonstrated that dental unit waterlines can become colonized with microorganisms. Exposing patients or DHCP to water of uncertain microbiological quality, is inconsistent with accepted infection-control principles.”Question: But I use distilled water.Answer: “Simply using source water containing <500 CFU/mL of bacteria (e.g., tap, distilled, or sterile water) in a self-contained water system will not eliminate bacterial contamination in treatment water if biofilms in the water system are not controlled. Removal or inactivation of dental waterline biofilms requires use of chemical germicides.”Question: Okay, train me. What’s the most painless way to provide clean water to my patience.Answer: The most popular products these days are tablets that you drop in your independent water bottle, and they keep the water clean for a few weeks to a few months, then you need to “shock” your waterlines with something stronger. The bugs that grow in DUWLs require the occasional use of a stronger disinfectant to clean the lines. The tablets are safe to ingest so they are not strong enough to last forever. BluTab® is very popular because it keeps the lines clean for at least 8 weeks, much longer than other maintenance products. It is very easy to use, economical, and you can buy a little at a time: 50 tablets cost $28.95. Some other products cost $200/year/operatory and you must buy a year’s worth at a time. More at Rust can be contacted at [email protected].