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Testing, Treating and Managing Dental Unit Waterlines

Categories: Infection Control

Author(s): Kevin D. Plummer

Date: 01-04-2019 13:50:38 pm


Dental unit waterlines supply water to handpieces, air-water syringes, ultrasonic scalers, the cuspidor and the rinsing cup. Due to the nature of the tubing, as water passes through it, microbial colonization can occur and biofilm can accumulate within them. As such, dental unit waterlines are a source of potential pathogens, and must be maintained at the same water quality level as the public water supply, which is 500 CFU/mL of heterotrophic bacteria. Therefore, regular water testing, and dental unit waterline treatment and maintenance, are required to ensure the water quality for patients and dental healthcare workers.

Dental unit waterlines (DUWLs) consist of the tubes in the dental unit that connect the high-speed handpiece, air/water syringe, ultrasonic scaler, rinsing water and cuspidor water to the water supply Bio lms form in DUWLs as they are colonized by water-borne microorganisms, which can lead to contamination and potential health risks for patients and dental healthcare workers (DHCW). Water introduced into DUWLs typically meets the public health safety standards for potable (drinking) water. In the United States, that standard is less than or equal to 500 colony forming units (CFU) of heterotrophic bacteria per milliliter (mL) of water. The United States Army Dental Command (DENCOM) recommends less than or equal to 200 CFU/mL, while the European Union
(EU) guidelines recommend that drinking water should be delivered at <100 CFU/mL.

Educational Objectives
The overall goal of this article is to provide the reader with information on the management and treatment of dental unit waterlines. On completing this article, the reader will be able to:
1. Describe the features of dental unit waterlines that encourage biofilm to accumulate within them;
2. List key microorganisms that are potential pathogens for immune-compromised and other susceptible patients;
3. Review options for the management and treatment of dental unit waterlines; and,
4. Describe available options for testing the quality of water derived from dental unit waterlines.

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