Getting to the Root of a Fail

Dental hygienists often play detectives. We see signs of disease or listen to patients’ complaints and work to get to the root of the issue. The same might be said if you fail a dental unit waterline test. And before you get defensive about failing, know that ⅓ of offices doing the right thing regarding their waterline protocol still have a failed line.¹ Much like the challenge our patients face controlling their biofilm, dental unit waterlines (DUWL) are a perfect environment for biofilm. The challenge is getting to the root of the problem.

The first step to remediating a failure is to go back to basics. Just like pulling out that toothbrush to review plaque removal, DUWLs have a proven protocol to get you passing: shock, treat, and test.

Step 1. Shock

Shocking your waterlines is using a strong disinfectant to clean out the bacteria, biofilm, and product residue built up in your DUWL. This is like a periodontal maintenance visit. The idea is to get the environment as healthy as possible before moving on to the next step.

Step 2. Treat

Treatment products are low-level antimicrobials that slow the spread of all the microorganisms that grow in your DUWLs. They help to maintain the clean environment you created when you shocked, much like our patients’ home care between visits — it keeps the biofilm at bay. Treating your lines without first shocking is like brushing your teeth with your finger. You’ll remove a little plaque, but you won’t disrupt the biofilm.

Step 3. Test

Testing is how you know if all your shocking and treating efforts are working. And it’s how you prove to any inspectors that you are doing the right thing. The Association for Dental Safety recommends testing monthly until you pass for 2 consecutive months and then moving to quarterly testing.²

Still Failing?

Just like those patients who do everything right but still have disease, some DUWLs require a little extra detective work. Here are some common sources of trouble to help you in your investigation.

• Try switching your shock product. Some shocks are stronger than others, and bacteria are smart and can become resistant to some chemicals. So change it up!
• If you’re filling your bottles with contaminated water, it’s an uphill battle that biofilm will eventually win. Try testing the water before you fill it up.
• A dead leg is a section of tubing that does not get consistent water flow, meaning it gets stagnant and lets the biofilm grow. Have your service tech look for and remove any dead legs.
• Sometimes, the slow-speed handpiece line acts like a dead leg and builds up biofilm. Don’t forget to flush that line and be sure to shock it.
• Dental unit water bottles are at risk for growing biofilm. Check the instructions for use for how to clean your bottles.
• Many traditional units come with a city/​bottle toggle switch. While this switch may seem great when your bottle runs dry, untreated water enters your lines and a dead leg is introduced into the system. Make sure that switch stays on bottle.

No one likes to struggle alone. For almost 15 years, ProEdge Dental Water Labs has been helping dental professionals achieve safe water.  Contact the ProEdge water safety experts to assist further and access a helpful failure investigation document. n

References

1. Dewhirst N, Molinari JA. Treating and monitoring dental water. Compend Contin Educ Dent. 2018;eBook:11–21.
2. Mills S, Porteous N, Zawada J. Dental Unit Water quality: organization for safety, asepsis and prevention white paper and recommendations–2018. Journal of Dental Infection Control and Safety. 2018;1(1):1-27.

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From Dimensions of Dental Hygiene. October/November 2024; 22(6):31.