Management of bacteriological quality of dental unit water systems at ACTA Amsterdam

The Academic Center for Dentistry at Amsterdam (ACTA) is one of the largest Dental Schools in Europe. ACTA educates over 1000 students and treats 600 patients per day at more than 200 dental chairs. About 175 students per year start their practical dental training at the pre-clinical department. This large facility is situated on the first floor of the 8-story University of Amsterdam dental building at Louwesweg 1, Amsterdam. It consists of two halls A and B, housing 92 and 72 pre-clinical units respectively. Although the individual units are spatially organized in groups of 4, each unit is self supporting, provided with a phantom head, cooling water, rotary instruments, dental light and suction system. All units in A and B were manufactured and installed (in 1997) by KaVo. Municipal Amsterdam drinking water was used for feeding of all clinical and pre-clinical units. Read More

More Articles and Studies

Aims: To assess the efficacy of a disinfectant, Alpron, for controlling microbial contamination within dental unit water lines.
Methods: The microbiological quality of water emerging from the triple syringe, high speed hand piece, cup filler and surgery hand wash basin from six dental units was assessed for microbiological total viable counts at 22°C and 37°C before and after treatment with Alpron solutions. Results: The study found that the use of Alpron disinfectant solutions could reduce microbial counts in dental unit water lines to similar levels for drinking water. This effect was maintained in all units for up to six weeks following one course of treatment. In four out of six units the low microbial counts were maintained for 13 weeks.
Conclusions: Disinfectants may have a short term role to play in controlling
microbial contamination of dental unit water lines to drinking water quality. However, in the longer term attention must be paid to redesigning dental units to discourage the build up of microbial biofilms.  Read More

Dental unit water line systems are used to irrigate the oral cavity during dental treatment.  Water delivered from these devices is not sterile and can contain high numbers of bacteria, mainly because of formation of biofilms within the pipework. Some of these bacteria can be pathogenic to humans (e.g. Pseudomonas aeruginosa, Legionella species, non-tuberculous mycobacteria). In 2009 guidance from the Department of Health (HTM 01-05: Decontamination in primary care dental practices) set an expectation: that the quality of
DUWL water, where monitored, would lie in the range of less than 200 colony forming units per millilitre (cfu/ml) (i.e. it meets drinking water standards). The guidance also recommended untreated DUWLs should be flushed for at least two minutes at the beginning and the end of the day and after any significant period when they have not been used (for example, after lunch breaks). In addition they should be flushed for at least 20 seconds between patients. Read More

Study by Department of Prosthodontics, Dentistry Faculty, Marmara University, Istrambul,
Turkey. Read More

A water quality study of dental units showed biofilm and opportunistic microorganisms. We report the steps that ultimately allowed us to obtain water quality as water for standard care with no pathogens throughout all dental units. In summary, treatment with continuous disinfection associated with use of sterile water allowed us to restore the water quality at the output of dental care units while ensuring the safety of care. Read More