Dental Infection Prevention Regulations in Washington State

The world of dental infection prevention is not a new one. All professionals in medical fields are continuously on the defense against their microscopic nemeses. However, as time goes on and as, unfortunately, real people experience the real danger of these bacteria, new regulations and compliance guidelines are enacted.

What does the Washington state amendment mean for dental unit waterline maintenance?

After seeing the heartbreaking dental unit waterline-based infection outbreaks in Orange County, CA, and Atlanta, GA, the Washington State Department of Health updated their waterline infection control and prevention on January 23, 2021. WAC 246-817-660 which details rules for dental unit water quality, reads as follows:

(1) A licensed dentist shall use water for nonsurgical procedures that meets United States Environmental Protection Agency regulatory standards for drinking water of five hundred or less colony-forming units or CFUs/mL.

(2) A licensed dentist shall follow dental equipment manufacturer’s instructions when testing the water delivery system for acceptable water quality. If manufacturer’s instructions are unavailable, a licensed dentist shall test the water delivery system for acceptable water quality quarterly. A licensed dentist shall test the water delivery system five to ten days after repair or changes in the plumbing system and again at twenty-one to twenty-eight days later.

(a) Effective December 1, 2021, all water lines must be tested.

(i) All water lines for each operatory or dental unit can be pooled as one single sample.

(A) A pooled sample must use an equal amount of water from each water line.

(B) A pooled sample can have up to ten water lines included.

(C) The number of water lines pooled into one sample must be documented.

(ii) All water lines for each operatory or dental unit can be tested individually.

(b) In the event of an unacceptable level of colony-forming units or CFUs, a licensed dentist shall take immediate remedial action. For the purposes of this section, remedial action means any action necessary to reduce the CFUs to five hundred or a lesser number currently recognized by the United States Environmental Protection Agency as acceptable for drinking water.

(c) A licensed dentist shall record the water delivery system testing and maintenance either in the form of a log reflecting dates and person or persons conducting the test or maintenance or copies of reports from an independent testing entity. A licensed dentist shall maintain this documentation for a period of five years.

While most states refer to the CDC guidelines for waterline maintenance, Washington has mandated additional standards for those practicing in their state.

What do Washington’s dental waterline regulations have to do with my practice?

Even if your state does not have formal legal regulations that are specific to dental waterlines, if OSHA or the DOH receives a complaint, they will follow the CDC guidelines in evaluating if necessary and reasonable steps were taken to prevent infection or illness. In short, it doesn’t mean any practice is in the clear from the guidelines set by governing bodies simply because your state has not formalized these standards.

Regardless of your current situation, we’re here to help you achieve better patient care through safe water.

What steps can my office take to prevent waterline-borne infections?

To start, check out our 3 simple steps to safe water, this is a great launching point for any dental pro looking to maintain their waterlines. For those that need to get testing documentation soon, here are your next steps:

1. Test your waterlines to see if you are compliant. Over 31% of treated waterlines fail to meet the ≤500 CFUs/mL standard.
2. Shock your waterlines if testing reveals failure(s).
3. Retest to ensure your waterlines are now clean and safe.
4. Develop a waterline maintenance protocol (or use the proven protocol) to help develop consistent testing procedures.
5. Document maintenance procedures and test results.

What can ProEdge do to help your dental offices with infection prevention and infection control?

We know that you didn’t go into dentistry to treat waterlines, but we did. It’s our goal to help you succeed in achieving compliance and patient health.

Get started by taking advantage of these different offerings from ProEdge:

1. Productive, free consultations:  We are passionate about sharing the knowledge we’ve acquired over the past two decades. Our Customer Success team is the real secret to our sauce. So, whether you use our blue check products or any other waterline product, we are more than happy to answer your questions and help you develop a protocol for you and your team. Skeptical? Try it out. Give us a call with any questions, silly or complex–we love talking waterlines.
2. Globally trusted blue check approved products: When it comes to effectively maintaining waterlines, it’s critical that you use products that really work. We get this sounds like a “duh” statement, but you’d be surprised by how many products are less effective when you look at the test results. That’s why we developed BluTab, our first antimicrobial tablet, which has since become one of the most effective treatment products on the market with an efficacy rate of 88%. Or BluTube, our dual cartridge system you can count on. When we realizes that 1 year straws begin to lose strength around 7-9 months, we looked at the hard facts and realized that a two-straw product may not be revolutionary, but it’s effective.
3. Our experience at your fingertips: Over the years we have developed a robust library of everything waterlines. Whether you want to learn what you need to shock your lines, how to evaluate treatment products, how to test your water, or join a webinar that deep dives into the science behind dental unit waterlines, we’re here to help.