November 28, 2022
5 Ways to Build Trust with Your Patients through Dental Unit Waterlines

How can dental practices rebuild trust with their patients?
Dental professionals are likely feeling the influx of skepticism amongst their patients after the CDC’s Health Advisory regarding dental unit waterlines reached national media with headlines, such as “CDC warns of bacteria in dental waterlines after children are infected” and “CDC Warns of Rare Bacterial Infections From Dentists’ Water Lines.”
The October 2022 CDC Health Advisory was published in order to “emphasize the importance of following existing recommendations for maintaining and monitoring dental waterlines” because “multiple outbreaks of nontuberculous Mycobacteria (NTM) infections have occurred in children who received pulpotomies in pediatric dental clinics where the dental treatment water contained high levels of bacteria.”
It’s understandable that patients may come to their regular visits with more trepidation and questions.
Just as Jackie Dorst, RDH, BS said, “This CDC public health advisory was sent to all medical and dental communities. When patients hear the news, I believe they will have questions about the safety of the water in dental offices. Dental, orthodontics, and pediatric dental offices need to be prepared to answer these questions with confidence that their water is safe and they have documentation to prove it.”
So, the question is, how can you help your patients understand they are safe in your care?
Here are 5 ways you can build trust with patients around dental waterline infection prevention:
1. Continually Educate Yourself on Infection Control and Compliance
Infection prevention may be a widely discussed topic in dentistry, but even the pros rarely look at dental waterlines as a potential source of danger. The impact of neglecting these small tubes can lead to devastating repercussions, as we have seen in other pediatric practices.
Additionally, we must remember that our understanding of science is ever-evolving. It is essential that key members of each dental office utilize a portion of their CE credits to keep up with the latest techniques for testing and treating dental unit waterlines.
Your patients trust that as a trained medical professional, you have deep knowledge of all the variables of dental treatment that can lead to an infection.
Sadly, many professionals in dentistry are unfamiliar with waterline maintenance and do not realize that standards for safe water are outlined by CDC, ADA, and AAPD. In order to make sure dental water remains safe for patients, dental pros have to know what “safe” truly means.
We’ve compiled the Complete Guide to Dental Unit Waterline Compliance to see the recommendations these key groups in waterline maintenance have published.
2. Develop a Dental Unit Waterline Maintenance Protocol (and Stick to It!)
Where there are small-bore, carbon-based (usually), lines that have slow-moving water sitting at room temperature a majority of the day, you have the potential for biofilm growth.
It’s important that dental professionals know that simply using straws, tablets, or even centralized systems alone to treat lines will not be enough to deter stubborn bacteria from multiplying and forming biofilms. The only way to truly keep bacteria at bay and your dental water compliant is to follow a consistent waterline maintenance protocol.
Now, keep in mind, when we say “maintain” your waterlines, we do not mean shocking once a year, using a single straw for 16 months, or dropping a tablet in a water bottle once in a while. Doing this is the equivalent of bringing a broom to clean up spilled paint, the effort is appreciated but it’s not effective.
Effective waterline maintenance protocols should take time and effort, but it doesn’t need to be complicated. We recommend every practice follow the 3 Steps to Safe Water for consistently safe water.
The 3 Steps to Safe Dental Waterlines Protocol
3. Choose Infection Prevention Products Thoughtfully
As you venture into the world of dental unit waterline treatment options, it’s important to know this truth: there is no such thing as a silver bullet waterline treatment (or shock) product. If you’ve been told this about any single treatment product, you’ve been sold a horse with a spike glued to its head rather than a true unicorn–which disappointingly, does not exist.
Unfortunately, even the best straws or cartridges start becoming less effective after 7 months, water tablets are only effective if added at each refill, one missed day of daily liquids can lead to exponential bacterial growth, and centralized filtration systems do not eliminate the need for regular shocking and treating of lines.
While it would be wonderful if there was an option that required no effort and yielded consistently compliant water, true waterline maintenance will require effort and consistency.
It’s essential that you understand how each treatment solution works in order to identify which is the best for your practice. We’ve created the Complete Guide to Treating Dental Unit Waterlines to help dental pros determine which option is best for their practice. We believe many products on the market are indeed effective, but they are far from a silver bullet solution and do require your time and attention to stay on top of the continually growing biofilm in your lines.
4. Test Regularly and Document Results
There are various options for testing dental waterlines, such as the classic R2A, convenient QuickPass®, or cutting-edge Flo™. Regardless of which method you choose, make sure to test your lines monthly when you first start testing and then quarterly once you get consistent passing results.
Don’t forget to keep documentation of your waterline maintenance results for at least 5 years. This information serves as proof of your efforts and helps keep track of the quality of the water in lines over time. Without these records, there is no way of proving that your practice is providing ordinary and reasonable care in a prudent and competent manner.
If there are complaints filed with OSHA or the DOH, having these documents will protect your practice.
5. Tell Patients About Your Safe Water
You’ve put in the hard work, now it’s perfectly acceptable to brag about it! Find creative ways to tell patients the steps you are taking to ensure the water you deliver is safe.
Providing notice to your patients also makes them aware that these standards are ones they should come to expect from any dental office. For example, this pediatric dentistry has done a wonderful job of sharing what they are doing to keep their patients safe.
We recommend that any public message you share about your waterline monitoring include at least:
- What protocol you are following
- Why you are following this protocol
- What regulations you are using to evaluate your protocol’s effectiveness
You might even post a printed notice in your office so concerned patients can review the information while waiting or when considering whether or not to choose your practice as their primary dental office.
As practitioners, you know that trust is paramount to the success of your practice. While you are surely already taking the time to build personal relationships with your patients, sometimes, extenuating circumstances require additional effort from all of us in dentistry.
Don’t have the answer? Just ask!
In our book, asking “silly” questions is a whole lot better than risking patient safety. If anyone asks you about waterline maintenance and you don’t know the answer, just say so! You didn’t get into dentistry to become dental waterline experts, but we did.
If you are new to this world or have questions, please reach out to ProEdge Dental Water Labs. Our team of experts are here to help keep your patients, staff, and practice safe through maintaining dental unit waterlines. Schedule a free consultation to start building your custom protocol today.
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