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Waterline infection control can be confusing, here are answers to questions that professionals like you have asked

Dental unit waterlines are the plastic tubing that carries water to the high-speed handpiece, air/water syringe, and ultrasonic scaler. Unfortunately, waterlines are notorious for being an excellent environment for growing bacteria, which is why maintaining your waterline is so important to patient care.

We recommend using our three simple step protocol: shock, treat test. Shocking your waterlines means using a strong cleaner like diluted bleach to clear your lines of any bacteria or biofilm buildup. Treating is using a daily, patient-safe antimicrobial that maintains your clean lines. Practices often use a treatment product to keep lines clean in-between shock cycles. Testing is the only way to ensure that your waterlines are in fact clean and provide the necessary documentation to keep your practice compliant.

The CDC provides a checklist that is often used by OSHA, the Health Board, and the Dental Board during inspections. Waterline maintenance is broken into three sections. The first is your dental unit water meets EPA standard of ≤500 CFU/mL. The second is your water testing frequency follows dental unit manufacturer recommendations (which is often monthly, then quarterly when passing consecutively). The third is using sterile water and a sterile delivery system during surgical procedures.

We recommend starting monthly. Our data shows that once a practice gets into a routine with testing their water, they are also more routine with shocking and treating. Regular testers maintain compliance twice as often as irregular testers. Once your practice is consistently passing, then we recommend moving to a quarterly testing schedule.

Dental unit waterlines are the perfect place for bacteria to grow. They are small, narrow, porous, and almost always wet. This allows bacteria to nestle down and form robust thriving biofilm. Water can become contaminated at the source, inside the dental unit, and even from retraction at the end of the handpiece. It’s nearly impossible to have sterile lines or equipment, so we have to adapt and create maintenance plans to help combat bacteria that may enter the waterline.

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