1 / 31

Dental Unit Water

“The dirtiest area in dental surgery.” www.dentalproducts.net. Dental Unit Water. “The Dirtiest Area in Dental Surgery” www.dentalproducts.net. Bacterial colonization of dental water lines (DUWLs) was first reported in scientific literature in 1963.

ashby
Télécharger la présentation

Dental Unit Water

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. “The dirtiest area in dental surgery.” www.dentalproducts.net Dental Unit Water

  2. “The Dirtiest Area in Dental Surgery”www.dentalproducts.net Bacterial colonizationof dental water lines (DUWLs) was first reported in scientific literature in 1963. Conventional DUWLsexpose patients and staffto harmful microorganisms in the office in which you work.

  3. The “Big Four” agree DUWL’s are a problem. These organizations provide the primary opinions on standards of care in Dentistry. All of them have issued many statements regarding DUWL contamination and infection control recommendations.

  4. DUWL Contamination Dynamics Input: Water quality Waterline: Biofilm Output: Retraction and Backflow

  5. Water Quality Tap water is a reliablesource of contamination. You haveno wayof knowing exactly what is in it at any given time. Distilled or sterile water is not good enoughunless the reservoir and the DUWL aresterile.

  6. Retraction and Backflow Oral microflora have been recovered from DUWL’s. If retraction of patient fluids is not a problem, thenwhy are there anti-retraction valves built into the handpieces??? Howdo you test a handpiece anti-retraction valve? Eddies of backflow can travel through an open anti-retraction valveeven during positive flow!

  7. Waterline Biofilm The small diameter and long length of the DUWL provides a large surface area for the adherence of microorganisms. Microorganisms from water and patients combine in the DUWL and form a biofilm complex similar to dental plaque.

  8. Bacteria in Biofilms Bacteria in biofilmstend to be: -more difficult to culture (for waterline testing) -more resistant to control strategies(antibiotics and biocides) than when grown in the laboratory. Their resilience has been related to physiology and protection by the EPS slime matrix that they produce. Source: http://centerforgenomicsciences.org/research/biofilm.html

  9. Changes in Biofilm Bacteria • Become Chronic in Nature • Become Culture Negative • Poor Response to Antibiotics • Greater Potential for Metastasis Changes which occur in microorganisms incorporated in biofilms: http://www.genomenewsnetwork.com /articles/06_02/biofilms.shtml

  10. Sterilization Destroys Biofilms Because of the highly resistant effects of biofilm and its ability to leech endotoxinsand microorganismsinto dental watereven after disinfection, it iscritical to sterilize the entire pathwayto eliminate the risk of contamination during dental procedures.

  11. Disinfection is not Sterilization Disinfection: Destruction of pathogenic and other kinds of microorganisms by physical or chemical means. * Sterilization:Use of a physical or chemical procedure to destroyall microorganisms including substantial numbers of resistant bacterial spores. *Disinfection does not ensure the degree of safety associated with sterilization processes. Disinfection is less lethal than sterilization, because it destroys the majority of recognized pathogenic microorganisms, but not necessarily all microbial forms (e.g., bacterial spores). Source:CDC Guidelines for Infection Control in Dental Health-Care Settings -2003

  12. Universal Precautions Sincedisinfection does not =sterility, and dangerous pathogens have been found in DUWL’s, the moment thatbiofilm contaminated water enters thepatient’s mouth, universal precautions are compromised.

  13. Standard of Care Most state Dental Boardsconsider the 2003 CDC Guidelines for Infection Control in Dental Health Care Settings to be thestandard of care in their communities.

  14. Standard of Care What does that mean for Dental Unit Water compliance in your office?

  15. CDC Guidelines for Infection Control in DUWL’s “Exposingpatients or dental health care personnelto waterofuncertainmicrobiological quality, despitethe lack of documented adverse health effects, isinconsistentwithgenerally acceptedinfection control principles.”

  16. “Exposingpatients …” According to the CDC: you are exposing patients if you perform anyof the following procedures: • incision, excision, or reflection of tissue… • biopsy • periodontal surgery • apical surgery • implant surgery • surgical extractions of teeth requiring elevation of mucoperiosteal flap

  17. “…to water of uncertain microbiological quality …” According to the CDC: “Conventional dental units cannotreliably deliver sterile water… …because the water-bearing pathway cannot be reliably sterilized.”

  18. “… despitethe lack of documented adverse health effects, …” Since dentistry is typically performed in an outpatient setting, patients are not usually monitored for post-treatment illness. Although this makes it difficult to establish an epidemiologic association between infection and recent exposure to dental unit water, there are several notable exceptions.

  19. “… despitethe lack of documented adverse health effects, …” The death of a California dentist from legionellosis. “It is likely that aerosols from those dental units were the source of the fatal Legionella infection." Atlas RM, et al. Appl Environ Microbiol 1995;61:1208-13. Two patients with immunodeficiency infected with Pseudomonas aeruginosa after dental visit. “Identical strain of microorganism identified in the dental unit waterline." Martin MW. Br Dent J 1987;163:152-4. "58 (81.2%) out of 71 patients colonized with Pseudomonas aeruginosa identified in dental unit waterlines. “The microorganism could be identified in the patients 7 days after dental appointment." Martin MW. Br Dent J 1987;163:152-4.

  20. “… despitethe lack of documented adverse health effects, …” "The temporal onset of asthma may be associated with occupational exposure to contaminated dental unit waterlines”. “Most of the organisms isolated from dental unit waterlines are Gram-negative bacteria, which contain cell wall endotoxin. A consequence of endotoxin exposure is the exacerbation of asthma." Pankhurst, et al. Prim Dent Care. 2005 Apr;12(2):53-9. "Dentists had the highest prevalence of L. pneumophila antibodies, followed by assistants and technicians, when compared with a control group of non-medical workers, indicating that dental personnel are at an increased risk of legionella infection." Reinthaler FF, et al. J Dent Res. 1988 Jun;67(6):942-3.

  21. “… despitethe lack of documented adverse health effects, …” OSAP Agrees: “The present lack of epidemiologic evidence of illness or injury among patients or dental healthcare workers does not provide a valid rationale for inaction.”

  22. “… isinconsistentwithgenerally accepted infection control principles.” Generally accepted infection control principles are based on ensuring no cross contamination and on not introducing new pathogens as a result of the dental procedure. Oral microflora have been recovered from DUWL’s proving cross contamination is possible if not likely.

  23. CDC Recommendations 1. Use water that meets EPA standards. 2. Consult with manufacturer to maintain water quality. 3. Monitoring of water quality 4. Maintenance of the anti-retraction mechanism. 5. Boil water advisories. 6. Eliminate the risk of DHCP non-compliance with disinfectant and water line monitoring.

  24. What can you do? • How can you incorporate the recommendations of the CDC into your practice? • How can you protect your patients and staff from the dangerous contaminants found in DUWL’s? • How can you prevent costly malpractice litigation due to contamination from your practice?

  25. STERILE DELIVERY is possible if you choose an unconventional delivery system…

  26. AQUASEPT Sterile Delivery The AQUASEPT sterile delivery system can be retrofitted onto your existing unit to enable you to meet or exceed all of the CDC recommendations for water used in dental procedures.

  27. AQUASEPTCDC Recommendations 1. Use water that meets EPA standards. AQUASEPT lets you use whatever water you want from the sterilized bottle. 2. Consult with manufacturer to maintain water quality. AQUASEPT is sterile every time – no consultation needed. 3. Monitoring of water quality. AQUASEPT allows you to choose the quality of water you are putting in the sterile bottle.

  28. AQUASEPT CDC Recommendations 4. Maintenance of the anti-retraction mechanism. AQUASEPT eliminates reliance on this since the entire pathway is sterilized between each patient. 5. Boil water advisories. AQUASEPT prevents work stoppage, accidental patient exposures and contamination due to boil water advisories. 6. Virtually eliminates the risk of DHCP non-compliance with disinfectant and water line monitoring. AQUASEPT only requires proper sterilization technique- no messy flushing and dangerous chemicals and improper flushing technique.

  29. AQUASEPT DON’Tput your patients, staff, and practice at risk!

  30. AQUASEPT Choose AQUASEPT and operate with the peace of mind that sterile delivery brings!

  31. AQUASEPT Sterile Delivery It’s the right thing to do!!!

More Related