by Patti DiGangi, RDH, BS
In the time of the COVID-19 crisis, our patients will need even more assurance when they come back to see us that everything is safe. Though they may not realize the risk contaminated waterlines can create, we know and it is our duty to keep them safe. When we are protecting our patients, we are protecting ourselves and our businesses.
Is COVID-19 Growing in the Lines?
Dental unit waterlines (DUWLs) are used daily in dental practices. The importance of proper infection control to maintain the safety of both patients and healthcare professionals is apparent because DUWLs is a breeding ground for infection-causing biofilm.
The microorganisms that colonize in DUWLs can include bacteria, fungi, and protozoans, including Legionella, Pseudomonas aeruginosa, Candida albicans, and nontuberculous mycobacteria (NTM), and can increase in number to cause illness and infection. We must assume they contain COVID-19.
The CDC and the EPA regulatory standards call for < 500 CFU/ml of heterotrophic bacteria in DUWL. Heterotrophs are a group of microorganisms like yeast, molds & bacteria that use organic carbon as food as opposed to autotrophs like algae that use sunlight and are found in every type of water. Research shows microbial counts can reach 400,000 CFU/ml within 5 days after the installation of a new DUWL. That is 400x the recommended level. We know that COVID-19 grows quickly and is readily spread.
Keeping Lines Safe
Although flushing DUWLs was once recognized as an efficient way to control the microbial presence and decrease the planktonic bacteria in water, there are other strategies to control the presence of biofilm. Inside the tubing, water flows in a laminar fashion, meaning in parallel layers with no disruption in those layers. As a result, biofilm adheres to the sides of the narrow dental water line tubing and remains relatively stagnant, allowing continued growth. Biofilm can multiply rapidly and grow in an established, well-protected shell without treatment, so healthcare professionals must use effective methods to maintain water lines for the safety of themselves and their patients.
The product you choose must be an effective biofilm disruptor with rapid kill times. At the same time, it needs to be gentle on equipment and have no effect on restorative materials. Time is money so it needs to be time-efficient as well as sustainable with no harsh chemicals or leave a residue.
This means we must be picky when selecting products. For example, Monarch Lines Cleaner is a powerful formula that helps attack accumulated deposits in tubing lines without the use of harsh or aggressive chemicals.
Protecting Our Patients and Protecting Ourselves
Not only will patients have concerns coming back into the office; so will healthcare providers. With the COVID-19 Crisis, we have seen the importance of personal protective equipment (PPE). Every professional will be taking infection protection seriously more so in the future. We must take care of ourselves in order to take care of others.
Though waterlines may not have been subject to discussion with patients in the past, it can and should be. You can assure your patients you are doing everything possible to keep them safe.