Managing dental unit waterlines: a quality improvement programme

Area of Science:

• Microbiology
• Infectious Diseases
• Dental Public Health

Background:

• Dental unit waterlines (DUWLs) harbor bacterial biofilms, posing infection risks, especially to immunocompromised patients.
• High bacterial counts were identified in DUWLs at Aga Khan University Hospital, necessitating intervention.
• Effective management of DUWLs is a persistent concern for dental and medical professionals.

Purpose of the Study:

• To implement and assess a pragmatic approach for improving water quality in contaminated DUWLs.
• To evaluate the efficacy of daily flushing and chemical disinfection in reducing bacterial load in DUWLs.
• To ensure compliance with established water quality guidelines.

Main Methods:

• Formation of a committee to address DUWL contamination.
• Baseline water sampling from two dental units in July 2020.
• Implementation of daily flushing and 'shock treatment' with A-dec ICX capsules.
• Post-intervention water sampling from 16 dental units across multiple dates (August 2020, November 2020, April 2021).

Main Results:

• Significant reduction in bacterial counts across all assessed dental units post-intervention.
• Achieved compliance with Centers for Disease Control guidelines for water quality.
• Observed minimal bacterial counts in all units, with a slight decrease in pH noted in the final testing round.

Conclusions:

• Chemical disinfection using A-dec ICX tablets combined with daily flushing is an effective strategy for reducing bacterial load in DUWLs.
• The implemented approach successfully improved water quality in the hospital's dental units.
• DUWLs present a microbial risk to patients and dental healthcare professionals (DHCPs), highlighting the importance of regular disinfection protocols.