Regardless of whether dental operatories are plumbed directly to municipal water supply lines or utilize independent bottle systems—and regardless of the presence or absence of any water filtration system that might be installed—the following protocols and guidelines should be observed at all times for dental waterline maintenance:
- Flush all water-bearing lines at the beginning of each work day thoroughly with water for a minimum of two (2) minutes. This should include all handpiece, syringe and quick-disconnect lines with handpieces and tips removed.
- Discharge air and waterlines for a minimum of 20 seconds after each patient, as recommended by the CDC and Canadian guidelines.
- Do not use waterline heaters, as they serve to increase the growth rate of any microorganisms that might be present in the lines tremendously.
- Never use water from a standard dental delivery system during surgical procedures. Instead, use sterile water or saline delivered by sterile means, such as autoclavable bulb syringes, or autoclavable or disposable sterile tubing.
- Spot-check water quality throughout the operatory environment at least quarterly by submitting water samples to a laboratory for HPC testing, or by using an in-office testing product, to ensure compliance with water-quality standards recommended by the CDC and ADA.
Further, if using any type of water filtration system—whether plumbed directly to the dental delivery unit or for filling dental bottles—it’s important to follow maintenance procedures and change the filters at appropriate intervals, as specified by the manufacturer.
Finally, we highly recommend the use of some type of EPA-registered antimicrobial agent in the waterlines to reduce microbial contamination further. This stronger “shock” protocol should be performed according to the manufacturer's recommendations, and should involve first “purging” the waterlines with air before refilling with antimicrobial cleaning solution, and then rinsing thoroughly prior to patient care.
Because even the ideal-quality input water can quickly become contaminated in dental delivery systems, there is no one-step “magic bullet” for controlling microbiological contamination in dental unit waterlines. Following regular flushing protocols and routine maintenance procedures is absolutely critical.
Want to become a dental-water expert?
Water quality affects nearly every function of modern dental offices. Our (free!) eBook, The Book on Dental Water, is designed to help you understand how using the right water can help to improve patient care, staff productivity and practice profitability, while also protecting the investments you’ve made in the equipment and appliances in your office.