Journal of Dentistry
Volume 35, Issue 9 , Pages 701-711 , September 2007

The role of manufacturers in reducing biofilms in dental chair waterlines

  • D.C. Coleman

      Affiliations

    • Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental School & Hospital, University of Dublin, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland
    • Corresponding Author InformationCorresponding author. Tel.: +353 1 6127276; fax: +353 1 6127295.
  • ,
  • M.J. O’Donnell

      Affiliations

    • Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental School & Hospital, University of Dublin, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland
  • ,
  • A.C. Shore

      Affiliations

    • Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental School & Hospital, University of Dublin, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland
  • ,
  • J. Swan

      Affiliations

    • Buildings Department, Dublin Dental School & Hospital, Lincoln Place, Dublin 2, Ireland
  • ,
  • R.J. Russell

      Affiliations

    • Department of Microbiology, University of Dublin, Trinity College Dublin, Dublin 2, Ireland

Received 19 April 2007 ,Revised 3 May 2007 ,Accepted 8 May 2007.

References 

  1. Anonymous. Council Directive 93/42/EEC of 14 June 1993 concerning medical devices. Official Journal of the European Community 1993;L169:1–43.
  2. O’Donnell MJ, MacCarthy D, Coleman DC. Microbiology and cross-infection control. In:  Ireland R editors. Clinical textbook of dental hygiene and therapy. Oxford: Blackwell Munksgaard; 2006;p. 181–207
  3. Leggat PA, Kedjarune U. Bacterial aerosols in the dental clinic: a review. International Dental Journal. 2001;51:39–44
  4. Siegel SC, von Fraunhofer JA. The effect of handpiece spray patterns on cutting efficiency. Journal of the American Dental Association. 2002;133:184–188
  5. Harrel SK, Molinari J. Aerosols and splatter in dentistry: a brief review of the literature and infection control implications. Journal of the American Dental Association. 2004;135:429–437
  6. O’Donnell MJ, Tuttlebee CM, Falkiner FR, Coleman DC. Bacterial contamination of dental chair units in a modern dental hospital caused by leakage from suction system hoses containing extensive biofilm. The Journal of Hospital Infection. 2005;59:348–360
  7. O’Donnell MJ, Shore AC, Coleman DC. A novel automated waterline cleaning system that facilitates effective and consistent control of microbial biofilm contamination of dental chair unit waterlines: a one-year study. Journal of Dentistry. 2006;34:648–661
  8. O’Donnell MJ, Shore AC, Russell RJ, Coleman DC. Optimisation of the long-term efficacy of dental chair waterline disinfection by the identification and rectification of factors associated with waterline disinfection failure. Journal of Dentistry. 2007;35:438–451
  9. Stanley HR. Pulpal response to dental techniques and materials. Dental Clinics of North America. 1971;15:115–126
  10. Langeland K. Prevention of pulpal damage. Dental Clinics of North America. 1972;16:709–732
  11. Blake GC. The incidence and control of bacterial infection of dental units and ultrasonic scalers. British Dental Journal. 1963;115:413–416
  12. Abel LC, Miller RL, Micik RE, Ryge G. Studies on dental aerobiology. IV. Bacterial contamination of water delivered by dental units. Journal of Dental Research. 1971;50:1567–1569
  13. Martin MV. The significance of the bacterial contamination of dental unit water systems. British Dental Journal. 1987;163:152–154
  14. Mayo JA, Oertling KM, Andrieu SC. Bacterial biofilm: a source of contamination in dental air–water syringes. Clinical Preventive Dentistry. 1990;12:13–20
  15. Pankhurst CL, Philpott-Howard JN. The microbiological quality of water in dental chair units. The Journal of Hospital Infection. 1993;23:167–174
  16. Williams JF, Johnston AM, Johnson B, Huntington MK, Mackenzie CD. Microbial contamination of dental unit waterlines: prevalence, intensity and microbiological characteristics. Journal of the American Dental Association. 1993;124:59–65
  17. Pankhurst CL, Johnson NW, Woods RG. Microbial contamination of dental unit waterlines: the scientific argument. International Dental Journal. 1998;48:359–368
  18. Barbeau J, Tanguay R, Faucher E, et al. Multiparametric analysis of waterline contamination in dental units. Applied and Environmental Microbiology. 1996;62:3954–3959
  19. Meiller TF, Kelley JI, Bacqui AA, DePaola LG. Disinfection of dental unit waterlines with an oral antiseptic. The Journal of Clinical Dentistry. 2000;11:10–15
  20. Mills SE. The dental unit waterline controversy: defusing the myths, defining the solutions. Journal of the American Dental Association. 2000;131:1427–1441
  21. Walker JT, Bradshaw DJ, Bennett AM, Fulford MR, Martin MV, Marsh PD. Microbial biofilm formation and contamination of dental-unit water systems in general dental practice. Applied and Environmental Microbiology. 2000;66:3363–3367
  22. Tuttlebee CM, O’Donnell MJ, Keane CT, et al. Effective control of dental chair unit waterline biofilm and marked reduction of bacterial contamination of output water using two peroxide-based disinfectants. The Journal of Hospital Infection. 2002;52:192–205
  23. Davey ME, O’Toole GA. Microbial biofilms: from ecology to molecular genetics. Microbiology and Molecular Biology Reviews. 2000;64:847–867
  24. Watnick P, Kolter R. Biofilm, city of microbes. Journal of Bacteriology. 2000;182:2675–2679
  25. Kohn WG, Collins AS, Cleveland JL, Harte JA, Eklund KJ, Malvitz DM. Centers for disease control and prevention (CDC), guidelines for infection control in dental health-care settings—2003. Morbidity and Mortality Weekly Report. Recommendations and Reports. 2003;52:1–61
  26. Putnins EE, Di Giovanni D, Bhullar AS. Dental unit waterline contamination and its possible implications during periodontal surgery. Journal of Periodontology. 2001;72:393–400
  27. Fotos PG, Westfall HN, Snyder IS, Miller RW, Mutchler BM. Prevalence of Legionella-specific IgG and IgM antibody in a dental clinic population. Journal of Dental Research. 1985;64:1382–1385
  28. Reinthaler FF, Mascher F, Stunzner D. Serological examinations for antibodies against Legionella species in dental personnel. Journal of Dental Research. 1988;67:942–943
  29. Atlas RM, Williams JF, Huntington MK. Legionella contamination of dental-unit waters. Applied and Environmental Microbiology. 1995;61:1208–1213
  30. Pankhurst CL, Coulter W, Philpott-Howard JN, Surman-Lee S, Warburton F, Challacombe S. Evaluation of the potential risk of occupational asthma in dentists exposed to contaminated dental unit waterlines. Primary Dental Care. 2005;12:53–59
  31. Schulze-Robbecke R, Feldmann C, Fischeder R, Janning B, Exner M, Wahl G. Dental units: an environmental study of sources of potentially pathogenic mycobacteria. Tubercle and Lung Disease. 1995;76:318–323
  32. Anonymous. Council Directive 98/83/EC of 3 November 1998 on the quality of water intended for human consumption. Official Journal of the European Community 1998;L330:32–54.
  33. Anonymous. National primary drinking water standards. United States Environmental Protection Agency 2002; document number EPA 816-F-02-013.
  34. Anonymous. ADA statement on dental unit waterlines. Journal of the American Dental Association 1996;127:185–6.
  35. Walker JT, Marsh PD. A review of biofilms and their role in microbial contamination of dental unit water systems (DUWS). International Biodeterioration and Biodegradation. 2004;54:87–98
  36. United Kingdom Department for Environment, Food and Rural Affairs. Environmental protection (UK). Water Supply (Water Fittings) Regulations 1999 [online]; 2002. Available from: http://www.defra.gov.uk/environment/water/industry/wsregs99/ [Accessed April 17, 2007].
  37. Anonymous. Protection against pollution of potable water in water installations and general requirements of devices to prevent pollution by backflow. EN1717;2001:15/01/01.
  38. Montebugnoli L, Sambri V, Cavrini F, Marangoni A, Testarelli L, Dolci G. Detection of DNA from periodontal pathogenic bacteria in biofilm obtained from waterlines in dental units. The New Microbiologica. 2004;27:391–397
  39. Walker JT, Bradshaw DJ, Finney M, Fulford MR, Frandsen E, Østergaard E, et al. Microbiological evaluation of dental unit water systems in general dental practice in Europe. European Journal of Oral Science. 2004;112:412–418
  40. Berlutti F, Testarelli L, Vaia F, Luca MD, Dolci G. Efficacy of anti-retraction devices in preventing bacterial contamination of dental unit water lines. Journal of Dentistry. 2003;31:105–110
  41. Scheid RC, Kim CK, Bright JS, Whitley MS, Rosen S. Reduction of microbes in handpieces by flushing before use. Journal of the American Dental Association. 1982;105:658–660
  42. Furuhashi M, Miyamae T. Prevention of bacterial contamination of water in dental units. The Journal of Hospital Infection. 1985;6:81–88
  43. Pederson ED, Stone ME, Ragain JC, Simecek JW. Waterline biofilm and the dental treatment facility: a review. General Dentistry. 2002;50:190–195
  44. Walker JT, Bradshaw DJ, Fulford MR, Marsh PD. Microbiological evaluation of a range of disinfectant products to control mixed-species biofilm contamination in a laboratory model of a dental unit water system. Applied and Environmental Microbiology. 2003;69:3327–3332
  45. Karpay RI, Plamondon TJ, Mills SE, Dove SB. Combining periodic and continuous sodium hypochlorite treatment to control biofilms in dental unit water systems. Journal of the American Dental Association. 1999;130:957–965
  46. Smith AJ, Bagg J, Hood J. Use of chlorine dioxide to disinfect dental unit waterlines. The Journal of Hospital Infection. 2001;49:285–288
  47. Wirtilin MR, Marshall GW, Rowland EW. Formation and decontamination of biofilms in dental unit waterlines. Journal of Periodontology. 2003;74:1595–1609
  48. McDowell JW, Paulson DS, Mitchell JA. A simulated-use evaluation of a strategy for preventing biofilm formation in dental unit waterlines. Journal of the American Dental Association. 2004;135:799–805
  49. Kohno S, Kawata T, Kaku M, et al. Bactericidal effects of acidic electrolyzed water on the dental unit waterline. Japanese Journal of Infectious Diseases. 2004;57:52–54
  50. Porteous NB, Cooley RL. Reduction of bacterial levels in dental unit waterlines. Quintessence International. 2004;35:630–634
  51. Martin MV, Gallagher MA. An investigation of the efficacy of super-oxidised (optident/sterilox) water for the disinfection of dental unit water lines. British Dental Journal. 2005;198:353–354
  52. Schel AJ, Marsh PD, Bradshaw DJ, et al. Comparison of the efficacies of disinfectants to control microbial contamination in dental unit water systems in general dental practices across the European Union. Applied and Environmental Microbiology. 2006;72:1380–1387
  53. Szymanska J. Bacterial decontamination of DUWL biofilm using oxygenal 6. Annals of Agricultural and Environmental Medicine. 2006;13:163–167
  54. Spratt DA, Latif J, Montebugnoli LL, Wilson M. In vitro modeling of dental water line contamination and decontamination. FEMS Microbiology Letters. 2004;235:363–367
  55. Roberts HW, Karpay RI, Mills SE. Dental unit waterline antimicrobial agents’ effect on dentin bond strength. Journal of the American Dental Association. 2000;131:179–183
  56. Taylor-Hardy TL, Leonard RH, Mauriello SM, Swift EJ. Effect of dental unit waterline biocides on enamel bond strengths. General Dentistry. 2001;49:421–425
  57. Tuttlebee C. An investigation into biofilm-associated bacterial contamination of dental chair units and dental unit output water supplies and its control. PhD Thesis. University of Dublin, Trinity College Dublin, Ireland; 2004.
  58. Stone ME, Kuehne JC, Cohen ME, Talbott JL, Scott JW. Effect of iodine on mercury concentrations in dental-unit wastewater. Dental Materials. 2006;22:119–124
  59. Hammarback B, Mills S, Johnson R. Re: Stone et al.'s “Effect of iodine on mercury concentrations in dental-unit wastewater”. Dental Materials 2007; doi:10.1016/j.dental.2006.12.005.
  60. Roberts HW, Marek M, Kuehne JC, Ragain JC. Disinfectants’ effect on mercury release from amalgam. Journal of the American Dental Association. 2005;136:915–919
  61. Batchu H, Chou HN, Rakowski D, Fan PL. The effect of disinfectants and line cleaners on the release of mercury from amalgam. Journal of the American Dental Association. 2006;137:1419–1425
  62. Fan PL, Batchu H, Chou HN, Gasparac W, Sandrik J, Meyer DM. Laboratory evaluation of amalgam separators. Journal of the American Dental Association. 2002;133:577–584
  63. Anonymous. Council Directive 91/689/EEC of 12 December 1991 on Hazardous Waste. Official Journal of the European Community 2000;L226:3–25.
  64. Marais JT, Brozel VS. Electro-chemically activated water in dental unit water lines. British Dental Journal. 1999;187:154–158
  65. Bakhir VM, Zadorozhny Y, Leonov BI, Panicheva SA, Prilutsky VI. Electrochemical activation: water treatment and production of effective solutions. In: Proceeding of the third international symposium “electrochemical activation in medicine, agriculture and industry”. Moscow. 2001;p. 3–25
  66. Bakhir VM. Electrochemical activation; theory and practice. In: Proceedings of the first international symposium on electrochemical activation. Moscow. 1997;p. 38–45
  67. Archakov AI, Karuzina II. Oxidation of foreign compounds and toxicology problems. Bulletin of USSR Academy of Medical Sciences. 1988;1:14–28
  68. Wadowsky RM, Wolford R, McNamara AM, Yee RB. Effect of temperature, pH, and oxygen level on the multiplication of naturally occurring Legionella pneumophila in potable water. Applied and Environmental Microbiology. 1985;49:1197–1205
  69. Stampi S, Zanetti F, Bergamaschi A, De Luca G. Comamonas acidovorans contamination of dental unit waters. Letters in Applied Microbiology. 1999;29:52–55
  70. Volk CJ, LeChevallier MW. Impacts of the reduction of nutrient levels on bacterial water quality in distribution systems. Applied and Environmental Microbiology. 1999;65:4957–4966
  71. Flemming HC. Biofouling in water systems-cases, causes and countermeasures. Applied Microbiology and Biotechnology. 2002;59:629–640
  72. Kampf G, Dietze B, Grosse-Siestrup C, Wendt C, Martiny H. Microbicidal activity of a new silver-containing polymer, SPI-ARGENT II. Antimicrobial Agents and Chemotherapy. 1998;42:2440–2442
  73. Jones GL, Muller CT, O’Reilly M, Stickler DJ. Effect of triclosan on the development of bacterial biofilms by urinary tract pathogens on urinary catheters. Journal of Antimicrobial Chemotherapy. 2006;57:266–272
  74. Rogers J, Dowsett AB, Dennis PJ, Lee JV, Keevil CW. Influence of temperature and plumbing material selection on biofilm formation and growth of Legionella pneumophila in a model potable water system containing complex microbial flora. Applied and Environmental Microbiology. 1994;60:1585–1592
  75. Rogers J, Dowsett AB, Dennis PJ, Lee JV, Keevil CW. Influence of plumbing materials on biofilm formation and growth of Legionella pneumophila in potable water systems. Applied and Environmental Microbiology. 1994;60:1842–1851
  76. Yabune T, Imazato S, Ebisu S. Inhibitory effect of PVDF tubes on biofilm formation in dental unit waterlines. Dental Materials. 2005;21:780–786
  77. Sacchetti R, De Luca G, Zanetti F. Influence of material and tube size on DUWLs contamination in a pilot plant. The New Microbiologica. 2007;30:29–34

PII: S0300-5712(07)00095-4

doi: 10.1016/j.jdent.2007.05.003

Journal of Dentistry
Volume 35, Issue 9 , Pages 701-711 , September 2007