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Written by

Amanda Hill

Posted On

January 9, 2020

Recently, dental unit waterline testing has become a frequent topic of conversation, both on social media and in print. As stories of illnesses due to contaminated dental waterlines are hitting the news cycle, this is something that dental offices need to make sure we are on top of. I don’t know about you, but I never learned about waterline testing in hygiene school, so this is certainly something I needed to get up to speed on and get our team on board!

Thankfully, there are lots of resources out there to help us be in compliance with infection control standards. OSAP and the CDC are great resources to find fact-based information. While social media is a great place to crowdsource opinions, this is not the place to get infection control information; there is way too much misinformation out there about waterline safety.

My waterline journey was a deep dive into some cool hard science. It was a great opportunity to geek out and relive that microbiology course I took back in college. I think it’s key to establish one person in the office that will be the point-person for this task. Make sure they think it’s fascinating or else the ball will get dropped and your and your patients’ safety will be compromised for sure. 

One Friday, after the office was done for the day, I spent an hour or so getting our office compliant. I started with a diluted bleach shock of all the waterlines in the office–and by all the lines, I mean ALL the lines, handpieces, air water syringes, ultrasonic scalers, any lines that have water in them—whether we use them or not, in each operatory. Then I used Quickpass in-office dental water test for each waterline to get a baseline. The instructions were simple and quick. I put the tabs away to incubate and count in a few days. When counting day came, I strapped in my loupes and got to counting. This was fun stuff. Some lines looked good. Others, not so much. For the questionable lines, another shock and a re-test was in order. Once everything was within standards we put Steri-straws in the self-contained water bottles and used Blu Tabs in the ultrasonic scaler.

The tough part was getting the team on board with compliance. Now that the lines were safe, it was key to keep them that way. Many offices are under the impression that once you put in the Steri-straw you are good to go. I wish it were that simple. It is critical to dry the lines each night and flush the lines each morning and in between patients, or else that biofilm is going to build right back up. Trust me, I know what I’m talking about. At the quarterly spot check, I discovered one room was failing again. An after-hours inspection showed someone in the office wasn’t fully on board with the nightly purging of the lines. So another re-shock of the lines and full testing of that unit happened right away, along with some delicate retraining of the staff to help them understand that this wasn’t just silly busywork–that this was directly impacting the health and safety of our office.

While this might seem like another thing to do in an already overloaded schedule, this is indeed important. Not only to be compliant with the CDC but for your safety. The aerosols from the handpieces and ultrasonic scalers travel up to eight feet through the air. We are inhaling this stuff all day long. Even with proper PPE, some bacterial aerosols can linger around your operatory for hours. The most common reason for dental professionals to miss work is a respiratory infection. We need to protect our patients and ourselves.

The takeaway here is shock, test, treat and retest, it’s that simple. There are some great online resources, checklists, and YouTube videos to help you. This task does not need to be as daunting as it may appear. Change is rarely easy or convenient. But overwhelmingly, we in the dental world have got to get on board, not only to be within the law, but to preserve our, and anyone that enters our office, health and wellness.

Amanda HIll
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Amanda Hill

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Amanda Hill, RDH, BS has been in the dental industry for over 30 years, she earned her B.S. in Dental Hygiene at Old Dominion University in Norfolk, Virginia and has had the opportunity to experience dentistry around the world.   Amanda  has a love for learning and is obsessed with continuing education in all its many forms.  Amanda practices part time clinically and is an industry educator for the nation’s largest dental job board, DentalPost.net.  Amanda is a proud Navy spouse and mom of 3.


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