Reducing bacterial counts in dental unit waterlines: tap water versus distilled water. 2002

James D Kettering, and Joni A Stephens, and Carlos A Muñoz-Viveros, and W Patrick Naylor
Department of Biochemistry and Microbiology at Loma Linda University Schools of Medicine, USA. jkettering@som.llu.edu

BACKGROUND The maximum recommended level of microbial contamination of water from dental unit waterlines (DUWL) is 200 colony-forming units per milliliter (CFU/mL). This article addresses the importance of water selection in achieving that standard. METHODS Microbial contamination in water samples from 75 new dental units, with a closed-circuit water system, were compared using combinations of tap water and sterile distilled water with and without two chemical disinfectants (bleach and 0.12% chlorhexidine gluconate, Bio2000) over a six-week period. Baseline tap water samples were collected and tested initially. RESULTS The microbial plate counts of seven tap water specimens (controls) ranged from 4 to 95 CFU/mL. These results were well below both the 500 CFU/mL standard for public drinking water and the 200 CFU/mL goal for dental treatment water. However, when passed through dental units, no significant bacterial reduction was achieved for samples of tap water (Group 1), tap water treated with bleach (Group 2), or tap water treated with Bio2000 (Group 4). Only water samples from dental units using Bio2000 alone (Group 3) or a combination of sterile, distilled water with Bio2000 (Group 5) met or exceeded the 200 CFU/mL standard. CONCLUSIONS Using tap water alone or tap water with bleach did not improve water quality. However, the American Dental Association (ADA) standard for reduced microbial contamination of dental unit waterlines was met using Bio2000 and distilled water treated with Bio2000. CONCLUSIONS The ADA standard of 200 CFU/mL was achieved using a closed water system and distilled water treated with Bio2000. Using 100% Bio2000 is also effective, but more costly.

UI MeSH Term Description Entries
D008452 Maximum Allowable Concentration The maximum exposure to a biologically active physical or chemical agent that is allowed during an 8-hour period (a workday) in a population of workers, or during a 24-hour period in the general population, which does not appear to cause appreciable harm, whether immediate or delayed for any period, in the target population. (From Lewis Dictionary of Toxicology, 1st ed) Maximum Permissible Exposure Level,MPEL,Maximum Permissible Exposure Concentration,Allowable Concentration, Maximum,Allowable Concentrations, Maximum,Concentration, Maximum Allowable,Concentrations, Maximum Allowable,MPELs,Maximum Allowable Concentrations
D002140 California State bounded on the east by Nevada and Arizona, on the south by Mexico and the Pacific Ocean on the south and west, and on the north by Oregon.
D002710 Chlorhexidine A disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque. Chlorhexidine Acetate,Chlorhexidine Hydrochloride,MK-412A,Novalsan,Sebidin A,Tubulicid,Acetate, Chlorhexidine,Hydrochloride, Chlorhexidine,MK 412A,MK412A
D003748 Dental Equipment The nonexpendable items used by the dentist or dental staff in the performance of professional duties. (From Boucher's Clinical Dental Terminology, 4th ed, p106) Equipment, Dental,Dental Equipments,Equipments, Dental
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000704 Analysis of Variance A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. ANOVA,Analysis, Variance,Variance Analysis,Analyses, Variance,Variance Analyses
D000900 Anti-Bacterial Agents Substances that inhibit the growth or reproduction of BACTERIA. Anti-Bacterial Agent,Anti-Bacterial Compound,Anti-Mycobacterial Agent,Antibacterial Agent,Antibiotics,Antimycobacterial Agent,Bacteriocidal Agent,Bacteriocide,Anti-Bacterial Compounds,Anti-Mycobacterial Agents,Antibacterial Agents,Antibiotic,Antimycobacterial Agents,Bacteriocidal Agents,Bacteriocides,Agent, Anti-Bacterial,Agent, Anti-Mycobacterial,Agent, Antibacterial,Agent, Antimycobacterial,Agent, Bacteriocidal,Agents, Anti-Bacterial,Agents, Anti-Mycobacterial,Agents, Antibacterial,Agents, Antimycobacterial,Agents, Bacteriocidal,Anti Bacterial Agent,Anti Bacterial Agents,Anti Bacterial Compound,Anti Bacterial Compounds,Anti Mycobacterial Agent,Anti Mycobacterial Agents,Compound, Anti-Bacterial,Compounds, Anti-Bacterial
D012973 Sodium Hypochlorite It is used as an oxidizing and bleaching agent and as a disinfectant. (From Grant & Hackh's Chemical Dictionary, 5th ed) Antiformin,Clorox,Sodium Hypochlorite (Solution),Hypochlorite, Sodium
D014871 Water Microbiology The presence of bacteria, viruses, and fungi in water. This term is not restricted to pathogenic organisms. Microbiology, Water

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