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http://dx.doi.org/10.17135/jdhs.2015.15.4.383

The Microbial Contamination and Effective Control Method of Dental Unit Water System  

Yoon, Hye Young (Department of Oral Microbiology, College of Dentistry, Research Institute of Oral Science, Gangneung-Wonju National University)
Lee, Si Young (Department of Oral Microbiology, College of Dentistry, Research Institute of Oral Science, Gangneung-Wonju National University)
Publication Information
Journal of dental hygiene science / v.15, no.4, 2015 , pp. 383-392 More about this Journal
Abstract
Dental chair unit (DCU) is the most essential equipment for the dental treatment in dentistry. DCU output water is used for various applications during dental treatment. DCU output water must be clean at the same level as drinking water since patients and dental staff are regularly exposed to water and aerosols generated from the DCU. Many studies demonstrated that DCU output water is frequently contaminated with microorganisms including opportunistic pathogen such as Legionella and Pseudomonas species. Thus, DCU output water may be a potential source of infection. In order to reduce microbial contamination levels in DCU output water, periodic management and continuous disinfection are necessary. Currently, there are a variety of disinfection methods for managing DCU output water and its efficacy is also diverse. We reviewed the level of microbial contamination, clinical implications of contaminated DCU output water and the various DCU disinfection methods.
Keywords
Biofilms; Dental infection control; Disinfection; Water microbiology; Water quality;
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1 Walker JT, Bradshaw DJ, Finney M, et al.: Microbiological evaluation of dental unit water systems in general dental practice in europe. Eur J Oral Sci 112: 412-418, 2004.   DOI
2 Karpay RI, Plamondon TJ, Mills SE: Comparison of methods to enumerate bacteria in dental unit water lines. Curr Microbiol 38: 132-134, 1999.   DOI
3 Uzel A, Cogulu D, Oncag O: Microbiological evaluation and antibiotic susceptibility of dental unit water systems in general dental practice. Int J Dent Hyg 6: 43-47, 2008.   DOI
4 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. Appl Environ Microbiol 66: 3363-3367, 2000.   DOI
5 Barbeau J, Tanguay R, Faucher E, et al.: Multiparametric analysis of waterline contamination in dental units. Appl Environ Microbiol 62: 3954-3959, 1996.
6 Lee BM, Kim CW, Kim YS: A study on the microbial contamination of dental unit and ultrasonic scaler. J Korean Acad Prosthodont 36: 64-80, 1998.
7 Yoon HY, Lee SY: Bacterial contamination of dental unit water systems in a student clinical simulation laboratory of college of dentistry. J Dent Hyg Sci 2: 232-237, 2015.
8 Ma'ayeh SY, Al-Hiyasat AS, Hindiyeh MY, Khader YS: Legionella pneumophila contamination of a dental unit water line system in a dental teaching centre. Int J Dent Hyg 6: 48-55, 2008.   DOI
9 Al-Hiyasat AS, Ma'ayeh SY, Hindiyeh MY, Khader YS: The presence of Pseudomonas aeruginosa in the dental unit waterline systems of teaching clinics. Int J Dent Hyg 5: 36-44, 2007.   DOI
10 Fotos PG, Westfall HN, Snyder IS, Miller RW, Mutchler BM: Prevalence of legionella-specific IgG and IgM antibody in a dental clinic population. J Dent Res 64: 1382-1385, 1985.   DOI
11 Porteous NB, Redding SW, Jorgensen JH: Isolation of non-tuberculosis mycobacteria in treated dental unit waterlines. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98: 40-44, 2004.   DOI
12 American Dental Association Council on Scientific Affairs: Dental unit waterlines: approaching the year 2000. ADA Council on Scientific Affairs. J Am Dent Assoc 130: 1653-1664, 1999.
13 Kumar S, Atray D, Paiwal D, Balasubramanyam G, Duraiswamy P, Kulkarni S: Dental unit waterlines: Source of contamination and cross-infection. J Hosp Infect 74: 99-111, 2010.   DOI
14 Yabune T, Imazato S, Ebisu S: Assessment of inhibitory effects of fluoride-coated tubes on biofilm formation by using the in vitro dental unit waterline biofilm model. Appl Environ Microbiol 74: 5958-5964, 2008.   DOI
15 Williams JF, Johnston AM, Johnson B, Huntington MK, Mackenzie CD: Microbial contamination of dental unit waterlines: Prevalence, intensity and microbiological characteristics. J Am Dent Assoc 124: 59-65, 1993.
16 Szymanska J: Evaluation of mycological contamination of dental unit waterlines. Ann Agric Environ Med 12: 153-155, 2005.
17 Meiller TF, Depaola LG, Kelley JI, Baqui AA, Turng BF, Falkler WA: Dental unit waterlines: biofilms, disinfection and recurrence. J Am Dent Assoc 130: 65-72, 1999.   DOI
18 Szymanska J, Sitkowska J, Dutkiewicz J: Microbial contamination of dental unit waterlines. Ann Agric Environ Med 15: 173-179, 2008.
19 Chao Y, Mao Y, Wang Z, Zhang T: Diversity and functions of bacterial community in drinking water biofilms revealed by high-throughput sequencing. Sci Rep 5: 10044, 2015.   DOI
20 Gomez-Alvarez V, Revetta RP, Santo Domingo JW: Metagenomic analyses of drinking water receiving different disinfection treatments. Appl Environ Microbiol 78: 6095-6102, 2012.   DOI
21 Schmeisser C, Stockigt C, Raasch C, et al.: Metagenome survey of biofilms in drinking-water networks. Appl Environ Microbiol 69: 7298-7309, 2003.   DOI
22 Szymanska J: Biofilm and dental unit waterlines. Ann Agric Environ Med 10: 151-157, 2003.
23 Tall BD, Williams HN, George KS, Gray RT, Walch M: Bacterial succession within a biofilm in water supply lines of dental air-water syringes. Can J Microbiol 41: 647-654, 1995.   DOI
24 Davey ME, O'toole GA: Microbial biofilms: From ecology to molecular genetics. Microbiol Mol Biol Rev 64: 847-867, 2000.   DOI
25 Coleman DC, O'Donnell MJ, Shore AC, Russell RJ: Biofilm problems in dental unit water systems and its practical control. J Appl Microbiol 106: 1424-1437, 2009.   DOI
26 Rabin N, Zheng Y, Opoku-Temeng C, Du Y, Bonsu E, Sintim HO: Biofilm formation mechanisms and targets for developing antibiofilm agents. Future Med Chem 7: 493-512, 2015.   DOI
27 Peters E, McGaw WT: Dental unit water contamination. J Can Dent Assoc 62: 492-495, 1996.
28 Walker JT, Marsh PD: Microbial biofilm formation in DUWS and their control using disinfectants. J Dent 35: 721-730, 2007.   DOI
29 Cobb CM, Martel CR, McKnight SA 3rd, Pasley-Mowry C, Ferguson BL, Williams K: How does time-dependent dental unit waterline flushing affect planktonic bacteria levels? J Dent Educ 66: 549-555, 2002.
30 Williams HN, Baer ML, Kelley JI: Contribution of biofilm bacteria to the contamination of the dental unit water supply. J Am Dent Assoc 126: 1255-1260, 1995.   DOI
31 O'Donnell MJ, Boyle MA, Russell RJ, Coleman DC: Management of dental unit waterline biofilms in the 21st century. Future Microbiol 6: 1209-1226, 2011.   DOI
32 Pankhurst CL, Johnson NW, Woods RG: Microbial contamination of dental unit waterlines: the scientific argument. Int Dent J 48: 359-368, 1998.   DOI
33 Whitehouse RL, Peters E, Lizotte J, Lilge C: Influence of biofilms on microbial contamination in dental unit water. J Dent 19: 290-295, 1991.   DOI
34 Williams JF, Molinari JA, Andrews N: Microbial contamination of dental unit waterlines: origins and characteristics. Compend Contin Educ Dent 17: 538-540, 542, 1996.
35 Lewis DL, Arens M, Appleton SS, et al.: Cross-contamination potential with dental equipment see comments. Lancet 340: 1252-1254, 1992.   DOI
36 Dutil S, Veillette M, Meriaux A, Lazure L, Barbeau J, Duchaine C: Aerosolization of mycobacteria and legionellae during dental treatment: low exposure despite dental unit contamination. Environ Microbiol 9: 2836-2843, 2007.   DOI
37 Yabune T, Imazato S, Ebisu S: Inhibitory effect of PVDF tubes on biofilm formation in dental unit waterlines. Dent Mater 21: 780-786, 2005.   DOI
38 Ryan MP, Adley CC: Sphingomonas paucimobilis: a persistent gram-negative nosocomial infectious organism. J Hosp Infect 75: 153-157, 2010.   DOI
39 Choi HJ, Kim MH, Cho MS, et al.: Improved PCR for identification of Pseudomonas aeruginosa. Appl Microbiol Biotechnol 97: 3643-3651, 2013.   DOI
40 Fernandez M, Dreyer Z, Hockenberry-Eaton M, Baker CJ: Methylobacterium mesophilica as a cause of persistent bacteremia in a child with lymphoma. Pediatr Infect Dis J 16: 1007-1008, 1997.   DOI
41 Rafiee M, Jahangiri-Rad M, Hajjaran H, Mesdaghinia A, Hajaghazadeh M: Detection and identification of legionella species in hospital water supplies through polymerase chain reaction (16S rRNA). J Environ Health Sci Eng 12: 83-336X-12-83. eCollection 2014, 2014.   DOI
42 Ghotaslou R, Yeganeh Sefidan F, Akhi MT, Soroush MH, Hejazi MS: Detection of legionella contamination in tabriz hospitals by PCR assay. Adv Pharm Bull 3: 131-134, 2013.
43 Briancesco R, Semproni M, Della Libera S, Sdanganelli M, Bonadonna L: Non-tuberculous mycobacteria and microbial populations in drinking water distribution systems. Ann Ist Super Sanita 46: 254-258, 2010.
44 Schulze-Robbecke R, Feldmann C, Fischeder R, Janning B, Exner M, Wahl G: Dental units: an environmental study of sources of potentially pathogenic mycobacteria. Tuber Lung Dis 76: 318-323, 1995.   DOI
45 Martin MV: The significance of the bacterial contamination of dental unit water systems. Br Dent J 163: 152-154, 1987.   DOI
46 Atlas RM, Williams JF, Huntington MK: Legionella contamination of dental-unit waters. Appl Environ Microbiol 61: 1208-1213, 1995.
47 Oppenheim BA, Sefton AM, Gill ON, et al.: Widespread Legionella pneumophila contamination of dental stations in a dental school without apparent human infection. Epidemiol Infect 99: 159-166, 1987.   DOI
48 Santiago JI, Huntington MK, Johnston AM, Quinn RS, Williams JF: Microbial contamination of dental unit waterlines: short- and long-term effects of flushing. Gen Dent 42: 528-535, 1994.
49 Kohn WG, Harte JA, Malvitz DM, et al.: Guidelines for infection control in dental health care settings-2003. J Am Dent Assoc 135: 33-47, 2004.   DOI   ScienceOn
50 Council directive 98/83/EC of 3 november 1998 on the quality of water intended for human consumption. Off J Eur Community L330: 32-54, 1998.
51 Mayo JA, Oertling KM, Andrieu SC: Bacterial biofilm: a source of contamination in dental air-water syringes. Clin Prev Dent 12: 13-20, 1990.
52 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. Appl Environ Microbiol 69: 3327-3332, 2003.   DOI
53 Karpay RI, Plamondon TJ, Mills SE, Dove SB: Combining periodic and continuous sodium hypochlorite treatment to control biofilms in dental unit water systems. J Am Dent Assoc 130: 957-965, 1999.   DOI
54 Kettering JD, Munoz-Viveros CA, Stephens JA, Naylor WP, Zhang W: Reducing bacterial counts in dental unit waterlines: Distilled water vs. antimicrobial agents. J Calif Dent Assoc 30: 735-741, 2002.
55 Kim PJ, Cederberg RA, Puttaiah R: A pilot study of 2 methods for control of dental unit biofilms. Quintessence Int 31: 41-48, 2000.
56 Liaqat I, Sabri AN: Effect of biocides on biofilm bacteria from dental unit water lines. Curr Microbiol 56: 619-624, 2008.   DOI
57 Wirthlin MR, Marshall GW Jr: Evaluation of ultrasonic scaling unit waterline contamination after use of chlorine dioxide mouthrinse lavage. J Periodontol 72: 401-410, 2001.   DOI
58 Lin SM, Svoboda KK, Giletto A, Seibert J, Puttaiah R: Effects of hydrogen peroxide on dental unit biofilms and treatment water contamination. Eur J Dent 5: 47-59, 2011.
59 Linger JB, Molinari JA, Forbes WC, Farthing CF, Winget WJ: Evaluation of a hydrogen peroxide disinfectant for dental unit waterlines. J Am Dent Assoc 132: 1287-1291, 2001.   DOI
60 Smith AJ, Bagg J, Hood J: Use of chlorine dioxide to disinfect dental unit waterlines. J Hosp Infect 49: 285-288, 2001.   DOI
61 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. Appl Environ Microbiol 72: 1380-1387, 2006.   DOI
62 Meiller TF, Kelley JI, Baqui AA, DePaola LG: Disinfection of dental unit waterlines with an oral antiseptic. J Clin Dent 11: 11-15, 2000.
63 Shahriari S, Mohammadi Z, Mokhtari MM, Yousefi R: Effect of hydrogen peroxide on the antibacterial substantivity of chlorhexidine. Int J Dent 2010: 946384, 2010.
64 Roberts HW, Karpay RI, Mills SE: Dental unit waterline antimicrobial agents' effect on dentin bond strength. J Am Dent Assoc 131: 179-183, 2000.   DOI
65 Taylor-Hardy TL, Leonard RH Jr, Mauriello SM, Swift EJ Jr: Effect of dental unit waterline biocides on enamel bond strengths. Gen Dent 49: 421-425, 2001.
66 Porteous N, Sun Y, Dang S, Schoolfield J: A comparison of 2 laboratory methods to test dental unit waterline water quality. Diagn Microbiol Infect Dis 77: 206-208, 2013.   DOI
67 Murthy BS, Manjula K, George JV, Shruthi N: Evaluation of effect of three different dental unit waterline antimicrobials on the shear bond strength to dentin-an ex vivo study. J Conserv Dent 15: 289-292, 2012.   DOI
68 Reasoner DJ: Heterotrophic plate count methodology in the united states. Int J Food Microbiol 92: 307-315, 2004.   DOI
69 Rice EW, Baird RB, Eaton AD, Clesceri LS: Standard methods for the examination of water and wastewater. 22nd. American Public Health Association, Washington, D.C., 2012.
70 Bartoloni JA, Porteous NB, Zarzabal LA: Measuring the validity of two in-office water test kits. J Am Dent Assoc 137: 363-371, 2006.   DOI
71 Jackson RW, Osborne K, Barnes G, et al.: Multiregional evaluation of the SimPlate heterotrophic plate count method compared to the standard plate count agar pour plate method in water. Appl Environ Microbiol 66: 453-454, 2000.   DOI