VIII. Dental Unit Waterlines, Biofilm, and Water Quality
A. General Recommendations
1. Use water that meets EPA regulatory standards for drinking water (i.e., <500 CFU/mL of heterotrophic water bacteria) for routine dental treatment output water (IB, IC).
2. Consult with the dental unit manufacturer for appropriate methods and equipment to maintain the recommended quality of dental water (II).
3. Follow recommendations for monitoring water quality provided by the manufacturer of the unit or waterline treatment product (II).
4. Discharge water and air for a minimum of 20–30 seconds after each patient, from any device connected to the dental water system that enters the patient’s mouth (e.g., handpieces, ultrasonic scalers, and air/water syringes) (II).
5. Consult with the dental unit manufacturer on the need for periodic maintenance of antiretraction mechanisms (IB).
B. Boil-Water Advisories
1. The following apply while a boil-water advisory is in effect:
a. Do not deliver water from the public water system to the patient through the dental operative unit, ultrasonic scaler, or other dental equipment that uses the public water system (IB, IC).
b. Do not use water from the public water system for dental treatment, patient rinsing, or handwashing (IB, IC).
c. For handwashing, use antimicrobial-containing products that do not require water for use (e.g., alcohol-based hand rubs). If hands are visibly contaminated, use bottled water, if available, and soap for handwashing or an antiseptic towelette (IB, IC).
2. The following apply when the boil-water advisory is cancelled:
a. Follow guidance given by the local water utility regarding adequate flushing of waterlines. If no guidance is provided, flush dental waterlines and faucets for 1–5 minutes before using for patient care (IC).
b. Disinfect dental waterlines as recommended by the dental unit manufacturer (II).
