PROTECTING YOUR PRACTICE - Are Your Dental Water Lines Hurting Your Patients

The Problem

I know this topic isn't our favorite.  Many would say it is downright boring.  However, when it comes to protecting your practice, it is one of the most important hidden dangers that hides within your dental water lines. 

I give many OSHA / HIPAA classes to dental offices that are required to have this training yearly.  While some like to use that time as their daily nap, I like to take them on a "field trip" into their own operatories.  We go over how water travels either from a bottle that is filled up by a dental team member or from the floor brought in by the city.  That water travels through tubings that are very small and transported all the way through until it comes out in an air/water syringe or handpiece.  

A picture of the insides of a dental unit that show how small the dental unit waterlines can be. 

When water travels through those lines and the dental teams wrap up their day and head home, water is typically left inside those dark lines.  Moisture and the absence of light are perfect opportunities for CFU's (colony forming units) or biofilm to build. 

Sometimes Biofilm can be seen.  Other times, it hides within your water lines and can come out into a patients mouth without you noticing. 

I try to save this image after the dental team has eaten lunch during our OSHA training.  However, it is a stark reminder that we have a responsibility to protect our dental practice.  There are some harsh realities that can develop if we don't.  Here is one case where water lines have caused growths in children.  These cases are growing because the dental teams across the country just don't know the dangers associated with water lines.  They think that using distilled water protects them.  They think that if they put a tablet in the bottle, that protects them.  Unfortunately, it doesn't.   Here is an example of what biofilm can do. 

Actual patient that obtained a growth from a dental office as a result of their waterlines. 

The Solution

Now that we have identified the problem, let's start protecting your practice.  There is a 3 step solution that I recommend to all offices.  Some offices skip step 1 and go straight to steps 2 and 3.   Either they don't want to know or just want to get straight to the ultimate fix. 

Step 1:  Know Your Numbers

Have your dental water lines tested.  Tests have gotten quicker and less expensive.  They measure your CFU counts.  I have had many dentists test their water just to make sure I wasn't making this stuff up.  Many were shocked at the hidden danger lurking inside their office. 

Let me know if you would like to test your waterlines. There are products now that can test the lines within 30 minutes to see if we need to get to the next step.

Step 2: Shock Your Systems

I highly suggest shocking your system once you decide that you need to do something about the biofilm issue.  It helps get all of the biofilm out all at once before your patient consumes it.   It involves running the product through your lines at the end of the day until you see the color change.  The solution will need to sit in the lines overnight.  The next morning before you see patients, the solution will need to be flushed all the way through until it is completely clear.  This process gets out all of the biofilm that is currently in your dental water lines.  Warning - It's not a pleasant sight when the biofilm comes out.  Also, this solution CAN NOT sit over the weekend.  It can be damaging to the waterlines if left over the weekend. 

Liquid Ultra is a product that I recommend that can handle the problem quickly. 

Step 3: Maintain Your Water Lines

You have a couple options here.  However, I completely recommend an option that is much easier and more effective.  I recommend a product called Blutube.  Blutube is a straw (if you have a self-contained system) or a filter (if you are hooked up to city water) that your water travels through before it goes through your water lines.  

This shows how the straw fits onto your self contained system. 

The great thing about this product is once it is in place, your dental team doesn't have to touch it for a year.  The product works "behind the scenes" protecting your dental water lines from biofilm.  Once you do the initial shock, there is no need to shock throughout the year.   Blutube is a 2 straw system which is replaced every 6 months. It’s actually the same price as the 1 straw system. The reason why I like the 2 straw system is because studies show that the efficacy of the straw over time goes way down over the course of a year.  

 An alternative method to the straws and the one that most everyone knows is to put a tablet into your water bottle.  The problem with that method is many.  One, your dental team has to remember to put a tablet in the bottle every time they fill it up.  Two, you are supposed to shock the system every month when using a tablet to maintain.  That gets very tedious because it requires your dental team participation after you see patients and before you see patients the next morning.   In fact, I haven't met one office that actually shocks every month when using a tablet.  They really don't shock at all.  So, in essence, they are doing something that doesn't really help since they are not shocking.  Money and time, as well as not reaching the intended goal, are efforts wasted. 

You may start hearing more nationally about this specific issue.  There have been a number of incidents pop up where patients have been affected by dental water lines.  Many of the dentists weren't aware of the problem until it became one.  My goal is to make you aware that you possibly have a problem lurking in your office.  The first step that you can take is educating yourself about your own practice and get a water test to truly know your own numbers.  Those numbers can lead to protecting and having a thriving practice.  If left ignored, it can also potentially lead to the demise of it.  

I have worked with Atlanta Dental Supply for over 23 years.  I write a series of blogs that help protect dental practices in order to prevent lawsuits and build thriving dental practices. 

I may be reached at jacobsigmon@atlantadental.com