Start-up advice for Dental Practices

Whilst water systems may not seem to be high on the priority list during the COVID-19 pandemic it is important for the health and safety of patients and staff, that water systems within dental practices, including Dental Unit Water Lines (DUWL) and associated equipment are managed safely.

Where dental water lines have been shut down for several weeks there may be considerable biofilm formation. You may need to consider replacing the DUWL tubing as it is accepted that it is difficult to achieve effective disinfection. Whilst some manufacturers suggest that their disinfectants can be stored within DUWL systems for a fixed time period to manage biofilm, the shutdown period may be for a considerably longer time period than these products are designed to be effective for and the internal equipment components can tolerate.

DUWL should not be put back into use until the results show they are safe to use. Where in-line filters are present, these will also require replacement or treatment using a cleaning solution as recommended by the manufacturer and this step should be performed after the first DUWL flush. Ensure that any other disposable filters are changed as per manufacturer’s instructions. As part of the recommissioning process, dental equipment requiring backflow protection should have the anti-retraction valves (incorporated on handpieces or waterlines) checked by the RP or service engineer. They should ensure they have been suitably decontaminated, are refitted correctly and operating correctly.

Examples of dental equipment requiring backflow protection are:

• ultrasonic scalers;

• three-in-one syringes;

• dental spittoons;

• wet-line suction apparatus; and

• self-filling automatic radiographic processors (where still used).

Please ensure all documentation is kept for inspection including reviews of risk assessments (these can be annotated by hand) revised management plans, validation and monitoring data, with evidence of who carried out the monitoring, add time date and signature.

Dental Chair, Spittoon and Cup Filling Services Ensure thorough flushing of each dental unit and consider (if dental chair and spittoon are connected to domestic water services with appropriate air gap) disinfection as recommended by the manufacturer’s instructions.

Reverse Osmosis Systems Reverse osmosis systems and associated pipework can also become colonized when not used even for short periods of time. Always check with the manufacturer operator’s manual for appropriate storage and disinfection regimes and follow instructions. Ensure samples are taken before re-instating the system to validate the disinfection process.

Remember, if we can be of any assistance with returning your buildings to service by carrying out system disinfections, sampling, and/or water quality checks please don’t hesitate to contact us.

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