Duwl Product Sheet & Protocol

A.B.N. 83 132 312 515 ORDERS: 1300 65 88 22 FAX ORDERS: 1300 65 88 10 TEETH ORDERS: 1300 65 88 11 www.henryschein.com.au

Dental Unit Waterline Product Sheet

Water Test Kit SCT-7MERHPCSAMP - Sampler HPC Test Water lines Pack of 25 ST-9MERHPCSAMP - Sampler HPC Test Water lines Pack of 5

Shock Treatment RD-3179 – Biofilm Removal System

Continuous Waterline Disinfection Chairs with water bottle RD-ALPRON – Alpron 1L Bottle Decontaminates the water

CR1-DP365B – Dentapure Straw for water bottle iodine

A.B.N. 83 132 312 515 ORDERS: 1300 65 88 22 FAX ORDERS: 1300 65 88 10 TEETH ORDERS: 1300 65 88 11 www.henryschein.com.au

Continuous Waterline Disinfection Chairs with which are plumbed CR1-DP365M – Dentapure Cartridge for plumbed chairs

Please remember as per the ADA Guidelines – waterlines must be flushed in the morning for 2 mins and 30 secs between patients.

Waterline testing is recommended every 3-5 months once stable.

1 initial shock treatment may not be enough to remove entirely the biofilm and may have to be carried out several times.

A.B.N. 83 132 312 515 ORDERS: 1300 65 88 22 FAX ORDERS: 1300 65 88 10 TEETH ORDERS: 1300 65 88 11 www.henryschein.com.au

Dental Unit Waterline Protocol

The Australian Dental Association "Guidelines for Infection Control" 3rd Edition 2015 states that water used in dental settings be tested to ensure microbial levels are within recommended limits.

The number of bacteria in water used as a coolant/irrigant for non-surgical dental procedures should be less than 500 CFU/mL, since this is a widely used international limit for safe drinking water. When treating immunocompromised patients, it is recommended that water from dental unit waterlines contain less than 200 CFU/mL.

4. Huntington M. K., Williams J. F. and Mackenzie C. D. Endotoxin contamination in the dental surgery. J Med Microbiol 56:1230-1234, 2007.

A.B.N. 83 132 312 515 ORDERS: 1300 65 88 22 FAX ORDERS: 1300 65 88 10 TEETH ORDERS: 1300 65 88 11 www.henryschein.com.au

Test Waterline Using a CFU count test – (refer to product sheet for suggested products) collect and analyse a water sample from the DUWL, follow the steps below:

1. Before collecting the sample, remove: the handpiece from the handpiece line; the syringe tip from the 3-way air/water syringe; and the insert from the ultrasonic scaler. Flush the lines for a minimum of two minutes prior to collection of sample.

2. Label the plastic case with the sample location (room) and date using a permanent marker 3. Remove the paddle from the case.

4. Collect a sample from each DUWL and fill to upper line on the container.

5. Replace the paddle firmly in the case with the water sample.

6. Lay the HPC Sampler horizontally with the filter-side down for 30 seconds.

7. Remove the paddle from the case and shake off the excess water.

8. Empty the plastic case completely and firmly replace the paddle in the case.

9. Incubate the HPC Sampler with the filter-side down at room temperature for seven days.

10. Examine the filter.

11. Count the colonies and record results.

A.B.N. 83 132 312 515 ORDERS: 1300 65 88 22 FAX ORDERS: 1300 65 88 10 TEETH ORDERS: 1300 65 88 11 www.henryschein.com.au

Compare Waterline Results

Using the CFU count check chart – check the result of your DUWL

Requirement is: Less than 200 CFU for immune compromised patients

Example of TNTC

A.B.N. 83 132 312 515 ORDERS: 1300 65 88 22 FAX ORDERS: 1300 65 88 10 TEETH ORDERS: 1300 65 88 11 www.henryschein.com.au

Shock Treatment If your reading comes back above 200CFU then you will need to perform a shock treatment to remove the biofilm before disinfecting the lines.

Refer to product sheet for suggested products.

Chair with water bottle = add biofilm remover solution to the bottle and follow manufacturers recommendations for hold time. Flush biofilm remover with fresh water. Follow next steps for continuous water disinfection.

Chairs that are plumbed = a technician will need to temporarily install a water pump and complete the shock treatment as this involves disconnecting mains water. Henry Schein service technicians are trained to do so and can carry this service out.

Before / After

A.B.N. 83 132 312 515 ORDERS: 1300 65 88 22 FAX ORDERS: 1300 65 88 10 TEETH ORDERS: 1300 65 88 11 www.henryschein.com.au

Continuous Disinfection Now that an initial shock treatment has been performed it is recommended to continuously disinfect the waterlines to reduce the amount of biofilm build up.

Chair with water bottle = bottle systems are easier to maintain and have several options for continuous disinfection. These typically come in the forms of fluid which a small amount is put in the bottle with the correct dilution ratio to water, a tablet form or an iodine straw form (refer to product sheet for more information).

Chairs that are plumbed = a technician can install an iodine cartridge to the chair water supply which will provide the dental unit with continuous small amounts of iodine to disinfect the lines when in use (refer to product sheet for more information).

As Per the Ada guidelines DUWLs must be flushed for 2 mins in the morning and 30 secs between patients.

A.B.N. 83 132 312 515 ORDERS: 1300 65 88 22 FAX ORDERS: 1300 65 88 10 TEETH ORDERS: 1300 65 88 11 www.henryschein.com.au

RE Testing of DUWLs It’s recommended to re test your waterlines every 3-5 months once your DUWLs are stable.

Every dental unit is different and it’s not guaranteed that an initial shock treatment is sufficient.

Factors to consider are: -

Age of dental unit How long the lines have been left stagnant for?

Water quality in local area Amount of existing biofilm Have the recommended ADA instrument flushing requirements been carried out daily?

In some cases you will need to complete multiple shock treatments if the dental unit is older and contains a high degree of biofilm before you achieve a stable waterline reading.

Test > Shock > Re Test