Efficacy of 0.12% chlorhexidine gluconate on periodic disinfections of dental unit waterlines
DOI:
https://doi.org/10.14456/jmu.2023.3Keywords:
dental unit waterlines, microorganisms, chlorhexidine gluconateAbstract
The water flowing into a dental unit waterline (DUWL) system has a small amount of microorganisms while that forced intraorally a large one. The latter may put both patients and dental personnel at risk of some infections. Objective: To study an efficacy and an optimal usage frequency of 0.12% chlorhexidine gluconate (CHX) solution in periodic disinfections for reducing DUWL microbial contamination. Materials and Methods: Three dental units designated as Units A, B, and C, respectively, with their own water-container were used for two weeks. On a weekly basis, DUWLs of Units A and B underwent a 5- (method 1) and a 1- (method 2) day disinfection, respectively, overnight with 0.12% CHX. Unit C was left undisinfected control. Water samples were collected within 2 weeks. The filtered water of Siriraj Hospital, which is the water source of dental units was collected one sample per week. Before disinfection of DUWL, 3 samples of water from each dental unit (A, B, C) were collected for use as the baseline samples. After disinfection of DUWL, water from each unit A and B were collected 1 sample per day, 5 days a week for use as the test samples. For unit C, water were collected 1 sample per day, 5 days a week for use as the control samples. Total of 35 water samples were examined for total aerobic microbial count and type of microorganisms according to drinking water standards.
Results: When compared to that determined by American Dental Association (200 cfu/ml), water samples from all dental units in each week contained more microorganisms. When compared to those of controls, a significantly lower amount of microorganisms was disclosed in only that obtained from Unit A at Week 1 post-disinfection (P = 0.034), with non-significant differences in microbial amount among other samples during the experimental period.
Conclusions: Within the limitations of this in vitro study, the use of 0.12% CHX solution in DUWL periodic disinfections was unable to reduce microbial contamination to the international standard. Hence, it was suggested that 0.12% CHX solution should be used as frequently over five days a week as possible for maximal efficacy of DUWL disinfections.
References
ADA Council on Scientific Affairs [CSA]. (1999). Dental unit waterlines: approaching the year 2000. Journal of the American Dental Association, 130(11), 1653–1664.
Ajami, B., Ghazvini, K., Movahhed, T., Ariaee, N., Shakeri, MT., & Makarem, S. (2012). Contamination of a dental unit water line system by legionella pneumophila in the Mashhad School of Dentistry in 2009. Iranian Red Crescent Medical Journal, 14(6), 376–378.
Atlas, RM., Williams, JF., & Huntington, MK. (1995). Legionella contamination of dental-unit waters. Applied and Environmental Microbiology, 61(4), 208–1213. https://doi.org/10.1128/aem.61.4.1208-1213.1995
Blake, GC. (1963). The incidence and control of bacterial infection of dental spray reservoirs. British Dental Journal, 115(10), 413–416.
Donlan, RM. (2002). Biofilms: microbial life on surfaces. Emerging Infectious Diseases, 8(9), 881–890.https://doi.org/10.3201/eid0809.020063
Donlan, RM., & Costerton, JW. (2002). Biofilms: survival mechanisms of clinically relevant microorganisms.Clinical Microbiology Reviews, 15(2), 167–193.https://doi.org/10.1128/CMR.15.2.167-193.2002
Harper, NJN., Cook, TM., Garcez, T., Farmer, L., Floss, K., Marinho, S., Torevell, H., Warner, A., Ferguson, K., Hitchman, J., Egner, W., Kemp, H., Thomas, M., Lucas, DN., Nasser, S., Karanam, S., Kong, KL., Farooque, S., Bellamy, M., & McGuire, N. (2018). Anaesthesia, surgery, and life-threatening allergic reactions: epidemiology and clinical features of perioperative anaphylaxis in the 6th National Audit Project (NAP6).British Journal of Anaesthesia, 121(1), 159–171.https://doi.org/10.1016/j.bja.2018.04.014
Karpay, RI., Plamondon, TJ., Mills, SE., & Dove, SB.(1999).Combining periodic and continuous sodium hypochlorite treatment to control biofilms in dental unit water systems. Journal of the American Dental Association, 130(7), 957–965. https://doi.org/10.14219/jada.archive.1999.0336
Martin, MV. (1987). The significance of the bacterial contamination of dental unit water systems. British Dental Journal, 163(5), 152–154. https://doi.org/10.1038/sj.bdj.4806220
Mills, SE.(2000).The dental unit waterline controversy: defusing the myths, defining the solutions. Journal of the American Dental Association, 131(10), 1427–1441.https://doi.org/10.14219/jada.archive.2000.0054
Morrison, AJ. Jr., & Shulman, JA.(1986). Community-acquired bloodstream infection caused by Pseudomonas paucimobilis: case report and review of the literature. Journal of Clinical Microbiology, 24(5), 853–855. https://doi.org/10.1128/jcm.24.5.853-855.1986
Noopan, S., Unchui, P., Techotinnakorn, S., & Ampornaramveth, RS.(2019).Plasma sterilization effectively reduces bacterial contamination in dental unit waterlines. International Journal of Dentistry, 2019(4), 1–6. https://doi.org/10.1155/2019/5720204
Pankhurst, CL. (2003). Risk assessment of dental unit waterline contamination. Primary Dental Care, 10(1), 5–10. https://doi.org/10.1308/135576103322504030
Porteous, NB. & Cooley, RL. (2004). Reduction of bacterial levels in dental unit waterlines. Quintessence International, 35(8), 630–634.
Schiff, J., Suter, LS., Gourley, RD., & Sutliff, WD. (1961). Flavobacterium infection as a cause of bacterial endocarditis. Report of a case, bacteriologic studies, and review of the literature. Annals of Internal Medicine, 55(3), 499–506. https://doi.org/10.7326/0003-4819-55-3-499
Singh, V., Nagaraja, C., & Hungund, SA. (2013). A study of different modes of disinfection and their effect on bacterial load in dental unit waterlines.European Journal of General Dentistry, 2(3), 246–251. https://doi.org/10.4103/2278-9626.115999
Szymańska, J., Sitkowaska, J., & Dutkiewicz, J. (2008). Microbial contamination of dental unit waterlines.Annals of Agricultural and Environmental Medicine, 15(2), 173–179.
Walker, JT., Bradshaw, DJ., Finney, M., Fulford, MR., Frandsen, E., ØStergaard, E., ten Cate, JM., Moorer, WR., Schel, AJ., Mavridou, A., Kamma, JJ., Mandilara, G., Stösser, L., Kneist, S., Araujo, R., Contreras, N., Goroncy-Bermes, P., O’Mullane, D., Burke, F., . . . Marsh, PD. (2004). Microbiological evaluation of dental unit water systems in general dental practice in Europe. European Journal of Oral Sciences, 112(5), 412–418. https://doi.org/10.1111/j.1600-0722.2004.00151.x
Zhang, W., Onyango, O., Lin, Z., Lee, SS., & Li, Y. (2007). Evaluation of Sterilox for controlling microbial biofilm contamination of dental water.Compendium of Continuing Education in Dentistry, 28(11), 586–588, 590–592.
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ผู้ประพันธ์ต้องเปิดเผยเป็นลายลักษณ์อักษร (ระบุในรายงาน)ถึงทุกปัจจัยรวมทั้งปัจจัยด้านการเงินที่อาจมีอิทธิผลต่อ การศึกษาผลการศึกษาหรือข้อสรุปจากรายงานการศึกษาวิจัย และจำเป็นต้องระบุหากได้รับการสนับสนุนทางการเงินจาก แหล่งทุนภายนอกเพื่อให้สอดคล้องกับคำประกาศของบรรณาธิการ ผู้ร่วมประพันธ์ทุกท่านต้องมีส่วนร่วมในผลงานการศึกษาวิจัย และควรมีการระบุไว้อย่างชัดเจนในหนังสือปะหน้าประกอบการส่งเรื่องที่จะตีพิมพ์ รวมทั้งระบุไว้ในส่วนของกิตติกรรมประกาศ (acknowledgements) ในตอนท้ายของรายงานต้นฉบับ
