Dental Unit Water Lines and their Disinfection and Management: A Review.

The perceived threat to public health from dental unit water line (DUWL) contamination comes from opportunistic and respiratory pathogens such as Legionella spp, Nontuberculous Mycobacteria (NTM) and pseudomonads. These organisms can grow and multiply in the DUWL biofilm to reach infective concentrations, with the potential for inhalation leading to respiratory infections or direct contamination of surgical wounds. In this paper we discuss current legislation and practical methods for delivering water within the DUWL that meets the standards for safety.

Candidiasis (oropharyngeal).

Introduction: Candida is a fungus present in the mouths of up to 60% of healthy people, but overt infection is associated with immunosuppression, diabetes, broad-spectrum antibiotics, and corticosteroid use. In most people, untreated candidiasis persists for months or years unless associated risk factors are treated or eliminated. In neonates, spontaneous cure of oropharyngeal candidiasis usually occurs after 3 to 8 weeks.

Candidiasis (oropharyngeal).

Introduction: Candida is a fungus present in the mouths of up to 60% of healthy people, but overt infection is associated with immunosuppression, diabetes, broad-spectrum antibiotics, and corticosteroid use. In most people, untreated candidiasis persists for months or years unless associated risk factors are treated or eliminated. In neonates, spontaneous cure of oropharyngeal candidiasis usually occurs after 3 to 8 weeks.

Candidiasis (oropharyngeal).

Introduction: Candida is present in the mouths of up to 60% of healthy people, but overt infection is associated with immunosuppression, diabetes, broad-spectrum antibiotics, and corticosteroid use. In most people, untreated candidiasis persists for months or years unless associated risk factors are treated or eliminated. In neonates, spontaneous cure of oropharyngeal candidiasis usually occurs after 3-8 weeks.

Do contaminated dental unit waterlines pose a risk of infection?

Objectives: To review the evidence that the dental unit waterlines are a source of occupational and healthcare acquired infection in the dental surgery.

Data: Transmission of infection from contaminated dental unit waterlines (DUWL) is by aerosol droplet inhalation or rarely imbibing or wound contamination in susceptible individuals. Most of the organisms isolated from DUWL are of low pathogenicity.

Testing relationships between clinical and non-clinical variables in xerostomia: a structural equation model of oral health-related quality of life.

Objectives: The aim of the study was to systematically test Wilson and Cleary's [Wilson IB, Cleary PD. JAMA 1995; 273: 59-65] conceptual model of the direct and mediated pathways between clinical and non-clinical variables in relation to the oral health-related quality of life (OHRQoL) of patients with xerostomia.

Methods: We collected measures of clinical variables, self-reported symptoms, OHRQoL, global oral health perceptions and subjective well-being from 85 patients attending outpatient clinics.

Utility of two oral health-related quality-of-life measures in patients with xerostomia.

Objectives: The study compared the validity of the short form of the Oral Health Impact Profile (OHIP) and Oral Impacts on Daily Performance (OIDP) as measures of oral health-related quality of life in patients with xerostomia in the UK.

Methods: A cross-sectional comparison of OHIP14 and OIDP with measures of clinical indicators, xerostomia symptom status, speech function, global oral health ratings and psychological well-being, in 85 patients attending outpatient clinics.

Results: Both OHIP14 and OIDP had excellent internal reliability, and good criterion and construct validity when used in this population of xerostomia patients.

The effect of infection-control barriers on the light intensity of light-cure units and depth of cure of composite.

Aim: Dental curing lights are vulnerable to contamination with oral fluids during routine intra-oral use. This controlled study aimed to evaluate whether or not disposable transparent barriers placed over the light-guide tip would affect light output intensity or the subsequent depth of cure of a composite restoration.

Methods: The impact on light intensity emitted from high-, medium- and low-output light-cure units in the presence of two commercially available disposable infection-control barriers was evaluated against a no-barrier control.

Evaluation of the potential risk of occupational asthma in dentists exposed to contaminated dental unit waterlines.

Introduction: Most of the organisms isolated from dental unit waterlines (DUWL) are Gram-negative bacteria, which contain cell wall endotoxin. A consequence of endotoxin exposure is the exacerbation of asthma.

Objectives: This study examined the prevalence and onset of asthma among dentists and determined whether or not these were associated with the microbiological quality of DUWL in their practices.

Randomized-controlled trial: effect of a reservoir biteguard on quality of life in xerostomia.

Background: To assess the effect of a reservoir biteguard for artificial saliva on the oral health-related quality of life of patients with xerostomia.

Methods: Double-blind randomized placebo-controlled trial among 86 adults with xerostomia. Study group received the trial biteguard.

Vulnerability and presenting symptoms in burning mouth syndrome.

Objectives: To investigate if burning mouth syndrome (BMS) patients have differing health perceptions, medication, and life experiences compared with controls and to examine the role of vulnerability factors and differentiate them from the presenting symptomology in patients with BMS.

Study Design: A nonprobability convenience sample of patients presenting with BMS and age- and sex-matched controls were recruited from Queen's University, Belfast, King's College London, and Baylor College of Dentistry, Dallas. Participants completed a questionnaire to assess 9 aspects of their medical and social history, including early and past life experiences.

Risk assessment of dental unit waterline contamination.

Biofilms form rapidly on dental unit waterlines. The majority of the organisms in the biofilm are harmless environmental species, but some dental units may harbour opportunistic respiratory pathogens. This paper describes a risk assessment approach to analysing the hazard from biofilm organisms contaminating dental unit waterlines on the respiratory health of both the dental team and patients.

Management of dental unit water lines.

Dental unit water lines harbour considerable amounts of bacteria, derived from the biofilm on their inner surfaces, and the continuous reservoir of bacteria carries the potential to infect patients and dental workers alike. This article reviews the different methods of control and provides recent recommendations for ensuring that water of satisfactory quality is delivered to the patient.