For all non-surgical dental treatment output water, dental health care personnel should use water that meets environmental protection agency regulatory standards for drinking water (i.e., ≤500 colony forming units (CFU)/mL of heterotrophic water bacteria).2 Consult with the dental unit manufacturer for appropriate methods and equipment to maintain the quality of dental water. Commercial devices and procedures designed for this purpose include:
- Self-contained water systems (e.g., independent water reservoir) combined with chemical treatment (e.g., periodic or continuous chemical germicide treatment protocols).
- Systems designed for single-chair or entire-practice waterlines that condition or treat incoming water to remove or inactivate microorganisms.
- Combinations of these methods.
Available products to treat waterlines include tablet systems, continuous release straws and cartridges, initial and periodic shock treatments, and centralized systems. All products and systems must be used and maintained according to the manufacturer instructions for use (IFUs). If you have questions about the IFUs, contact the manufacturer of the treatment product or device that you are using.
For surgical procedures, sterile saline or sterile water should be used as a coolant/irrigant. Conventional dental units cannot reliably deliver sterile water even when equipped with independent water reservoirs containing low-microbial or sterile water because the water-bearing pathway cannot be reliably sterilized. Appropriate delivery devices (e.g., bulb syringe; sterile, single-use disposable products; or sterile water delivery systems that bypass the dental unit by using sterile single-use disposable or sterilizable tubing) should be used to deliver sterile water during surgery.
For all non-surgical pulpal and endodontic procedures, clinicians can also consider using sterile irrigants or antimicrobial solutions.3-6