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Int. J. Environ. Res. Public Health 2014, 11(2), 2064-2076; doi:10.3390/ijerph110202064

Effect of Different Disinfection Protocols on Microbial and Biofilm Contamination of Dental Unit Waterlines in Community Dental Practices

1
Unit of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, via S. Giacomo 12, Bologna 40126, Italy
2
Unit of Hygiene and Quality of Residencial Services, Bologna Local Health Authority, Bellaria Hospital, via Altura 3, Bologna 40139, Italy
3
Department of Specialized, Experimental, and Diagnostic Medicine, University of Bologna, via Massarenti 9, Bologna 40138, Italy
4
Bologna Provincial Division, Agency for Environmental Protection and Health Prevention in Emilia-Romagna, via Triachini 17, Bologna 40138, Italy
*
Author to whom correspondence should be addressed.
Received: 6 November 2013 / Revised: 20 January 2014 / Accepted: 28 January 2014 / Published: 18 February 2014
(This article belongs to the Special Issue IJERPH: 10th Anniversary)
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Abstract

Output water from dental unit waterlines (DUWLs) may be a potential source of infection for both dental healthcare staff and patients. This study compared the efficacy of different disinfection methods with regard to the water quality and the presence of biofilm in DUWLs. Five dental units operating in a public dental health care setting were selected. The control dental unit had no disinfection system; two were disinfected intermittently with peracetic acid/hydrogen peroxide 0.26% and two underwent continuous disinfection with hydrogen peroxide/silver ions (0.02%) and stabilized chlorine dioxide (0.22%), respectively. After three months of applying the disinfection protocols, continuous disinfection systems were more effective than intermittent systems in reducing the microbial contamination of the water, allowing compliance with the CDC guidelines and the European Council regulatory thresholds for drinking water. P. aeruginosa, Legionella spp, sulphite-reducing Clostridium spores, S. aureus and β-haemolytic streptococci were also absent from units treated with continuous disinfection. The biofilm covering the DUWLs was more extensive, thicker and more friable in the intermittent disinfection dental units than in those with continuous disinfection. Overall, the findings showed that the products used for continuous disinfection of dental unit waterlines showed statistically better results than the intermittent treatment products under the study conditions. View Full-Text
Keywords: dental unit waterlines; water disinfection; biofilm; peracetic acid; hydrogen peroxide; chlorine dioxide dental unit waterlines; water disinfection; biofilm; peracetic acid; hydrogen peroxide; chlorine dioxide
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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MDPI and ACS Style

Dallolio, L.; Scuderi, A.; Rini, M.S.; Valente, S.; Farruggia, P.; Sabattini, M.A.B.; Pasquinelli, G.; Acacci, A.; Roncarati, G.; Leoni, E. Effect of Different Disinfection Protocols on Microbial and Biofilm Contamination of Dental Unit Waterlines in Community Dental Practices. Int. J. Environ. Res. Public Health 2014, 11, 2064-2076.

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