GULF DIAGNOSTIC CENTER

HOSPITAL

NURSING POLICY
TITLE: WATER LINES & WATER MONITORING IN
DENTAL UNIT
Department
: Medical Management
Section
: Infection Control
Distribution
: Hospital Wide

Policy No: MED-DEN-P0004/09

Issue Date : March 2009
Revision No.: 02
Revision Date : July 2012
Next Revision : July 2014
Page 1 of 5

WATER LINES & WATER MONITORING

IN DENTAL UNIT
APPROVAL SHEET
Prepared by:
Name

Signature

Date

Signature

Date

Signature

Date

Ms Amal Bint Mohammad

Infection Control Officer
Reviewed by:
Name
Dr.Hassan Al Mahdi
Infection Control Chair Person
Mr. Zuher Arawi
Quality Manager
Approved by:
Name
Dr Emad Yassin Al Rahmani
Medical Director
Mrs. Jamal Kaddoura
Hospital Director, Co-founder

DOCUMENT AMENDMENT RECORD SHEET

GULF DIAGNOSTIC CENTER

HOSPITAL
NURSING POLICY
TITLE: WATER LINES & WATER MONITORING IN
DENTAL UNIT
Department
: Medical Management
Section
: Infection Control
Distribution
: Hospital Wide

Date

Description of Change

Policy No: MED-DEN-P0004/09
Issue Date : March 2009
Revision No.: 02
Revision Date : July 2012
Next Revision : July 2014
Page 2 of 5

Page Effected

Revision
Number

GULF DIAGNOSTIC CENTER

HOSPITAL
NURSING POLICY
TITLE: WATER LINES & WATER MONITORING IN
DENTAL UNIT
Department
: Medical Management
Section
: Infection Control
Distribution
: Hospital Wide

Policy No: MED-DEN-P0004/09
Issue Date : March 2009
Revision No.: 02
Revision Date : July 2012
Next Revision : July 2014
Page 3 of 5

1. PURPOSE:
1.1. This manual consolidates recommendations for preventing and controlling infectious
diseases and managing personnel health and safety concerns related to infection control
in dental settings in order to maintain high quality of infection control standards at all
times.
2. TARGET AUDIENCE:
2.1. This is applies to all involved services of dental in the GDC Hospital and all clinical
staff should familiarize themselves with the policy.
3. RESPONSIBILITY:
3.1. It is the responsibility of each staff member of the dental services to deal and to ensure
that this policy, procedures, and guidelines are implemented and followed meticulously.
4. POLICY:
4.1. The key to minimize the spread of infection is to decrease opportunities for cross
contamination, especially in clinics room where direct care is given.
4.2. To be used in conjunction with GDC Hospital policies and procedures.
5. DENTAL UNIT WATERLINES, WATER QUALITY:
5.1. In most Dental practice settings water used for dental treatment comes from the
municipal water supply directly into the dental UNIT thin plastic, tubing carries water
from the dental unit to the high-speed hand-piece, air water syringe, , and subsequently
to the operating field in the patient mouth. The inside surface of this dental water lines
can become colonized with variety of microorganisms, including bacteria fungi and
protozoa that live inside a slim layer that protects and feeds them. This phenomenon,
called a bio-film allows micro-organisms to survive in the dental water lines, and raises
concerns about possible health effect of exposure to dental unit water.
5.2. Recommendations: Use water that meets standards for drinking water. Consult with the
dental unit manufacturer for appropriate methods and equipment to maintain the
recommended quality of dental water. Discharge water and air for a minimum of 20-30
seconds after each patient from any device connected to the dental water system that
enters the patient's mouth (e.g., hand pieces, ultrasonic scalers, air/water syringes).
6. WATER MONITORING:
6.1. Maintaining and monitoring water quality

GULF DIAGNOSTIC CENTER

HOSPITAL
NURSING POLICY
TITLE: WATER LINES & WATER MONITORING IN
DENTAL UNIT
Department
: Medical Management
Section
: Infection Control
Distribution
: Hospital Wide

6.2.
6.3.

6.4.

6.5.

6.6.

Policy No: MED-DEN-P0004/09
Issue Date : March 2009
Revision No.: 02
Revision Date : July 2012
Next Revision : July 2014
Page 4 of 5

6.1.1. Consult the Dental Manufacturing unit or other agencies for appropriate
methods and equipment to maintain the recommended quality of Dental Water
(< 500 Colony Forming Units)
6.1.2. Do not use Sodium hypochlorite to routinely clean dental water lines.
6.1.3. Monitor dental water quality using commercial self contained test kits or
commercial water testing laboratories.
If bacterial counts exceed 500 CFU/ml, re-evaluate the technique, re-treat the dental unit
water, and retest the dental unit immediately before the next scheduled treatment
interval. Continue to monitor until acceptable water quality is achieved.
Sterile Surgical irrigationsTo help guard against post-surgical infections use only sterile
water or sterile saline as a coolant/irrigate for surgical procedures that present an
increased opportunity for microorganisms to gain entry into the bloodstream, bone or
tissue under the skin.
Flushing waterlines
6.4.1. Flush through the waterlines at the beginning of the clinic day to reduce the
microbial load.
6.4.2. The recommendation is to discharge water and air for a minimum of 20-30
seconds through high /low speed hand pieces, after each patient.
6.4.3. This procedure is intended to physically flush out patient material that might
have entered the turbine, air or waterlines.
Waterline Sampling
6.5.1. Water samples will be collected randomly from the waterlines in clinics on a
quarterly basis.
6.5.2. Bacteriology and environmental flora analysis of water samples is carried out by
GDC Hospital.
6.5.3. Samples will be collected by an infection control member or their designee.
6.5.4. Print clearly details of clinic and clinic number on the label.
6.5.5. Remove lid of sterile container, run high speed hand piece with water on into
the container until approximately full.
6.5.6. Replace the lid on the container and place in the appropriate collection bag.
6.5.7. The recommendation by EPA is <500 CFU/ml
Water Supply Analysis
6.6.1. Water supply is tested every month for bacterial and chemical analysis.
6.6.2. Every two to three weeks water supply is tested for hardness, total dissolved
salts (TDS), alkalinity (pH), iron content and conductivity.

7. Single Use Items:

7.1. A single-use device, also called a disposable device, is designed to be used on one
patient and then discarded, not reprocessed for use on another patient (e.g., cleaned,
disinfected, or sterilized) Single-use devices in dentistry are usually not heat-tolerant
and cannot be reliably cleaned. Examples include syringe needles, prophylaxis cups and

GULF DIAGNOSTIC CENTER

HOSPITAL
NURSING POLICY
TITLE: WATER LINES & WATER MONITORING IN
DENTAL UNIT
Department
: Medical Management
Section
: Infection Control
Distribution
: Hospital Wide

Policy No: MED-DEN-P0004/09
Issue Date : March 2009
Revision No.: 02
Revision Date : July 2012
Next Revision : July 2014
Page 5 of 5

brushes, and plastic orthodontic brackets. Certain items (e.g. prophylaxis angles, saliva
ejectors, high-volume evacuator tips, and air/water syringe tips) are commonly available
in a disposable form and should be disposed of appropriately after each use. Single-use
devices and items (e.g., cotton rolls, gauze, and irrigating syringes) for use during oral
surgical procedures should be sterile at the time of use.
7.2. The whole organization follows the same policy, which includes Dental Services and all
the satellite facilities. Single use means the item/device is to be used on an individual
patient during a single procedure and then disposed of. Items designed for single use
must NOT be re-processed. Single use packaging may be labeled as follows:
(disposable, for single use only, do not re-use)
8. DENTAL HAND PIECES AND OTHER DEVICES ATTACHED TO AIR AND
WATERLINES:
8.1. Clean and heat-sterilize hand pieces and other intraoral instruments that can be removed
from the air and waterlines of dental units between patients.
8.2. Follow the manufacturer's instructions for cleaning, lubrication and sterilization of hand
pieces and other intraoral instruments that can be removed from the air and waterlines
of dental units.
8.3. Do not advise patients to close their lips tightly around the tip of the saliva ejector to
evacuate oral fluids.
8.4. Before removing the hand piece from the hose after treatment, with the bur still in the
chuck, briefly run the water/air system to flush water lines and airlines.
8.5. Remove the bur from the hand piece, wipe visible debris from the outer surfaces of the
hand piece, and disconnect the hand piece from the hose.
9. REFERENCES:
9.1. CDC Guidelines for Infection Control in Dental Health-Care Settings December 19,
2003
9.2. Disclaimer: The contents of Guidelines for Infection Control were gathered from CDC,
OSAP, ADA and OSHA. Care has been taken to confirm the accuracy of the
information present.
9.3. www.cdc.gov
9.4. www.osap.org
9.5. www.ada.org
9.6. www.osha.gov