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Biofilms in dental unit waterlines (DUWL) are a potentially significant source of contamination posing a significant health risk as these may come into contact with patients and dental staff during treatment. The aim of this study was to evaluate the microbiological quality of DUWL water treated by Biofilm-Removing-System® (BRS®) and Alpron®/Bilpron® disinfectant solutions for six years in a French university hospital. The microbiological quality of water supplied by 68 dental units—initially shock treated with BRS®, then continuously treated by Alpron® with sterile water during working days and Bilpron® during inactivity period, and combined with purging every morning and after each patient—was assessed biannually during six years for total culturable aerobic bacteria at 22 °C and 36 °C, Legionella sp., Pseudomonas aeruginosa, and total coliforms. A total of 628 samples were analyzed, 99.8% were compliant with extended microbiological levels, and we never detected pathogen bacteria like Legionella sp. and P. aeruginosa. Only one sample (0.2%) was noncompliant with the level of total culturable aerobic bacteria at 36 °C, which exceeded 140 colony forming units per mL. The protocol implemented in our university hospital gives excellent results and enables control of the microbiological quality of DUWL water in the long term.

Water is essential during dental care. Physical and chemical techniques should be used to maintain a good water quality with respect to bacteria, and to ensure the safety of exposed patients and dental staff. The aim of this survey was to assess the modalities used by dental practitioners in Eastern France to maintain the water quality of their dental unit waterlines (DUWLs). A questionnaire about water quality maintenance practices was sent to 870 dental offices in 2016. The questionnaires were completed by 153 dental offices, covering about 223 dental care units. The majority of units were fed by mains water (91.0%), which is generally unfiltered (71.3%). One-third (33.6%) of the units had an independent water bottle reservoir. Flushing, a basic physical technique to improve the quality of units’ outflow water, was practiced in 65.4% of dental offices. Concerning the chemical treatment of water, it was used for 62.1% of the units. An analysis of the microbiological quality of the DUWL water was only carried out in 2.6% of the offices. In conclusion, providing better training to dental staff seems necessary to improve their practices and to generalize procedures that improve the microbiological quality of the water used.

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