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Background. Severe contamination of dental unit waterlines was found in healthcare settings. The benefits of decontamination methods are controversial. The aim of this review was to systematically evaluate disinfection methods in contamination control of dental unit waterlines. Methods. The terms ‘dental unit waterline(s) or DUWL(s) or dental unit water line(s)’ were searched through PubMed, Cochrane Library, Embase, Web of Science and Scopusup to 31 May 2021. The DUWLs’ output water was incubated on R2A agar at 20–28 °C for 5–7 days to evaluate heterotrophic mesophilic bacteria. The risk of bias was evaluated by a modified Newcastle-Ottawa quality assessment scale. Results. Eighteen papers from the literature were included. One study indicated that water supply played a crucial role in disinfecting DUWLs. Three studies indicated that flushing decreased bacteria counts but did not meet the American CDC standard (500 c.f.u. ml−1). All chlorine- and peroxide-containing disinfectants except sodium hypochlorite in one of 15 studies as well as three mouthrinses and citrus botanical extract achieved the standard (≤500 c.f.u. ml−1). The included studies were of low (1/18), moderate (6/18) and high (11/18) quality. Conclusion. Independent water reservoirs are recommended for disinfecting DUWLs using distilled water. Flushing DUWLs should be combined with disinfections. Nearly all the chlorine-, chlorhexidine- and peroxide-containing disinfectants, mouthrinses and citrus botanical extract meet the standard for disinfecting DUWLs. Alkaline peroxide would lead to tube blockage in the DUWLs. Regularly changing disinfectants can reduce the risk of occurrence of disinfectant-resistant strains of microbes.

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Objectives To evaluate the effectiveness of a prevention strategy against the spread of SARS-CoV-2 infection among dental hospital staff over a 3-month period. Materials and methods The effectiveness of the prevention strategy, which adopted healthcare staff protective measures, including patient triage and correct usage of personal preventive equipment, was evaluated by SARS-CoV-2 detection and serological testing. Patients who visited the Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China, between January 31 and March 1 (lockdown period) and March 2 and April 27 (reopening period) in 2020 and in the same period in 2019 were included in the study. Patients’ diagnosis, age, gender, and several undergoing aerosol-generating procedures during the study period were collected from the hospital’s database. Corresponding data were compared year-on-year (2020-on-2019). A total of 757 hospital staff underwent SARS-CoV-2 detection and serological testing on April 28–29, 2020. Results During the lockdown and reopening period in 2020, the number of hospital visits was dramatically decreased to about 6% and 58%, respectively, compared with the same period in 2019. However, emergency visits were increased 16- and 6.4-fold. A total of at least 6654 patients (13.58%) underwent aerosol-generating procedures during the study period in the year 2020. All hospital staff were negative according to SARS-CoV-2 detection and serological testing (IgG, IgM) data. Conclusion During the study period in 2020, the total number of hospital visits dramatically reduced but emergency visits significantly increased. The prevention strategy implemented successfully prevented SARS-CoV-2 infection spread among healthcare workers in a dental hospital. Clinical relevance The prevention strategy indicated patient triage and how to adopt preventive measures for controlling SARS-CoV-2 spread among healthcare workers. These data can be used as a reference for other sectors suffering from the COVID-19 pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-03886-9.

The contamination of dental unit waterlines (DUWLs) is a major health concern since it can pose cross-infection risks among dental professionals and their patients. Silver is one of the widely used metals in medical fields due to its superior antimicrobial properties. Silver-based agents have been commercially available for the decontamination of dental unit water currently. This systematic review aims to examine the evidence supporting efficacy and safety of application of silver to decontaminate DUWLs. We performed a search of the peer-review literature of studies in six electronic databases using corresponding search terms. Eligibility was restricted to English-language studies exploring the application of silver to decontaminate dental unit water, e.g., silver-based disinfectants and silver-coated dental waterlines tubing. The search identified 148 articles, and 9 articles that met the criteria were synthesized with qualitative narrative analyses. We observed good evidence of antimicrobial efficacy of silver with hydrogen peroxide on diverse microorganism present in DUWLs. Furthermore, there is insufficient evidence on the application of silver nanoparticles (AgNPs) as an efficient material to control the biofilms in DUWLs. Post-treatment data of either the bactericidal and bacteriostatic effects of silver or AgNPs, especially the actual clinical efficacy of long-term application, are scarce. More high-quality research is needed to resolve the gap on the optimal dosage and treatment options required to control bacterial and biofilm in DUWLs with silver-containing materials.

Background. Emergency gingival uncontrollable bleeding after nonsurgical periodontal therapy (NSPT) could be caused by a variety of factors; local oral factors are the main cause of gingival bleeding in most patients. Because the doctor will do a good job of evaluating the patient’s physical condition before nonsurgical periodontal therapy. This study is subjected to evaluate the possible factors associated with emergency uncontrollable bleeding within 24-48 hours after NSPT. Material and Methods. A total of fifty-eight patients with emergency bleeding after NSPT in the past four years were enrolled. The related factors in patients, such as age, gender, clotting function, systemic diseases, and baseline periodontitis severity, were analyzed. The site-related factors, such as tooth type, tooth distribution, and alveolar bone resorption at the bleeding site, were compared. The possible relationship of the parameters to the causes of emergency bleeding with NSPT was also evaluated. Results. Gingival bleeding after NSPT was registered. In this retrospective study, a total of 58 patients were selected. There were 29 males and 29 females, aged from 20 to 67 years old, with an average age of 35.21 ± 10.09 years. Among them, 8.6% were over 50 years old, and 91.4% were under 50 years old. Completed evaluations were performed in 15.5% gingivitis and 84.5% periodontitis. The causes of emergency bleeding after nonsurgical periodontal therapy in this study were residual subgingival calculus or granulation tissue in 63.79% of cases: severe gingival inflammation, 29.32%; gum trauma, 3.45%; and poor compliance, 3.45%. The therapy method before bleeding includes supragingival scaling accounted for 72.4% and subgingival scaling accounted for 27.6%. 23 cases of horizontal absorption at the bleeding site accounted for 39.66%, and 35 cases of angular absorption accounted for 60.34%. Bleeding of maxillary posterior teeth accounted for 34.48%; mandibular anterior teeth accounted for 15.52%; mandibular anterior teeth accounted for 8.62%; and mandibular posterior teeth accounted for 18.97%; multiple sites accounted for 22.41%; eliminating residual subgingival calculus and granulation tissue were the main and most effective hemostatic methods, 86.21%. Conclusion. Residual subgingival calculus or granulation tissue and severe gingival inflammation were the main causes of emergency gingival bleeding after nonsurgical periodontal therapy. Severe gingival inflammation causing emergency bleeding was more common in maxillary posterior teeth areas. Angular alveolar bone resorption was more likely to cause bleeding than horizontal resorption. Careful debridement of residual subgingival calculus and granulation tissue was the main hemostatic method.

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