Evaluation of a hydrogen peroxide disinfectant for dental unit waterlines

Linger, Jackson B.; Molinari, John A.; Forbes, W. Cameron; Farthing, Craig F.; Winget, William J.

doi:10.14219/jada.archive.2001.0374

Cited by 45 publications

(52 citation statements)

References 9 publications

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“…Various products have now been developed to reduce the number of bacteria delivered to the patient by decontamination of the water used in DUWS (12,13,17,18,20,31,36,38,40,49), and although these have been tested in a variety of settings, no multiproduct comparison in GDP surgeries has been done until now. In this trial, seven antimicrobial products approved for use in dental units were tested in seven EU countries for their ability to reduce TVCs to meet the ADA guideline of 200 CFU · ml Ϫ1 in the outflowing water (1) (Tables 1 and 2).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Efficacies of Disinfectants To Control Microbial Contamination in Dental Unit Water Systems in General Dental Practices across the European Union

Schel

Marsh

Bradshaw³

et al. 2006

Appl Environ Microbiol

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Water delivered by dental unit water systems (DUWS) in general dental practices can harbor high numbers of bacteria, including opportunistic pathogens. Biofilms on tubing within DUWS provide a reservoir for microorganisms and should be controlled. This study compared disinfection products for their ability to meet the American Dental Association's guideline of <200 CFU · ml ؊1 for DUWS water. Alpron, BioBlue, Dentosept, Oxygenal, Sanosil, Sterilex Ultra, and Ster4Spray were tested in DUWS (n ‫؍‬ 134) in Denmark, Germany, Greece, Ireland, The Netherlands, Spain, and the United Kingdom. Weekly water samples were tested for total viable counts (TVCs) on yeast extract agar, and, where possible, the effects of products on established biofilm (TVCs) were measured. A 4-to 5-week baseline measurement period was followed by 6 to 8 weeks of disinfection (intermittent or continuous product application). DUWS water TVCs before disinfection ranged from 0 to 5.41 log CFU · ml ؊1 . Disinfectants achieved reductions in the median water TVC ranging from 0.69 (Ster4Spray) to 3.11 (Dentosept) log CFU · ml ؊1 , although occasional high values (up to 4.88 log CFU · ml ؊1 ) occurred with all products. Before treatment, 64% of all baseline samples exceeded American Dental Association guidelines, compared to only 17% following commencement of treatment; where tested, biofilm TVCs were reduced to below detectable levels. The antimicrobial efficacies of products varied (e.g., 91% of water samples from DUWS treated with Dentosept or Oxygenal met American Dental Association guidelines, compared to 60% of those treated with Ster4Spray). Overall, the continuously applied products performed better than those applied intermittently. The most effective products were Dentosept and Oxygenal, although Dentosept gave the most consistent and sustained antimicrobial effect over time.

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Section: Discussionmentioning

confidence: 99%

Comparison of the Efficacies of Disinfectants To Control Microbial Contamination in Dental Unit Water Systems in General Dental Practices across the European Union

Schel

Marsh

Bradshaw³

et al. 2006

Appl Environ Microbiol

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“…Յ100 CFU ⅐ ml Ϫ1 , the high levels of bacteria are assumed to be due to build up of biofilm, followed by shedding from the biofilm lining the tubing into the water phase (33). As the water from the DUWS is used to irrigate the oral cavity during dental treatment, it has been recommended that the levels of microbial contamination should be reduced (for example, the ADA have proposed a threshold value of Ͻ200 CFU ⅐ ml Ϫ1 ) (16). Therefore, the biofilm that accumulates on the tubing must be a major target for any control strategy.…”

Section: Discussionmentioning

confidence: 99%

Microbiological Evaluation of a Range of Disinfectant Products To Control Mixed-Species Biofilm Contamination in a Laboratory Model of a Dental Unit Water System

Walker¹,

Bradshaw²,

Fulford

et al. 2003

Appl Environ Microbiol

137

132

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Dental unit water system (DUWS) tubing harbors complex multispecies biofilms that are responsible for high microbial levels at the distal outlet. The aim of this study was to use an established biofilm laboratory model to simulate biofouling of DUWS to evaluate practical, cost-effective, and evidence-based methods of microbial decontamination. Reproducible biofilms were developed in the model over 14 days; decontamination was assessed using total viable counts (TVC) and microscopic-image analysis techniques to view the inner surface of tubing. Flushing did not reduce the biofilm coverage or TVC. Combizyme and ozone did not completely eliminate the viable bacteria (70 and 65% reduction in biofilm TVC, respectively), nor did they remove the biofilm (45 and 57% reduction in biofilm coverage, respectively). Chlorhexidine and Bio2000 (active agent: ethanol and chlorhexidine), Tegodor and Gigasept Rapid (aldehyde based), and Grotanol (hydroxide based) completely eliminated the TVC but did not completely remove biofilm (31, 53 33, 34, and 64.9% reduction of biofilm coverage, respectively). Other products including Grotanol Flussig (phenol based), Betadine (povidone-iodine based), Alpron (chlorite based), and the hydroxide-containing products Sporklenz, Sterilex Ultra, Dialox, Sterilox, Sanosil, Oxigenal, and Grotanat Bohrerbad resulted in a 100% reduction in the biofilm TVC and a >95% reduction in biofilm coverage. The study demonstrated that while many disinfectants achieve a sufficient reduction in TVC they may not necessarily remove unwanted biofilm from the tubing surfaces as tested in this laboratory-controlled biofilm model.

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“…Chlorination has no effect on bacteria entrapped in poultry skin or on reducing numbers of Salmonella-positive carcasses (Linger et al, 2001). Hydrogen peroxide showed high antimicrobial activity against Salmonella, Escherichia coli, Salmonella aureus, Salmonella hyicus, Escherichia faecalis, and Escherichia faecium (Aarestrup & Hasman, 2004).…”

Section: Mic and Fic Of A Biocidal Combinationmentioning

confidence: 96%

“…Chlorine dioxide showed antimicrobial effects in several studies including drinking water treatment, dental unit waterline, fruits, vegetables, and fish (Lee, Costello, & Kang, 2004;Monarca et al, 2004;Shin, Chang, & Kang, 2004;Wirthlin, Marshall, & Rowland, 2004). Sodium hypochlorite is a FDA approved disinfectant, but there are concerns about the possible formation of carcinogens or toxic chlororganic compounds, such as trihalomethanes and haloacetic acids in the process waters (Batterman, Zhang, & Wang, 2000;Linger, Molinari, Forbes, Farthing, & Winget, 2001). Extensive use of sodium hypochlorite (NaOCl) may also cause corrosion of in-line metal valves.…”

Section: Introductionmentioning

confidence: 99%