title: Evaluation of bacterial contamination of dental unit waterlines and use of a newly designed measurement device to assess retraction of a dental chair unit.
abstract: BACKGROUND
  Dental unit waterline (DUWL) output water is delivered through instruments of a dental chair unit (DCU) to irrigate and cool teeth. However, these waterlines can be heavily contaminated with bacteria.
  
  
  OBJECTIVE
  The purpose of the present study was to assess retraction and investigate the contamination level and prevalence of bacteria in DUWL output water.
  
  
  METHODS
  Fifty-eight DCUs were randomly selected from 30 hospitals in 10 districts of Tianjin, one of the four special municipalities of China. A unique sampling connector was used in place of the dental handpiece to collect water samples. Evaluation of retraction was accomplished using a retraction measurement device designed in accordance with the International Standard ISO 7494-2:2015(E).
  
  
  RESULTS
  A total of 263 water samples were collected, and the highest concentration of bacteria [1.8 × 10(6) colony-forming units (CFU)/mL] was found in the handpiece group. Thirty (51.72%) water samples in the handpiece group and 21 (36.21%) in the air/water syringe groups were cultured, yielding colony counts of > 500 CFU/mL. Potential infectious agents, such as Bacillus cereus, Kocuria kristinae and Pseudomonas fluorescens, were isolated from the water samples. Thirty (51.72%) DCUs failed the retraction evaluation. There was a significant, positive correlation (P < 0.05) between the concentration of bacteria in the water sample and the retracted volume.
  
  
  CONCLUSIONS
  It is of paramount importance to increase compliance with the standards for controlling DUWL contamination. Routine microbial monitoring and evaluation of retraction are necessary to provide high-quality water for use in dental treatment.
authors.affiliation: Tianjin Centers for Disease Control and Prevention, Tianjin, China.
authors.forename: Xue-Yue
authors.initials: XY
authors.lastname: Ji
authors.affiliation: Tianjin Centers for Disease Control and Prevention, Tianjin, China.
authors.forename: Chun-Nan
authors.initials: CN
authors.lastname: Fei
authors.affiliation: Tianjin Centers for Disease Control and Prevention, Tianjin, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Tianjin Centers for Disease Control and Prevention, Tianjin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Tianjin Centers for Disease Control and Prevention, Tianjin, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.affiliation: Tianjin Centers for Disease Control and Prevention, Tianjin, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Dong
mesh_terms: D058491:Bacterial Load; D002681:China; D003748:Dental Equipment / Q000382:microbiology*; D004866:Equipment Contamination; D006801:Humans; D019552:Infection Control, Dental / Q000592:standards; D014881:Water Supply / Q000592:standards
keywords: Dental unit waterlines; bacteria; dental handpieces; retraction; water microbiology