Dental Water Line

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Description of Niche

Where located?

Modern dentists utilize various apparatuses in treating patients in their offices. These apparatuses include but are not limited to: dental chair units, triple syringe system, high speed handpieces, ultra sonic scalers and etc. These dental units provide suitable conditions for dwelling for several forms of organisms including microbes and fungi. [5] One common condition that these dental units possess in providing the organisms a suitable condition to live in is that these units are always in contact with water. In order for these dental instruments to work properly with water, water-lining are installed through out the clinic from the city-water output to the primary filtering system to each dental chair unit, which has the secondary filtering system.[2] These units, however are left unused and their powers are off during the night, which aggravates the condition of the dental water line units ( or facilitates the growth of bacteria in these parts).

Physical Conditions?

What are the conditions in your niche? Temperature, pressure, pH, moisture, etc.

Temperature: Temperatures vary from one dental unit to another in most cases and also from one dental office to another. However, according to most of the references, it indicates that the temperature of this niche fall under the range of 23 to 37 degrees Celcius. [4]

Moisture: There must be a constant flow of water since most dental unit waterlines require water.

pH of water discharged from the handpiece after inflow of acidic electrolyzed water <1>

pH: The pH of this niche is neutral. There have been studies where researchers used acidic electrolyzed in dental fields to effectively disinfect the contamination at the microbial level of dental waterlines, and these studies showed that the water before it was washed with acidic electrolyzed solution had a pH of 7. [1]

Influence by Adjacent Communities (if any)

Is your niche close to another niche or influenced by another community of organisms?

Many possibilities include: contamination or microbes getting transferred from one patient to dental units. When the patients are getting treated using the dental units, there is a possibility that dental units may collect the patient’s oral microbes and etc.

Another possibility may be the hands of dental staff since they deal with dental units and patients at the same time.

Conditions under which the environment changes

Do any of the physical conditions change? Are there chemicals, other organisms, nutrients, etc. that might change the community of your niche.

The physical conditions vary from one dental office to another, but for one particular dental office's waterline, their chemicals, water supply, nutrients, and organisms tend to stay constant most of the time.

However, by using disinfectants, organisms that live in this niche may be effected (killed, numbers reduced, etc). [3]

Who lives there?

Which microbes are present?

You may refer to organisms by genus or by genus and species, depending upon how detailed the your information might be. If there is already a microbewiki page describing that organism, make a link to it.

Achromobacter xylosoxidans, Acidovorax defluvii, Acidovorax spp., Acinectobacter spp., Actinomyces spp., Alcaligenes dentifricans, Bacillus spp., Bacteroides spp., Caulobacter spp., Flavobacterium spp., Fusobacterium, Klebsiella pneumoniae, Lactobacillus spp., Legionella pneumophila, Legionella spp., Methylophilus spp., Micrococcus spp., Moraxella spp., Mycobacterium avium, Nocardia spp., Pasteurella spp., Proteus vulgaris, Pseudomonas aeruginosa, Burkholderia cepacia, Sphigomonas paucimobilus, Sphingomonas spp., Streptococcus spp., Staphylococcus aureus, and Xanthomonas spp. (Pankhurst et al, 1998; D. Spratt).

Are there any other non-microbes present?

Plants? Animals? Fungi? etc.

Fungi Phoma spp., Penicillium spp., Cladosporium spp., Alternaris spp., and Scopulariopsis spp. (Pankhurst et al, 1998; D. Spratt).

Protozoa Acanthamoeba spp., Cryptosporidium spp., Microsporidium spp., and Giardia spp. (Pankhurst et al, 1998; D. Spratt).

Do the microbes that are present interact with each other?

Describe any negative (competition) or positive (symbiosis) behavior

Do the microbes change their environment?

Do they alter pH, attach to surfaces, secrete anything, etc. etc.

Do the microbes carry out any metabolism that affects their environment?

Do they ferment sugars to produce acid, break down large molecules, fix nitrogen, etc. etc.

Current Research

First Topic: Effects of Various disinfectants.

Article: "The effect of disinfectant agents in eliminating the contamination of dental unit water." Journal of Oral Rehabilitation, 30; p290–294. [3]

Many times in a dentist office, poorly or inadequately treated dental units are left to collect many microbial organisms and other classes of small organism in and/or outside these units. This is not particular to a certain dental office but prevalent in most dental offices. This is inevitable since the units are in constant contact with moisture. More serious spread of these microbial organisms arise from forming a community, or biofilm, which helps the organisms to survive washing or even drying up in these dental units. Since this can be detrimental to patients[3],dental offices have been trying to lower or even to get rid of these microbial organisms living in the dental unit waterline niche. Even without these detrimental factors, the ADA recommends maximum permissible levels of less than 200 CFU/mL [3]. Many methods including using electrolyzed acidic water and various chemical products are used to treat these waterlines, and this paper focuses on two disinfectants (Bio® 2000 and Alpron®) and their effects on these waterlines. "Alpron includes 3% p-hydroxybenzoeicacidester, less than 0.5% polyaminoprophylbiguanid, 15–30% 1,2-prophyenglycol and Bio 2000 includes 0.12% chlorhexidine gluconate and 12% ethanol."[3] The unit for testing these waterlines’ condition was CFU (colony forming units) per mL[3]. In order to effectively carry out the test, these two disinfectants were used according to the manufacturer’s instructions. The waterlines were treated on a daily basis at the end of each day by using the two disinfectants in the waterlines. Then when the application of these disinfectants was over, the waterlines were flushed with tap water for two minutes. Moreover, to ensure the same condition of waterline, water samples were collected from each unit’s air/water syringe line before treating the very first patient of the day. This was done for two weeks and the CFU for these two weeks were used to get the mean value. Baseline, daily samples of 100 mL for the first week and the second samples for the week thereafter were plated on different agar plates. Lastly for meosifilic bacterial counts, Mueller Hinton agar plates with 1 mL direct and 1 ⁄ 10 were used in sterile serum[3]. This resulted in: for Bio 2000, baseline had the mean value of CFU/mL of 36.25, first week and second week had 0; for Alpron, baseline had the mean value of CFU/mL of 760 with the standard deviation of 480, first week had 0.75, and second week had 0.[3] According to these results, the baseline, which means the first day of treatment, had higher concentration of infection than the first week and second week of treatment for both Bio 2000 and Alpron. Moreover, since these two disinfectants were proved to be effective when used for more than two weeks, dental offices should be encouraged to use disinfectants to reduce the CFU/mL and detrimental health hazards.

References

(1) Kohno, S., Kawata T., et al. Bactericidal Effects of Acidic Electrolyzed Water on the Dental Unit Waterline. Shinya Jpn J Infect Dis. 2004. VOL.57 NO.2; p. 52-54

(2) Kim, Eugene. D.D.S. has given certain comments about how the dental clinic is constructed and how the water lining is installed. (this will be put in MLA form later).

(3) M. Ozcan, Y. Kulak, and E. Kazazoglu. The effect of disinfectant agents in eliminating the contamination of dental unit water. Journal of Oral Rehabilitation. 2003. Volume 30. p. 290–294.

(4) Robert M, Barbeau J, Prévost A, Charland R. Dental unit water lines: A propitious environment for bacterial colonization."

(5) SOUZA-GUGELMIN, Maria Cristina Monteiro de, LIMA, Carolina Della Torre, LIMA, Sergio Narciso Marques de et al. Microbial contamination in dental unit waterlines. Braz. Dent. J. [online. 2003, vol. 14, no. 1 [cited 2008-08-26], pp. 55-57. Available from: <http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-64402003000100010&lng=en&nrm=iso>. ISSN 0103-6440. doi: 10.1590/S0103-64402003000100010]

(6) James T. Walker, David J. Bradshaw, Allan M. Bennett, Martin R. Fulford, Michael V. Martin, and Philip D. Marsh. Microbial Biofilm Formation and Contamination of Dental-Unit Water Systems in General Dental Practice. Appl Environ Microbiol. 2000 August; 66(8): 3363-3367

Edited by Jane Choi, Bo R. Heo, Jinsoo Lee, Soh Yun Lee, and So Young Moon, students of Rachel Larsen