Atlas · Plate XIV · Infection Control · 10

Waterlines and waste

Biofilm grows inside narrow dental unit tubing, so water for nonsurgical care must meet the drinking-water limit of 500 CFU/mL or less. Flush lines for 20-30 seconds after each patient and use sterile water for surgery. Sharps and blood-soaked items are regulated medical waste, extracted teeth with amalgam are never incinerated, and most offices that place or remove amalgam need amalgam separators.

High-yield facts · 9

  1. Dental water for nonsurgical care should meet the EPA drinking water standard of 500 CFU/mL or less of heterotrophic bacteria.S7S64
  2. Biofilm forms inside narrow waterline tubing; untreated lines can exceed 200,000 CFU/mL.S64
  3. Flush water and air from handpieces and air-water syringes for at least 20-30 seconds after each patient.S7
  4. Use sterile water or saline delivered by a sterile device for surgical procedures (e.g., bone cutting).S7
  5. During a boil-water advisory, do not use tap or dental unit water for patient care or handwashing; use bottled or sterile water and alcohol hand rubs.S7
  6. Patients should not close their lips around the saliva ejector (backflow risk).S7
  7. Regulated medical waste includes sharps and blood-soaked items; states regulate its disposal.S7
  8. Extracted teeth go in regulated medical waste unless returned to the patient, except teeth with amalgam: these must not go into regulated medical waste that is incinerated; send them to a metal recycler.S7
  9. The EPA requires most dental offices that place or remove amalgam to use amalgam separators (2017 rule).S7

Facts are written in our own words; each tag links to its source. Values marked "sources vary" differ between references, so check the one your program uses.