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Dental Unit Waterlines: OSAP Recommendations to Clinicians

• Follow current OSAP, ADA, and CDC recommendations to discharge water and air from dental devices that are connected to the dental water system and that enter the patient's mouth (e.g., handpieces, ultrasonic scalers, or air/water syringes) for a minimum of 20 seconds after each patient.
• Always obtain and follow the dental unit manufacturer's instructions for use (IFU) for treating dental unit waterlines. Implementing protocols not recommended by the unit manufacturer could cause equipment damage and void warranties.
• If recommended by the dental unit manufacturer, install, and maintain antiretraction valves to prevent oral fluids from being drawn into dental waterlines.
• Avoid heating dental unit water. While it was common to heat water to increase patient comfort, warming the water may amplify biofilm formation and select organisms pre-adapted to growth in a human host.
• Consider using a separate water reservoir system to eliminate the inflow of municipal water into the dental unit. In addition to having better control over the quality of the source water used in patient care, it would eliminate interruptions in dental care when "boil-water" notices are issued by local health authorities. Contact the manufacturer of the dental unit for a compatible system and treatment protocols before undertaking this step.
• Use sterile solutions for all surgical irrigations. Additionally, ensure that only heat-sterilized/sterile-disposable bulb syringes or sterile water delivery devices are employed to deliver the sterile water.
• Educate and train oral healthcare workers on effective treatment measures to ensure compliance and minimize risks to equipment and personnel.
• Monitor scientific and technological developments in this area to identify improved technical approaches as they become available.
• It is important to ensure that any sterile water system or device marketed to improve dental water quality has been cleared for market by the U.S. Food and Drug Administration (FDA).

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