The efficacy of chlorination and filtration in the control and eradication of Legionella from dental chair water systems

Pankhurst, Caroline L.; Philpott‐Howard, John; Hewitt, J. H.; Casewell, M.W.

doi:10.1016/0195-6701(90)90044-o

Cited by 64 publications

(66 citation statements)

References 23 publications

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“…It could be argued that this might account for the low prevalence rate recorded in the study as Challacombe et al 16 found only 23 of 49 contaminated units to be positive on more than one occasion over a 44 month period. Whereas, Pankhurst et al 7 repeatedly sampled a dental unit waterline colonised with L. bozemanii on nine occasions over a period of 15 weeks and the water samples were consistently positive. Results obtained from a 13-year retrospective survey of a hospital water system concluded that specific strains of L. pneumophila can persistently colonize a hospital water supply and cause recurrent clusters of nosocomial infection.…”

Section: Discussionmentioning

confidence: 99%

“…Only one dentist had a positive antibody titre 1:16 to L. pneu- plex plumbing systems found in large institutions are more prone to colonisation with legionellae. 7 Whereas the vast majority of dentists in this survey took their surgery water supply directly from the mains water and only 10% used an intermediary coldwater storage tank, which may in part explain the low numbers of legionellae positive samples. Thermal control is recommenced as an infection control measure in hot and cold plumbing systems.…”

Section: Dentists' Legionella Serologymentioning

confidence: 99%

“…7,23 A single fatal case of legionella pneumonia in a dentist caused by L. dumoffi has been reported. L. dumoffi and other Legionella spp were recovered from his surgery waterlines after his death, but only in low numbers from his domestic water supply.…”

Section: Dentists' Legionella Serologymentioning

confidence: 99%

“…11,12 The reported prevalence of legionellae in DUWL varies widely from 0-68% depending, in part, on the isolation procedures. [13][14][15] Variations in recovery rates are seen with different geographic locations, presence of large cold-water tanks and complex plumbing systems, 7 thermal conditions and the type of dental equipment. 16 Much of the data on legionellae in DUWL has derived from hospital-based studies where the plumbing and environmental conditions may not replicate those found in general practice.…”

Section: N B R I E Fmentioning

confidence: 99%

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Prevalence of legionella waterline contamination and Legionella pneumophila antibodies in general dental practitioners in London and rural Northern Ireland

Pankhurst

Coulter²,

Philpott-Howard³

et al. 2003

Br Dent J

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Objectives To determine the prevalence of legionellae in dental unit waterlines (DUWL) in general dental practices in London and rural Northern Ireland and whether the organism occurs at a high enough frequency and magnitude in DUWL to represent a threat to dentists' health. Materials and method Two hundred and sixty six (166 London, 100 Northern Ireland) randomly selected dental surgeries were recruited. Standardised 250 ml water samples were taken from the DUWL and 1 litre samples from the surgery cold water tap to measure the prevalence of legionellae. The dentists provided a blood sample for legionella serology. Results The prevalence of legionellae was very low (0.37%). Legionellae were not isolated from DUWL or surgery basin taps in Northern Ireland. Legionella spp were isolated from the DUWL and surgery basin of one practice in London and from the cold water supply of a further three practices. The prevalence of Legionella pneumophila antibodies was less than that seen in a comparable group of London blood donors. Conclusion The risk to dentists' health from potential exposure to legionellae in this cohort of dentists was very low and this was confirmed by the very low seroprevalence and antibody titres to legionella detected in the dentists.

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Section: Discussionmentioning

confidence: 99%

Section: Dentists' Legionella Serologymentioning

confidence: 99%

Section: Dentists' Legionella Serologymentioning

confidence: 99%

Section: N B R I E Fmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of legionella waterline contamination and Legionella pneumophila antibodies in general dental practitioners in London and rural Northern Ireland

Pankhurst

Coulter²,

Philpott-Howard³

et al. 2003

Br Dent J

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“…[6][7][8][9][10][11][12][13] Although many microorganisms found in this environment may be potentially pathogenic, three genera in particular are of concern for the dental office, Pseudomonas, Mycobacteria and Legionella. Pseudomonas cepacia (Gram-negative bacillus) has been spread to patients in hospital settings through its presence in aqueous disinfectants.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Two Methods in Controlling Dental Treatment Water Contamination

Bansal¹,

Puttaiah²,

Harris³

et al. 2011

The Journal of Contemporary Dental Practice

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Dental unit water systems are contaminated with biofilms that amplify bacterial counts in dental treatment water in excess of a million colony forming units per milliliter (cfu/ml). The Centers for Disease Control and Prevention and the American Dental Association have agreed that the maximum allowable contamination of dental treatment water not exceed 500 cfu/ml. This study was conducted to evaluate two protocols in controlling contamination of dental unit water systems and dental treatment water. Both methods used an antimicrobial self-dissolving chlorine dioxide (ClO2) tablet at a high concentration (50 ppm) to shock the dental unit water system biofilms initially followed by periodic exposure. To treat dental treatment source water for patient care, 3 parts per million (ppm) ClO2 in municipal/tap water was compared to use of a citrus botanical extract dissolved in municipal water. Heterotrophic microbial counts of effluent water and laser scanning confocal microscopy were performed to evaluate effects of the two treatments. Results from this study indicated that both treatments were effective in controlling biofilm contamination and reducing heterotrophic plate counts <500 cfu/ml. A comprehensive study addressing compatibility of 50 ppm ClO2 on the metals and nonmetal components of the dental water system and effects of low-grade chemicals used on composite bonding to dentin and enamel is warranted before translation from efficacy studies to common clinical use. Clinical significance This study provides evidence-based information of using two methods of controlling dental treatment water contamination. The study was conducted in a clinical practice setting in an active dental clinic and the results are meaningful to a clinician who is interested in providing safe dental treatment water for patient care. How to cite this article Bansal R, Puttaiah R, Harris R, Reddy A. Evaluation of Two Methods in Controlling Dental Treatment Water Contamination. J Contemp Dent Pract 2011;12(2):73-83.

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Biofilms

Flemming¹,

Wingender²

2002

Biopolymers Online

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Introduction Historical Outline Composition and Structure of Biofilms The EPS matrix Structure of the Biofilm Matrix Functional Aspects of the Biofilm Matrix Formation and Development of Biofilms Role of Intercellular Communication in Biofilm Formation Environmental Role of Biofilms Biotechnological Use of Biofilms Wastewater Treatment Bioremediation Detrimental Biofilms Biofilms in Medicine Biofouling in Industrial Systems Microbially Influenced Corrosion Biodeterioration of Mineral Materials Biodeterioration of Synthetic Polymers Enhanced Resistance of Biofilm Organisms Transport Limitation by Reaction–Diffusion Interaction Slow Growth Rate and General Stress Response Role of Biofilm‐specific Phenotype Role of Persister Cells Outlook and Perspectives

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The efficacy of chlorination and filtration in the control and eradication of Legionella from dental chair water systems

Cited by 64 publications

References 23 publications

Prevalence of legionella waterline contamination and Legionella pneumophila antibodies in general dental practitioners in London and rural Northern Ireland

Prevalence of legionella waterline contamination and Legionella pneumophila antibodies in general dental practitioners in London and rural Northern Ireland

Evaluation of Two Methods in Controlling Dental Treatment Water Contamination

Biofilms

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