Skip to main content

Advertisement

Log in

Comparison of the microbial load of incoming and distal outlet waters from dental unit water systems in Istanbul

  • Published:
Environmental Monitoring and Assessment Aims and scope Submit manuscript

Abstract

This is a cross-sectional study of the incoming and distal outlet water quality from 41 dental units in Istanbul, carried out to compare the total microbial loads using traditional culture method versus epifluorescence microscopy. The possible presence of Legionella pneumophila using traditional culture method was also analyzed. One hundred and twenty three samples were taken from the high-speed handpiece lines, air–water syringe lines and source (incoming) water supplies from 41 dental units. The samples were assayed for live/dead bacteria, heterotrophic bacterial counts and presence of L. pneumophila bacteria. Thirty nine out of 41 dental units (91%) were not able to meet the standard limit of 200 CFU/ml in dental unit waters. The live bacterial counts were 1–1.5 orders of magnitude higher than aerobic mesophilic heterotrophic bacteria. L. pneumophila (serogroup 2–14) was isolated from five out of 41 units. Some dental units were using commercially bottled (19 l) drinking water as a source. The source water of eight dental unit was heavily contaminated which were fed up by commercially bottled drinking water.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • ADA Council on Scientific Affairs. (1999). Dental unit waterlines: Approaching the year 2000. The Journal of the American Dental Association, 130, 1653–1664.

    Google Scholar 

  • Atlas, R. M., Williams, J. F., & Huntington, M. K. (1995). Legionella contamination of dental-unit waters. Applied and Environmental Microbiology, 61, 1208–1213.

    CAS  Google Scholar 

  • Barbeau, J., Tanguay, R., Faucher, E., et al. (1996). Multiparametric analysis of waterline contamination in dental units. Applied and Environmental Microbiology, 62, 3954–3959.

    CAS  Google Scholar 

  • Barer, M. R., & Harwood, C. B. (1999). Bacterial viability and culturability. Advances in Microbial Physiology, 41, 93–137. doi:10.1016/S0065-2911(08)60166-6.

    Article  CAS  Google Scholar 

  • Blake, G. C. (1963). The incidence and control of bacterial infection in dental spray reservoirs. British Dental Journal, 115, 413–416.

    Google Scholar 

  • Bopp, C. A., Sumner, J. W., Morris, G. K., & Wells, J. G. (1981). Isolation of Legionella ssp. from environmental water samples by low-pH treatment and use of a selective medium. Journal of Clinical Bacteriology, 13, 714–719.

    CAS  Google Scholar 

  • Burke, F., Forde, A., Q’Sullivan, M., & Marsh, P. D. (2004). Microbiological evaluation of dental unit water systems in general dental practice in Europe. European Journal of Oral Sciences, 112, 412–418. doi:10.1111/j.1600-0722.2004.00151.x.

    Article  Google Scholar 

  • Coleman, D. C., O’Donnell, M. J., Shore, A. C., Swan, J., & Russell, R. J. (2007). The role of manufacturers in reducing biofilms in dental chair waterlines. Journal of Dentistry, 35, 701–711. doi:10.1016/j.jdent.2007.05.003.

    Article  CAS  Google Scholar 

  • Dennis, P. J. L. (1988) Isolation of legionellae from environmental specimens. In T. G. Harrison & A. G Taylor (Eds.), A laboratory manual for Legionella (pp. 31–44). Chichester: Wiley.

    Google Scholar 

  • Fitzgibbon, E. J., Bartzokas, C. A., Martin, M. V., Gibson, M. F., & Graham, Q. (1987). The source, frequency and extent of bacterial contamination of dental unit water system. British Dental Journal, 157, 98–101. doi:10.1038/sj.bdj.4805436.

    Article  Google Scholar 

  • Franco, F. F. S., Spratt, D., Leao, J. C., & Porter, S. R. (2005). Biofilm formation and control in dental unit waterlines. Biofilms, 2, 9–17. doi:10.1017/S1479050504001450.

    Article  Google Scholar 

  • Fulford, M. R., Walker, J. T., Martin, M. V., & Marsh, P. D. (2004). Total viable counts, ATP, and endotoxin levels as potential markers of microbial contamination of dental unit water systems. British Dental Journal, 196, 157–159. doi:10.1038/sj.bdj.4810943.

    Article  CAS  Google Scholar 

  • Geldreich, E. E. (1989). Drinking water microbiology—New directions toward water quality enhancement. International Journal of Food Microbiology, 9, 295–312. doi:10.1016/0168-1605(89)90098-6.

    Article  CAS  Google Scholar 

  • Göksay, D., Cotuk, A., & Zeybek, Z. (2008). Microbial contamination of dental unit waterlines in Istanbul, Turkey. Environmental Monitoring and Assessment. doi:10.1007/s10661-007-0118-0.

  • Montebugnoli, L., Chersoni, S., Prati, C., & Dolci, G. (2004). A between-patient disinfection method to control water line contamination and biofilm inside dental units. The Journal of Hospital Infection, 56, 297–304. doi:10.1016/j.jhin.2004.01.015.

    Article  CAS  Google Scholar 

  • O’Donnell, M. J., Shore, A. C., Russell, R. J., & Coleman, D. C. (2007). Optimization of the long-term efficacy of dental chair waterline disinfection by the identification and rectification of factors associated with waterline disinfection failure. Journal of Dentistry, 35, 438–451. doi:10.1016/j.jdent.2007.01.001.

    Article  Google Scholar 

  • Pankhurst, C., & Coulter, W. (2007). Do contaminated dental unit waterlines pose a risk of infection? Journal of Dentistry, 9, 712–720. doi:10.1016/j.jdent.2007.06.002.

    Article  Google Scholar 

  • Pankhurst, C. L., Coulter, W., Philpott-Howard, J. J., Harrison, T., Warburton, F., Platt, S., et al. (2003). Prevalence of Legionella waterline contamination and Legionella pneumophila antibodies in general dental practitioners in London and rural Northern Ireland. British Dental Journal, 195, 591–594. doi:10.1038/sj.bdj.4810735.

    Article  CAS  Google Scholar 

  • Rodriguez, G. G., Phipps, D., Ishiguro, K., & Ridgway, H. F. (1992). Use of a fluorescent redox probe for direct visualization of actively respiring bacteria. Applied and Environmental Microbiology, 58, 1801–1808.

    CAS  Google Scholar 

  • Sacchetti, R., Baldissari, A., De Luca, G., Lucca, P., Stampi, S., & Zanetti, F. (2006). Microbial contamination in dental unit waterlines: Comparison between ER:Yag Laser and Turbine Lines. Annals of Agricultural and Environmental Medicine, 13, 275–279.

    Google Scholar 

  • Sánchez, J. B., Alonso, J. M. Q., & Oviedo, M. D. C. (2005). Use of microbial activity parameters for determination of a biosolid stability index. Bioresource Technology, 97, 562–568. doi:10.1016/j.biortech.2005.04.021.

    Article  Google Scholar 

  • Schel, A. J., Marsh, P. D., Bradshaw, D. J., et al. (2006). Comparison of the efficacies of disinfectants to control microbial contamination in dental unit water systems in general dental practices across the European Union. Applied and Environmental Microbiology, 2, 1380–1387. doi:10.1128/AEM.72.2.1380-1387.2006.

    Article  Google Scholar 

  • Sedgwick, A. K., & Tilton, R. C. (1982). Identification of Legionella pneumophila by latex agglutination. Journal of Clinical Bacteriology, 2, 365–369.

    Google Scholar 

  • Smith, A. J., McHugh, S., Aitkin, I., & Hood, J. (2002). Evaluation of the efficacy of alpron disinfectant in dental unit water lines. British Dental Journal, 193, 593–596. doi:10.1038/sj.bdj.4801635.

    Article  CAS  Google Scholar 

  • Søndergaard, M., & Danielsen, M. (2001). Active bacteria (CTC+) in temperate lakes: Temporal and cross-system variations. Journal of Plankton Research, 23, 1195–1206. doi:10.1093/plankt/23.11.1195.

    Article  Google Scholar 

  • Souza-Gugelmin, M. C. M., Lima, C. D. T., Lima, S. N. M., Mian, H., & Ito, I. Y. (2003). Microbial contamination in dental unit waterlines. Brazilian Dental Journal, 14, 55–57. doi:10.1590/S0103-64402003000100010.

    Article  Google Scholar 

  • Szymanska, J. (2004). Risk of exposure to Legionella in dental practice. Annals of Agricultural and Environmental Medicine, 11, 9–12.

    Google Scholar 

  • Szymanska, J., Wdowiak, L., Puacz, E., & Stojek, N. M. (2004). Microbial quality of water in dental unit reservoirs. Annals of Agricultural and Environmental Medicine, 11, 355–358.

    Google Scholar 

  • Walker, J. T., & Marsh, P. D. (2007). Microbial biofilm formation in DUWS and their control using disinfectants. Journal of Dentistry, 9, 721–730. doi:10.1016/j.jdent.2007.07.005.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Irfan Türetgen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Türetgen, I., Göksay, D. & Cotuk, A. Comparison of the microbial load of incoming and distal outlet waters from dental unit water systems in Istanbul. Environ Monit Assess 158, 9–14 (2009). https://doi.org/10.1007/s10661-008-0560-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10661-008-0560-7

Keywords

Navigation