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Appraisal of microbial contamination of dental unit water systems and practices of general dental practitioners for risk reduction

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Abstract

The study aims to evaluate the microbial contamination in dental unit water system (DUWS) in Chandigarh, India, including knowledge, attitude, and practices of general dental practitioners (GDPs) to reduce the microbiological risks of DUWS. Microbiological risks were assessed by collecting water samples from 18 dental chair units including three main water supply units. Total of 44 water samples were examined for bacteriological contamination and the highest microbial contamination was observed in the ultrasound scalers having a range of 100 to 12,000 CFU/ml, with a median count of 950 CFU/ml. Only 2.3% of the water samples met the European Union recommendation of less than 100 CFU/ml, whereas 97.7% of the water samples have the total bacterial count exceeding 100 CFU/ml. In comparison to Center for Disease Control (CDC) guidelines, only 20.5% water samples fall within the recommended quality of drinking water (less than 500 CFU/ml), and the rest of the samples (79.5%) exceed the total bacteria count with a median count of 1100 CFU/ml. Acinetobacter species, Pseudomonas aeruginosa, and Sphingomonas paucimobilis were found in most of the water samples from DUWS. Dental chair units show higher microbial load and hence failed to meet any international guidelines, e.g., CDC. The highest microbial contamination was observed in ultrasound scaler and air/water syringe outlets. Hence, the study demand for Indian guidelines for the type of water used in DUWS water and urges for the proper training of GDPs to avoid further risks to the dental patients.

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Acknowledgments

RK would like to thank the Department of Health Research (DHR), Indian Council of Medical Research (ICMR), and Ministry of Health and Family Welfare, for providing the Fellowship Training Program in Environmental Health under Human Resource Development Health Research Scheme.

Contributorship statement

BL and RK designed, conceptualized the study and conducted the field work. MB helped to develop the intellectual content of the protocol and manuscript including review/editing.

Data sharing statement

A MPH thesis is available on the topic and can be provided by e-mail to Dr. Ravindra Khaiwal.

Funding statement

This research received no specific grant from any funding agency in public, commercial, or not-for-profit sectors.

Author information

Author notes

  1. Khaiwal Ravindra has an equal contribution to this work.

Authors and Affiliations

  1. School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India

    Bajrang Lal & Khaiwal Ravindra

  2. Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India

    Manisha Biswal

Authors
  1. Bajrang Lal
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  2. Khaiwal Ravindra
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  3. Manisha Biswal
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Corresponding author

Correspondence to Khaiwal Ravindra.

Ethics declarations

Competing interests

The authors declare that there are no competing interests.

Ethical approval

The protocol was approved by the Dissertation Approval Committee of the Institute and Departmental Peer Review committee. PGIMER Institute Ethics Committee approved the thesis protocol via letter number INT/IEC/2017/1425A dated 05/12/2017.

Additional information

Responsible editor: Philippe Garrigues

Highlights

• Contaminated DUWS increases public health risks.

• Microbial contamination in the ultrasound scalers ranges from 100 to 12,000 CFU/ml.

• Acinetobacter species, P. aeruginosa, and S. paucimobilis were most common in water samples.

• Dental practitioners lack knowledge related to the DUWS risk management.

• Study demand for universal guidelines for the type of water used in DUWS.

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Lal, B., Ravindra, K. & Biswal, M. Appraisal of microbial contamination of dental unit water systems and practices of general dental practitioners for risk reduction. Environ Sci Pollut Res 25, 33566–33572 (2018). https://doi.org/10.1007/s11356-018-3298-y

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  • DOI: https://doi.org/10.1007/s11356-018-3298-y

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