The Clean Bite: Real Talk About Infection Control: Dental Unit Water Line Safety

Image Credit: Pelton and Crane

Hey there, Clean Biters!
Welcome back to The Clean Bite! I’m your host, Sherrie, and today we’re diving into a topic that’s often overlooked but absolutely critical: Dental Unit Water Line (DUWL) safety. Yes, the water used during your dental visit is just as important as the treatment itself!

Why Water Safety Matters in Dentistry

I recently read a fantastic article by Ivan W. Gowne, MS, MLS(ASCP)CM, CIC, FAPIC, in Infection Control Today (September issue), which focused on water safety in long-term care facilities. It’s reassuring to see that water safety is gaining attention beyond dental offices, but it’s a wake-up call for us in dentistry to step up our game.

Have you ever asked your dental office how they maintain the water used during your cleaning, filling, or crown procedure? If not, now’s the time.

Biofilm: The Hidden Threat

In both nursing homes and dental offices, biofilm is the common enemy.

However, dental offices face a unique challenge due to the small diameter and long length of DUWLs—the perfect storm for biofilm to thrive.

Let me take you back... 

A Personal (and Gross) Story

Years ago—before I knew better—I was cleaning my operatory after a patient visit. My air/water syringe wasn’t working properly, so I took it apart. What did I find?
A slime worm bubbling out of the line.
I was horrified. I cleaned that one line with bleach water and blew it out, but I had no idea what was lurking in the rest of the unit.

Fast forward to today: DUWL safety is finally getting the attention it deserves.

State Regulations Are Catching Up

In July 2025, the Georgia Dental Board updated its rules to include written DUWL safety requirements, joining Washington and California in this critical effort. Shoutout to my friends at Solmetex/Sterisil for putting together an easy-to-read summary of Georgia’s new rule!

Step 1: Make a Plan

Every dental office needs a DUWL Safety Plan. Here’s how to build one:

Appoint a Safety Officer

Select someone who understands the scope and has the full support of the dentist and office manager. This person will oversee the program, training, and documentation.

Create a Standard Operating Procedure (SOP)

Your SOP should include:

What

• Why DUWL maintenance matters (Hint: Keep biofilm <500 CFU!)
• Products used + customer support contacts
• Responsible team member
• Effective date + review date
• Remediation plan for test failures or boil water advisories
• Signatures from the dentist and the office manager

When

• Daily: Use Environmental Protection Agency-compliant source water
• Daily: Treat water with each bottle refill
• Monthly: Shock the lines
• Quarterly: Test water (or after repairs/advisories)

How

Choose easy-to-use products that work together

Follow manufacturer instructions for use (IFU)

Train team on:

1. Water treatment product usage
2. Shocking procedures
3. Sample collection (pooled vs. per line)
4. Testing methods (mail-in vs inoffice)

Documentation

Keep a maintenance log with:

• SOP review dates
• Sample dates, locations, and collectors
• Sample method and lines tested
• Test results and corrective actions
• Retain records for 3 to 5 years (State-dependent)

Step 2: Train Your Team

Every team member should:

• Read and understand the SOP
• Ask questions and get clear answers
• Know when and how to treat, shock, and test DUWLs

Training Topics

• When maintenance should occur
• Product usage timelines
• Sample collection and shipping tips (avoid Thursday and Friday)
• Best times and places to shock/test
• Documentation requirements and retention timelines

Risk Assessment: A Dental Twist

In his article, Gowne emphasized the importance of risk assessments for long-term care; however, in dentistry, our daily maintenance, monthly shock, and quarterly testing serve as key risk assessments. It’s a continuous cycle of vigilance.

Final Thoughts

DUWL safety isn’t just a regulatory checkbox; it’s a patient safety priority. Let’s keep our water clean, our lines clear, and our teams informed.

Thanks for tuning in to The Clean Bite!
Until next time, friends—
Stay informed. Stay clean. Stay safe.

🦷✨ — Sherrie, The Clean Bite

References

1. Gowne IW. Writing an effective water management program for long-term care facilities. Infection Control Today. September 2025. Accessed October 6, 2025.
2. Centers for Disease Control and Prevention. Summary of infection prevention practices in dental settings: basic expectations for safe care. CDC. Accessed October 6, 2025. https://www.cdc.gov/dental-infection-control/hcp/summary/index.html
3. Dental unit water quality. CDC. May 15, 2024. Accessed October 6, 2025. https://www.cdc.gov/dental-infection-control/hcp/summary/dental-unit-water-quality.html
4. Solmetex; Sterisil. The new Georgia dental water quality rule: what you need to know. Solmetex. Accessed October 6, 2025. https://solmetex.com/new-georgia-dental-water-quality-rule/?hsCtaAttrib=192298606342