Contaminated water, as reports have shown, can occur even in institutions that manage health. Cases of bacterial colonisations have been discovered in dental water delivery systems, the earliest of which was in 1963. A most recent case of bacterial contamination reveals the demise of an 82-year-old woman in Italy who contracted Legionnaire’s disease after visits to her dentist.

Such a story is not meant to aggravate the existing anxieties that some people may have over dental appointments but rather serve as a compelling reason for dental practitioners to do more than just flush water lines after each procedure.

Legionnaire’s disease is a form of pneumonia, which can be fatal for certain people who fall under the “at risk” category. These include people over the age of 45, heavy smokers and drinkers, those who have impaired immune systems, and people who suffer from chronic respiratory and/or kidney disease. The disease is caught when people inhale droplets of water or aerosols, which contain the legionella bacteria. Contamination happens under certain conditions that increase the growth of legionella in water systems.

An effective form of controlling contamination (and, therefore, infection) can be achieved in a number of ways. These include using water systems that implement regular line-cleaning procedures, using a complete infection-control system to treat dental water, and undergoing specific checks for hot and cold water systems. One other essential step is to implement periodic testing using legionella testing kits. Proper testing can reveal the presence of bacteria, ensuring the safety of patients that are coming in for dental surgery or treatments.

A legionella test kit can come in the standard set, which analyses hot water and another set will be specific to dental surgeries which is suitable for analysing the water in dental water lines. Instructions will come with each pack and will include sterile bottles for filling the water samples. Instructions need to be followed to the letter in order to maintain the integrity of the test.

Once samples have been taken, a UKAS-accredited company will take the bottles to its laboratory where it will be incubated for a certain period. If the samples show legionella bacteria, the dental clinic will immediately be contacted and proper recommendations will be offered to prevent further risks to patients and to staff.

While different studies have revealed varying results, the prevailing and consistent conclusion has been that dental unit water lines can contain legionella bacteria and that cross-infection is possible. Healthcare professionals like dentists have a duty of care to check their dental water lines for potentially fatal bacteria, and that they should do so according to the code of practice set forth by the Health and Safety Executive. By practicing essential steps to reduce microbial growth and performing periodic testing for legionella, dental clinics can safeguard the health and safety of patients.