CDC Issues Health Advisory for Infection-Causing Bacteria in Dental Waterlines

The Centers for Disease Control and Prevention (CDC) has issued a health advisory on dental waterlines as multiple outbreaks of nontuberculous Mycobacteria (NTM) infections have occurred in children who received pulpotomies in pediatric dental clinics where dental treatment water contained high levels of bacteria, according to a press release from the CDC.

The CDC was first notified of this cluster of NTM infections in March 2022, and the investigation is ongoing now. Results from dental waterline testing have already revealed treatment water containing higher microbial counts than the amount recommended by the CDC. Because dental units are more prone to biofilm formation, per the CDC, it is important to partake in regular testing and infection control best practices.

Dental providers are encouraged to use sterile saline or sterile water as a coolant or irrigant for surgical procedures delivered through bulb syringes, single-use disposable products, or a sterile water delivery system that bypass the dental unit. The CDC also recommends for all non-surgical dental procedures that water meets the ≤500 CFU/mL of heterotrophic water bacteria guidelines in place, as well as to consider irrigating with a sterile and/or microbial solution.

Regular maintenance and testing of the dental unit is also key, with the CDC noting that consultation with the unit manufacturer is a best practice to ensure quality. The United States Food and Drug Administration also has a list of recommendations for dental practitioners on dental unit waterlines.

If patients present with symptoms such as a localized oral abscess, fever, or pain and swelling the mouth or neck it is recommended that they contact their dental provider. These infections should be reported to the public health authorities if they are suspected to be associated with receiving dental care.