How to Prevent Legionella in Dental Clinics: A Complete Guide
Legionella DNA has been often detected in dental water samples. Meaning, dental staff have had a higher risk of Legionella exposure than other healthcare workers. Without proper care and foresight, this can become a significant problem in dental clinics and often requires urgent attention.
But don’t worry. There is a way to prevent Legionella in dental clinics and ensure a safe and healthy environment for everyone. In this guide, we will show you how to implement a comprehensive water safety plan that covers:
- Legionella Risk Assessment
- Legionella Control Measures
- Dental Unit Waterline Management
- Water Treatment & Testing
- Record Keeping & Monitoring
By following this guide, and with the help of us at Pipe Testing Services, you will be able to reduce the risk of Legionella infection, comply with the legal requirements, and maintain your professional standards.
Legionella Risk Assessment for Dental Clinics
A Legionella risk assessment is the first and most important step in preventing Legionella in dental clinics. A Legionella risk assessment is a systematic evaluation of your dental water system, including the source, storage, distribution, and usage of water. The purpose of a Legionella risk assessment is to identify any potential hazards that could lead to Legionella growth and exposure, and to recommend appropriate actions to eliminate or reduce them.
A Legionella risk assessment should be carried out by a legionella contractors and qualified water treatment specialists, such as us at PTS.
The risk assessment should follow the guidelines from the Health and Safety Executive (HSE) and the Care Quality Commission (CQC), which are the main regulatory bodies for Legionella control in the UK.
Legionella outbreaks can always occur with proper assessments from professionals like us at PTS, we can help you with that. Get in contact for a quote, or take a look at some of our guides here on our website on how best to deal with Legionella at your facility or business, and how to prepare for your first Legionella Risk Assessment.
What should a Legionella Risk Assessment Involve?
- A description of your dental water system, including the layout, components, materials, and capacity
- Schematic diagram of your dental water system, showing the location of water outlets, valves, filters, heaters, and other devices
- Visual inspection of your dental water system, checking for any signs of corrosion, leakage, damage, or contamination
- Temperature measurement of your hot and cold water outlets, ensuring that they are within the safe range (below 20°C for cold water and above 50°C for hot water)
- Water sampling and testing for Legionella bacteria and other microorganisms, using a reputable laboratory or a rapid test kit
- Risk rating of your dental water system, based on the likelihood and severity of Legionella infection
- A list of recommendations for improving your dental water system, such as cleaning, disinfection, maintenance, or replacement of equipment
- Review date for your Legionella risk assessment, which should be at least every two years or sooner if there are any changes to your dental water system or the regulations
Legionella Risk Assessment – Consequences
A Legionella risk assessment is not only a good practice, but also a legal requirement.
According to the HSE, you have a duty to carry out a Legionella risk assessment if you are an employer, a self-employed person, or a person in control of premises where water is used or stored. The CQC also requires dental practices to have a Legionella risk assessment as part of their essential standards of quality and safety.
If you don’t have a Legionella risk assessment, or if the current one is outdated or incomplete, you could face serious consequences, such as:
- Failing your CQC inspection
- Receiving a notice, a fine, or a prosecution from the HSE
- Facing a lawsuit, a claim, or a compensation from your staff or patients
- Losing your reputation, your income, or your license
Legionella Control Measures
Once you have a Legionella risk assessment, you need to implement the recommended Legionella control measures. Legionella control measures are the actions that you take to prevent or reduce the growth and spread of Legionella bacteria in your dental water system. Legionella control measures can be divided into two categories: general and specific.
General Legionella control measures are the basic precautions that apply to all water systems, such as:
- Maintaining the water temperature below 20°C for cold water and above 50°C for hot water
- Flushing the water outlets regularly, especially after periods of non-use
- Removing any dead legs, redundant pipes, or unused outlets
- Insulating the pipes and tanks to prevent heat loss or gain
- Cleaning and descaling the taps, showerheads, and other fittings
- Replacing any damaged or corroded parts
- Using water treatment chemicals, such as chlorine, chlorine dioxide, or monochloramine, to disinfect the water and prevent biofilm formation
- Monitoring the water quality parameters, such as pH, hardness, and conductivity, to ensure optimal conditions
- Keeping records of all the Legionella control measures and their results
The specific Legionella control measures that you need to implement depend on the type and configuration of your dental water system and the equipment that you use. You should follow the recommendations from your Legionella risk assessment and the guidance from the HSE, the CQC, and the British Dental Association (BDA).
Importantly, Implementing Legionella control measures is not a one-time task, but an ongoing process. You need to regularly check, maintain, and update your dental water system and equipment to ensure that they are working properly and safely.
Dental Unit Waterline Management
Dental unit waterlines are the small-bore plastic tubes that supply water to dental equipment, such as hand pieces, scalers, and irrigators. Dental unit waterlines can create aerosols during dental procedures, such as drilling, scaling, or rinsing. If the water in the dental unit waterlines is contaminated with Legionella bacteria, these aerosols can pose a risk of infection for both the dental staff and the patients.
Dental unit waterlines are one of the most challenging aspects of Legionella prevention in dental clinics, as they offer ideal conditions for Legionella growth, such as:
- Warm temperatures, ranging from 20°C to 40°C
- Stagnant water, due to intermittent or low water flow
- Biofilm formation, due to the accumulation of organic and inorganic matter on the inner walls of the tubes
- Nutrient availability, due to the presence of bacteria, algae, fungi, and protozoa in the water
How to Prevent Legionella in Dental Unite Waterlines
To prevent Legionella in dental unit waterlines, you need to implement a dental unit waterline management plan that covers the following steps:
- Drain and flush the dental unit waterlines daily, before and after each patient, and after periods of non-use, to remove stagnant water and reduce biofilm build-up
- Disinfect the dental unit waterlines at least twice a week, using a suitable disinfectant, such as chlorhexidine, hydrogen peroxide, or chlorine dioxide, to kill any bacteria and remove any biofilm
- Replace the dental unit waterlines at least once a year, or more frequently if indicated by the manufacturer or the water quality test results, to prevent deterioration and contamination
- Use sterile or distilled water for dental procedures that involve irrigation or surgery, to avoid introducing any microorganisms or impurities into the water
- Use water filters, such as point-of-use or in-line filters, to remove any particles or microorganisms from the water before it reaches the dental equipment
- Test the water quality of the dental unit waterlines regularly, using a reputable laboratory or a rapid test kit, to ensure that it meets the microbiological standards set by the HSE and the CQC, which are less than 100 CFU/ml for general dental procedures and less than 10 CFU/ml for irrigation or surgery
Water Treatment & Testing
Water treatment and testing are the final steps in preventing Legionella in dental clinics. Water treatment and testing are the processes of applying physical, chemical, or biological methods to improve the quality and safety of your dental water. Water treatment and testing can help you achieve the following goals:
- Kill or remove any bacteria or other microorganisms from the water
- Prevent or reduce the formation of biofilm in the water system
- Adjust the water parameters, such as pH, hardness, and conductivity, to the optimal levels
- Monitor the water quality and detect any changes or problems
Water treatment and testing can be applied to different parts of your dental water system, such as the source, the storage, the distribution, or the usage of water. Water treatment and testing can also be applied to different types of water, such as mains water, bottled water, or sterile water.
Contact Pipe Testing Services
By choosing PTS, you can save time, money, and hassle, and ensure that your dental water system and equipment are in compliance with the legal requirements and the best practices for Legionella prevention. Plus, you can benefit from PTS’s competitive prices, fast turnaround, and excellent customer service.
Phone – 01922 451646
Email – enquiries@pipetestingservices.co.uk
Address – Unit 27 Birchbrook Industrial Estate, Shenstone, Lichfield, Staffs, WS14 0DJ
We are committed to delivering reliable and reputable services to ensure the safety and compliance of your water systems. Contact us now to discuss your needs or to schedule a consultation. Our knowledgeable team is ready to assist you.
Contact us today to discuss your Legionnaires risk assessment for your dental practice. Receive a personalised quotation that meets your budget and ensures the highest quality of service.