For dentists, successful decontamination is a multi-layered process, where vigilance is key. The microorganisms found in dental settings are often on surfaces and hidden in self-contained water supply systems. Moreover, many pathogens are growing ever more resilient to disinfectants and drugs so preventive methods are even more crucial. Also, our increasingly ageing population have weaker immune systems and greater susceptibility to water and blood-borne illnesses.
The quality of water supplying dental unit water systems (DUWS) e.g. autoclaves, washer disinfectors and Reverse Osmosis filters, has to be of optimum purity. The complex network of connecting plastic tubes integral to DUWS, have consistently proven to be prone to microbial biofilm cultivation. Whilst the majority of opportunistic pathogens are eliminated by chlorine added to our water supplies, the composite nature of some bacteria renders them either completely resistant to, or more robust in their defence against disinfectants.
One example is Cryptosporidium – a parasite causing the diarrheal disease, cryptosporidiosis, acquired through drinking contaminated water. It is resistant to most forms of disinfection and therefore constitutes something of a headache to the water industry and health officials. Reverse Osmosis water filters that have been correctly maintained, have shown to effectively eradicate this insidious pathogen.
Other gram-negative (multi-drug resistant) microorganisms found in DUWS output water include:
Reverse Osmosis water filters dilute water from a more concentrated state by passing it through a semi-permeable membrane. They are highly effective in removing protozoa (single celled microscopic organisms) such as Cryptosporidium and viruses such as Hepatitis A and Norovirus[iii].
CleanCert is one of the UK’s foremost suppliers of infection control solutions. For example, its range of exemplary Reverse Osmosis filters are demonstrably effective at reducing the risk of waterborne infections. The team is also dedicated to providing you with more cost-effective ways of maintaining compliance, by developing simple to use ‘annual maintenance kits’ and water analysis ‘dipslide apps’, to ensure you can manage and maintain your own decontamination protocols effectively, quickly and inexpensively.
Protect yourself, your staff and your patients, call CleanCert today.
[i] Daily Mirror - Five Former Patients of HIV-Scare Dentist D’Mello Test Positive For Hepatitis C. http://www.mirror.co.uk/news/uk-news/five-former-patients-hiv-scare-dentist-5353918 (Accessed 7/10/2015)
[iii] CDC Centers For Disease Control And Prevention – A Guide To Drinking Water Treatment Technologies For Household Usem 2008, http://www.cdc.gov/healthywater/drinking/travel/household_water_treatment.html (Accessed 7/10/2015)
These congresses, held every three years, aim to implement the EFP vision of "Periodontal health for a better life". BSDHT President Michaela ONeill, addressing delegates from the stage said:
"On behalf of the British Society of Dental Hygiene and Therapy, I would like to thank the European Federation of Periodontology and the British Society of Periodontology for what promises to be a very stimulating and productive few days.
My role, and the role of my fellow dental hygienists and therapists, is one part of a vast chain of dentistry that leads to good oral health.
We’re constantly trying to translate our research into patient friendly messages.
The recent results of the European Workshop in Periodontology have focussed new light on how we thought we should educate our patients – especially as it included what looks now like a one hundred and eighty degree turn in the new recommendation for interdental brushing rather than flossing.
But beyond conference, and indeed academia, it is crucial that we are "people facing" and that we can filter the messages of a major conference like this directly to our clinical staff: they are the gatekeepers who will present your messages direct to our patients.
And on behalf of the BSDHT, we are proud that the importance of our role within periodontology is being reflected at EuroPerio 8."
Follow the BSDHT on Twitter @BSDHTUK or further information about BSDHT
Address: Smile House, 2 East Union Street, Rugby, Warwickshire, CV22 6AJ
A recent study found that the vast majority of patients assessed (84%) had very poor levels of denture hygiene[ii]. This was attributed to the lack of hygiene instructions given by dental professionals, as after clinician led patient education, denture cleanliness index (DCI) scores increased significantly2.
Currently there is no clearly defined or regularly used standard or scoring system for determining denture hygiene in the UK. Therefore, the researchers devised the DCI scoring system prior to the audit, which ranges from 0-4. Additional studies are required to refine, test and evaluate the classification, however it could help dental professionals in the future to determine denture hygiene status of patients and highlight any areas of concern2.
Compared to dental care, denture hygiene has received little attention, yet neglecting to look after prostheses can significantly increase an individual’s risk of developing oral infections and systemic diseases[iii],[iv].
Dentures offer a reservoir for microorganisms to thrive and it is well documented that patients wearing partial sets are at a higher risk of developing periodontal disease and dental decay of the teeth directly adjacent to the dentures[v].
Several studies have shown that plaque biofilm accumulates on the internal surface of dentures and certain pathogens may even preferentially colonise on prostheses over oral soft tissues3,[vi]. Acting as a reservoir for bacteria and fungal microorganisms, these pathogens are involved not only in the appearance of local infections like denture stomatitis, but also systemic diseases such as endocarditis, pneumonia and respiratory track infections3.
Problems can also arise if there are any surface defects or other flaws in the denture which are either inherent and due to the fabrication process or acquired due to general use. These can cause imperfections and roughness, which increases the surface area on which bacteria can adhere and potentially colonise[vii].
Furthermore, if the finish is rough it can make cleaning the prosthesis and mechanical removal of the microorganisms difficult, as well as causing discoloration of the denture base materials. The irregularities on the surface can provide niches in which microorganisms are protected from oral hygiene measures, thus allowing the entrapped microbial cells to attach irreversibly to the prosthesis7.
Working with a laboratory, such as Sparkle Dental Labs, that complies with all of the current standards and regulations, uses the very best materials and creates dentures that fit perfectly is essential. The renowned company are able to offer complete traceability on every item and all dentures are fitted to duplicate models to ensure ultimate precision and patient comfort.
In the future the DCI scoring system could be used to help practitioners to identify patients suffering from poor denture hygiene. However, in the mean time dental professionals are encouraged to continue to fit quality dentures and offer patients oral healthcare advice.
[i] Health & Social Care Information Centre. Adult Dental Health Survey. Published 24th March 2011. Available online: http://www.hscic.gov.uk/article/3894/Adult-Dental-Health-Survey [Accessed 23rd December 2014].
[ii] Mylonas, P., et al. (2014). A clinical audit of denture cleanliness in general dental practice undertaken in the west midlands. British Dental Journal, 217.
[iii] de Andrade, I. M., et al. (2014). Trial of an experimental caster oil solution for cleaning dentures. Brazilian Dental Journal, 25 (1).
[iv] Milward, P., et al. (2013). Knowledge of removable partial denture wearers on denture hygiene. British Dental Journal, 215 (10).
[v] Coulthwaite, L., & Verran, J. (2007). Potential pathogenic aspects of denture plaque. British Journal of Biomedical Science, 64 (4), 180-189.
[vi] Salerno, C., et al. (2011). Candida-associated denture stomatitis. Oral Medicine and Pathology, 16 (2), 139-143.
[vii] Govindswamy., et al. (2014). The influence of surface roughness on the retention of candida albicans to denture base acrylic resins – an in vitro study. Journal of Nepal Dentists Association, 14 (1), 1-9.