Colonization of Dental Unit Waterlines by Helicobacter pylori: Risk of Exposure in Dental Practices

Int J Environ Res Public Health. 2019 Aug 19;16(16):2981. doi: 10.3390/ijerph16162981.

Abstract

Dental unit waterlines (DUWLs) can be considered one of the possible routes of H. pylori transmission, although its presence in DUWLs has not yet been investigated thoroughly. The present study aimed to discover the prevalence of H. pylori and oral streptococci (S. oralis and S. mutans) in DUWLs to evaluate the risk of exposure to human pathogens in dental practices. We collected the output water from 60 dental chair units (DCUs) in 26 private dentistry settings in Turin, searching for H. pylori and oral streptococci (OS) DNA, with a polymerase chain reaction (PCR) technique. At the same time, dentists completed a questionnaire about their DCUs, their main activities, the presence of anti-retraction devices, their attitudes about disinfection, etc. No dental chair unit tested was contaminated with H. pylori or S. mutans; only one dental chair was contaminated with S. oralis (1.7%). Considering the results, we can state that: (i) the lack of H. pylori DNA in water samples analyzed, suggests that municipal water is presumably treated with a sufficient chlorine level to inactivate DNA over time; (ii) the aspiration of oral fluids is limited by anti-retraction valves fitted distally to hand pieces; (iii) propidium monoazide qPCR (PMA-qPCR) could be a good technique to investigate and monitor potential environmental sources of infections such as DUWLs.

Keywords: Helicobacter pylori; cross-infection contamination; dental unit; dentistry; infection control; streptococci.

MeSH terms

  • Cross Infection / etiology
  • Cross Infection / prevention & control
  • Cross Infection / transmission
  • Dental Equipment / microbiology*
  • Environmental Exposure / analysis*
  • Helicobacter Infections / etiology
  • Helicobacter Infections / prevention & control
  • Helicobacter Infections / transmission
  • Helicobacter pylori / isolation & purification*
  • Humans
  • Infection Control
  • Risk Assessment
  • Streptococcus mutans / isolation & purification
  • Streptococcus oralis / isolation & purification
  • Water Microbiology*