Efficacy of A-dec's ICX dental unit waterline treatment solution in the prevention and treatment of microbial contamination in dental units

OBJECTIVE: Even though some chemical agents can disinfect biofilms in dental unit waterlines, there remains concern that all remnants of the biofilm matrix are not eliminated. Even with periodic treatments, the bacterial populations in dental unit waterlines recur rapidly. In addition, with some previously tested products, patient safety, as well as toxic, caustic and corrosive residual chemicals are also a concern. This study evaluated ICX, A-dec's new water treatment solution, in a series of experiments for prevention, microbial spectrum of activity, minimum inhibitory time determination, and treatment of established biofilms. METHODOLOGY: New dental unit waterline tubing was treated continuously during simulated patient care over 28 days with municipal water. It was then treated with ICX. Effluents from lines with established biofilms (averaging > 10(4) CFU/ml at day 0) were treated to assess levels of CFU counts within 21 days of exposure to ICX. RESULTS: Tubing treated with ICX did not develop a detectable biofilm using ruthenium red staining, and microbes in effluents remained undetectable. CONCLUSION: ICX is effective in maintaining the effluent within the American Dental Association's and the Centers for Disease Control's recommendation for < 500 CFU/ml. In addition, considering the preliminary finding that ICX reduces microbial contamination of effluents from established biofilm lines, it may be useful in long-term treatment alone or when coupled with a shock treatment to assist in biofilm destruction.