CDC warns dental patients about rare bacterial infections via water supply

CDC warns dental patients about rare bacterial infections via water supply

CDC warns dental patients about rare bacterial infections via water supply

The US Centers for Disease Control and Prevention (CDC) has issued an emergency response and preparedness health advisory regarding an outbreak of nontuberculous mycobacteria infections that occurred via dental root canals.

The warning was issued by the Health Alert Network agency. Remember dental patients and professionals about the importance of hygiene during dental procedures.

Non-tuberculous mycobacteria are defined as “opportunistic pathogens”. [that place] some groups at increased risk, including those with lung disease or a weakened immune system,” according to the CDC.

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Although the infections are rare, the CDC noted that there have been several documented cases of children contracting nontuberculous mycobacteria after undergoing a pulpotomy — a procedure that involves removing the diseased pulp of a tooth — according to the American Dental Association.

The documented outbreaks reportedly occurred in March 2022. They originated from a pediatric dental clinic where treatment water had high levels of bacteria, according to the CDC.

The city and state where the recent outbreak occurred have not been released.

CDC warns dental patients about rare bacterial infections via water supply

Water is usually used in dental procedures. The investigation into the cluster of outbreaks is ongoing, the CDC says.
(iStock)

Nontuberculous mycobacteria were transmitted to patients by dental unit water lines, defined by the CDC as “narrow-bore plastic tubing” that runs water through a “high-velocity handpiece, air/water syringe, and ultrasonic scaler.”

An outbreak cluster investigation is ongoing and a preliminary site visit has been conducted, the CDC alert said.

“A large number of common waterborne bacteria can be found in untreated dental unit water systems,” the CDC wrote.

Similar outbreaks at children’s dental offices occurred in the past, including 71 dental patients in California—who were infected with odontogenic (infections that originate in the teeth or surrounding tissue) nontuberculous mycobacteria after receiving pulpotomy procedures in 2016.

A year earlier, 24 dental patients in Georgia were infected with odontogenic nontuberculous mycobacteria after the same procedure.

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“The outbreaks in California and Georgia involved young children, ages 4 to 8,” the CDC wrote.

“Many children developed severe infections with clinical diagnoses such as cervical lymphadenitis and osteomyelitis of the mandible or maxilla, requiring hospitalization, treatment such as intravenous antibiotics and surgical procedures.”

Infections of dental fluid full of bacteria can lead to mild or severe complications.

Infections of dental fluid full of bacteria can lead to mild or severe complications.
(iStock)

“Complications caused by their infections included permanent tooth loss, hearing loss, facial nerve palsy, and incisional fibrosis,” the warning continued.

Dental water units are prone to biofilm formation and bacterial accumulation when water flow rates are low and have frequent periods of stagnation.

“As a result, large numbers of common waterborne bacteria can be found in untreated dental unit water systems,” the CDC wrote.

“Disease-causing microorganisms found in untreated dental unit water may include Legionella, Pseudomonas aeruginosa and non-tuberculous mycobacteria (NTM).”

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Other dental procedures that could also pose a risk if people are exposed to contaminated water include incisions, excisions, biopsies, periodontal surgery, apical surgery, implant surgery, tooth extraction and bone removal, the CDC noted.

Dental professionals should ensure that they work with disinfected tools and sterile water.

Dental professionals should ensure that they work with disinfected tools and sterile water.
(iStock)

According to the CDC.

The Agency recommends that dentists and institutions follow infection control guidelines in dental settings, monitor water quality and treat dental unit water lines for patient safety.

Biofilm can be removed and prevented by routine sanitation procedures, which may include disinfectants that meet the Environmental Protection Agency’s regulatory standards for drinking water or commercial disinfection products and devices.

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Dentists should consult the manufacturer’s instructions when handling dental equipment, the health agency said, to ensure they use “appropriate methods” and effectively maintain and monitor the quality of the dentifrice they use.

Dental patients can ask dentists about their sanitation policy.

Dental patients can ask dentists about their sanitation policy.
(iStock)

Dental patients and parents or guardians of pediatric Dental patients should contact their dentist if an infection is suspected after treatment, according to the CDC advisory.

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“Signs and symptoms of postoperative dental infection may include a localized oral abscess, fever, or pain and swelling in the mouth or neck,” the CDC wrote.

“Talk to your dentist about their infection prevention and control practices and the steps their staff takes to ensure safe treatment for all patients.”

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