Legionnaires’ Disease From Dental Water Lines
Most of us are aware that there's a risk of acquiring blood-borne infections like HIV and hepatitis B during dental procedures if universal precautions and proper sterilization techniques are not followed. But did you know that you could also pick up
Legionnaires' disease at the dentist's office?
Last year, an elderly woman in Rome, Italy, died from pneumonia caused by Legionella that was traced to her dentist's water line. The source of the infection was relatively easy to confirm: The patient had left home only twice during the incubation period, each time for a dentist appointment. After her illness was reported, health officials identified Legionella in the dental unit's water pump that genetically matched the strain found in the patient.
Legionnaires' disease, or the less serious variant known as Pontiac fever, can occur when mist or vapor containing the bacteria is inhaled. Legionella thrives in standing water, especially when it's kept at or near body temperature. The bacterium is frequently found in facilities with complex plumbing systems, and over the years, there have been highly publicized outbreaks in hotels, hospitals, and nursing homes. In 2011, a hot tub at the Playboy Mansion was also investigated as the cause of a suspected outbreak.
While this is the first time that a dental water line has been confirmed as a source of Legionnaires' disease, links have been suspected in the past. As a group, dental professionals have been shown to have higher than usual Legionella antibody titres. And after a California dentist died from a Legionella infection, the bacteria was found at both his home and his office---with significantly higher bacterial counts being detected at the office. This raises exposure concerns for both patients and dental professionals.
It is a risk that has long been recognized. In 2003, the CDC issued guidelines for infection control related to dental water lines. But since individual dental offices might have different infection control procedures, patients might want to have a conversation with their dental care providers about the implementation of these guidelines. Dental professionals can find helpful information on this topic on the Organization for Safety, Asepsis and Prevention's website at http://community.advanceweb.com/controlpanel/blogs/www.osap.org.