Frequently Asked Questions (FAQs)
1. General (11)
ALL disinfectants corrode materials after a period of time. The important thing to remember is a) not to exceed contact times and b) rinse surfaces prone to corrosion with water or with a dry wipe soaked in purified water.
A recent document published by the Centre for Sustainable healthcare highlights 5 ways dentistry can be called sustainable: travel, equipment and supplies, energy, waste and biodiversity/green spaces. ‘Equipment & suppliers’ section cites ‘reducing toxic usage’: CHL’s disinfectant range show the highest levels of toxic safety in all tests used by European Regulations (Article 95), including non-cytotoxic, non-mutagenic, no reproductive toxicity, no bioaccumulation, no damage to eyes and skin, no harm to aquatic life amongst many other tests- even in concentrate. All of this info can be found on your SDS (safety data sheet).
Further reading:
Cytotoxicity means poisonous to cells. Most traditional disinfectants are poisonous to all loving organisms, including human cells. By contrast, CHL’s range of productrs are NOT toxic to human cells (even when undiluted), yet are highly effective at killing pathogens (bacteria, viruses etc). All of this info should be available on the SDS (safety data sheet) of a reputable product.
Further reading:
Mutagenicity means changing the DNA of a living cell. Most traditional disinfectants will affect the DNA of the cells in your body. By contrast, CHL’s range of products will not affect the DNA in your cells (even when undiluted) , yet are highly effective at killing pathogens. All of this info should be available on the SDS (safety data sheet) of a reputable product
Further reading: Mutagenicity in a molecule- Hsu et al. PLoS one ‘16
Reproductive toxicity means having an effect on any of the components of reproduction (eggs, sperm) as well as the pregnancy process itself. The US government’s CDC states: ‘Working with chemical disinfectants and sterilants…during pregnancy could increase your chances of having a miscarriage or preterm birth.’
CHL’s range of products do not affect any of the components of reproduction, yet are highly effective at killing pathogens. All of this info should be available on the SDS (safety data sheet) of a reputable product.
Further reading:
Bioaccumulation means the gradual accumulation of substances (eg disinfectant chemiclas, heavy metals) in an organism, typically vital organs for humans.
It can happen through skin, inhalation and digestion, which in turn can cause reproductive issues, asthma, allergies, skin irritations and so on.
Front line clinical staff who use disinfectants several times per day need to be aware of the issue.
Further reading:
Because it shows how long it takes to kill bacteria and viruses. Some products can kill certain bugs in seconds, whilst other products could take minutes to kill the same bugs. It is vital you adhere to the timeframes listed. CHL disinfectants are typically much quicker at killing bugs than traditional disinfectants.
Further reading:
Yes! All products have been tested to specified timeframes. Exceeding those timeframes could produce unexpetcted microbiological and material degradation issues on the surfaces being disinfected.
Further reading:
Yes! Another one of nature’s gifts is that there is an active disinfectant molecule that is highly effective at destroying pathogens (viruses and bacteria) yet is totally harmless for humans. This is hypochlorous (HOCl), an oxidising agent that is produced in mammalian white blood cells, that evolution has perfected to kill bugs faster than any other disinfectant yet discovered. AKA a biomimetic!
That is because they contain a naturally occurring weak acid called HOCl (hypochlorous), that starts reverting back to its constituent parts (sodium chloride and water) after the shelflife has elapsed. This could be up to 2 years later, although most of the disinfectant efficacy of the product would have dissipated by then.
Look for the following info on the product label:
- Specific pathogens that are killed – either name or independent testing standard achieved (eg EN14476)
- Contact times. Often these can vary widely between products
Further reading:
- CDC – factors affecting efficacy of disinfection and sterilising
- Modern technologies for improving cleaning and disinfecting- Boyce- ARIC ‘16
2. OraWize+ mouthwash / dental rinse (4)
OraWize+ is non-cytotoxic in concentrate, with an LD50 (lethal dose) of 7500ml. Most other mouthwashes and dental rinses are cytotoxic with much lower LD50 volumes. Therefore it makes sense on many levels to use a non-toxic product on all vulnerable patients.
No! OraWize+ does not include other ingredients or additives that could potentially cause tooth staining.
65-80% of chronic and microbial illnesses caused by biofilm. In addition, most reactive dental treatment is due to a proliferation of biofilm in the mouth: plaque, caries, periodontitis, gingivitis & endodontitis. Hence a mouthwash/dental rinse that is highly effective at destroying all stages of pathogens (free-floating and biofilm) is ideal for dentistry.
Further reading:
The 3 main benefits of OraWize+ over other mouthwashes and dental rinses include:
- It can typically destroy oral biofilm faster than other products
- It is non-cytotoxic, so it is unlikely to harm patients
- It does not stain teeth
3. Reverse Osmosis and water purification (14)
All of these shapes indicate the presence of raised microbiological activity from your dipslide result and merit further investigation into where the problem lies.
Assume a 3 chair practice uses 5L purified water per day (so 5 x 5L bottles per week):
a) Bottled water:
- Generates over 78kg of plastic waste each year
- Requires dental staff to carry and store over 1.3 tons of water each year around the practice
- The financial cost is over £1150 pa (£4.50/bottle)
b) Distiller kettle:
- Only produces 1L of purified water each hour
- Up to 1/18 of each litre of water produced can turn to steam in the decon room, making for an unpleasant working environment for busy dental nurses
- Distiller (750w) can cost over £340* pa in electricity
*making 5L/day, 5 days p/wk, 35p kw/h
c) EauFlow RO:
- Produces 12-20L of purified water each hour (depending on water hardness)
- Is the only RO system to monitor both organic and non organic water impurities
- Is the only RO system with quick-change (and tool-free) cartridges on all 5 stages, thus reducing equipment downtime in busy practices
- Tailors packages to your specific practice’s water needs, thus ensuring cartridge change once pa
- RO costs approx 3p* per day to fill up a 12L tank or £7.80 pa in electricity- over £332 pa (97%) saving pa vs distiller
*making 5L/day, 5 days p/wk, 35p kw/h
Calculations:
Distiller: 5 hours to make 5L= £1.75= £8.75 p/wk= £455 pa x 750w kettle= £341.25.
vs
RO: The electricity consumption per hour of the pump is DC24V x 1.5A = 36w/h = 0.036 Kw/h. 35 pence x 0.036Kw/h = 1.26 pence. So running the EY505 pump for 1 hour (to fill up 12L tank)= 1.26 p. 2x for LED number display.
All purified water (inc RO water) is susceptible to bacterial growth.
As the purified water is used in dental chair waterlines, this needs to be bacteria free to avoid further microbiological issues further downstream.
CHL has developed a unique system to monitor and mitigate for bacteria in your RO water, so as to prevent microbiological issues manifesting in your waterlines.
In addition, CQC inspections can ask what systems you have in place to monitor purified water in your dental practice- the Eau Flow RO can help you keep compliant with that request.
Further reading:
If specified correctly, then you only need to do this once per year on your Eau Flow RO or Di cartridges. In soft water areas (eg Scotland, Wales etc) then this can be up to 2 years, as long as you monitor both TDS and TVC (bacterial levels)
Yes! The EauFlow’s benefits include quick change (bayonet) cartridges on all 5 stages- this means anybody can change them in seconds. In hard water models, the blue Di (EY30810) can be done in minutes as well without any special tools.
1) Soft water model: on the RO display
2) Hard water model: use the inline TDS meter, between the blue Di and the tap
Simply add together:
1.Dental chairs: how many in your practice (assume 1L bottle)= ?
PLUS
2. Autoclaves: how many units do you have in total (assume average 3L water reservoir)= ?
This total volume (litres) will tell you how much water you need at the beginning of the day and hence what RO tank size you need.
e.g. A practice has 8 dental chairs and 3 autoclaves: So they need:
- 8 x 1L for the chairs = 8
- PLUS
- 3 x 3L for the autoclaves = 9
-
8 + 9 = 17L of water at the beginning of the day. Hence our recomendation would be a 22L RO tank size.
Either:
- Cartridge lights 1,2,3 & 5 are flashing on the display OR
- Light 4 is flashing and your TDS reading is above 10
When the TDS reading on your inline meter is the same as the TDS reading on your RO unit.
- It helps keep the quality of purified water to a satisfactory level for your autoclave over extended periods (1 yr+)
- It helps prolong the life of your final stage Di cartridges.
Yes – it is simply water that has not made it through the membrane, not dirty water. It can be mitigated for by recycling back into your plumbing.
4. CleanCert 2-in-1 waterline disinfectant (6)
Because it is the only waterline cleaner that contains both processes in one bottle (continuous dosing and shock treatment) – easier staff training, inventory management, and storage. All helping make for happier working environment.
Because it is the only waterline cleaner that is 100% non-cytotoxic in undiluted form. This means next to zero risk for staff handling the product and patients ingesting the product. All helping make for happier working environment.
Yes – if you use a continuous dosing waterline cleaner, then biofilm can still grow.
Further reading:
TVC dipslides are an indication of microbial activity. They are a good first step in empowering dental teams to proactively monitor water quality, providing:
a) there is a wider procedural system to support positive (false) readings, for example with a UKAS water lab
b) the user is aware they can produce false positive and double negative readings. This can be caused by various external factors causing raised temperatures, which in turn affect the results: examples include hot weather, heat from other equipment (fans, heaters etc) or non-visible factors like warm air ducts.
Red smears or streaks on dipslides can be caused by false positives from raised water or air temperatures
Email technical@cleancert-hygiene.co.uk and ask for the questionnaire that helps establish where the issues may lie. The team can help you resolve issues quickly, safely and cost effectively.
All of these shapes indicate the presence of raised microbiological activity from your dipslide result and merit further investigation into where the problem lies.
5. Eau Flow Dental Softener (9)
A water treatment device that removes dissolved hardness salts from a mains water supply, usually at the point-of-entry to a property
As tap water passes through the softener, calcium and magnesium ions (which would form limescale) are adsorbed onto food-grade beads and replaced with sodium. Periodically, when the resin is coated with ions, the beads are washed with brine (salt water) flushing the hard water ions to drain and replenishing the sodium ready for the next treatment cycle. At the end of the cycle the softener is flushed with fresh water leaving the water wholesome and ready for use. The softener has to occasionally be filled with water softener salt (usually in the form of tablets).
Water softeners are set to perform the regeneration cycle at the optimum time to allow the continued use of treated water. All models vary according to use and local water hardness. Typical regeneration cycles for the EauFlow softeners are as follows:
Non-electric: 15 minutes, for approx. every 100 litres of water
Electric: 45 minutes, at 3am every 3 days.
Softened water has a higher level of sodium immediately after regeneration and then remains low throughout operation. It is suitable for drinking, although there is guidance for those on low sodium diets or for babies using formula milk made from softened water.
Softened water is not salty water.
The RDA (recommended daily allowance) in UK of sodium is approx 2500 mg from all sources, although typical adults consume approx 3500mg.
The harder the water, the higher the level of sodium in the softened water.
Typical examples are: two glasses of milk contain 325 mg of sodium, and two slices of bread contain 375 mg. For comparison, an adult in a hard water (300mg/l calcium carbonate) area drinking 4 pints (2 litres) of artificially softened water per day would add only 310mg of sodium (or less than 9%) to their average daily intake
An electric softener automatically shuts off water valves and starts the regeneration process at a specific time.
A non-electric softener requires water flow (at sufficient pressure, typically >1bar) for operation.
You want to install a softener that is able to shut off the backflow pressure valve, otherwise you will waste a lot of water down the drain.
See ‘where is it best to install a softener in a dental practice?’ FAQ
The ideal location for installation of an electric or non-electric water softener is just after the stop cock of the mains feed into the property.
If this is not feasible, then only install an electric water softener on the mains supply in a LDU (decon room) before a washer disinfector.
The World Health Organisation’s (WHO) position on drinking softened water is: “There are no firm conclusions on whether it poses long-term health risks so no health-based guidelines are proposed.” In over 90 years, there has never been a reported health-related problem associated with a water softener.
In the UK, The Water Supply (Water Quality) Regulations 2016 in England & Wales, published by The Drinking Water Inspectorate, allows for a concentration of sodium of up to a maximum level of 200mg/l in water supplied to a property. Very hard water up to 400mg/l hardness would still be considered wholesome after softening.
The answer depends on if there is a chance that the softened water will be consumed either by those on low sodium diets or by babies drinking formula milk made up from the water.
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