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When performing procedures on exposed dental pulp, water or other methods used for irrigation must be “sterile or contain recognized disinfecting or antibacterial properties,” according to a new requirement that all licensed dentists in California must follow beginning Jan. 1, 2019.

This requirement stemmed from a 2016 outbreak of mycobacterial infection in a Southern California dental clinic that led to the hospitalization of more than 60 children. Investigation into what occurred suggested that the bacterium that infected the children was likely introduced by water used during the performance of pulpotomies.

CDA worked with the state Legislature to ensure the new requirement appropriately addressed the vulnerability that occurs during treatment of exposed dental pulp and is pleased that it “sets a clear standard for infection control during dental pulp procedures.”

The new requirement is in addition to existing dental board regulations on water quality, which require that dental water lines be purged with air or flushed with water at the beginning of each workday and flushed between each patient.

Because waterline maintenance is also essential to water quality, the Centers for Disease Control and Prevention recommends that dentists consult with the dental unit manufacturer for appropriate methods and equipment to maintain the quality of dental water. Additionally, the Food and Drug Administration in July published a dedicated webpage on infection control in dental unit waterlines.

CDA Practice Support has infection-control resources.