How is your water? An interdisciplinary approach to management of biofilm in dental unit waterlines.

Much new information has become available as interest has grown in issues of biofilm formation and dental unit water quality. This interest is combined with a growing concern for occupational safety and for patients with diminished resistance. A review of recent literature spurred interest amongst the staff of The Hamilton-Wentworth Regional Public Health Department to carry out a quality audit of the dental unit water quality in clinics operated by the Department's Dental Services. Water testing was carried out, and problems with biofilm formation and water quality were identified. An interdisciplinary consultation process helped identify problems, offered possible solutions and made decisions on appropriate action to be taken. Some conservative interventions were successfully implemented even while it was recognized that more involved interventions were also needed. Repeat testing was carried out until the water quality in the clinical waterlines reached acceptable levels. Biofilm management to ensure water quality for both patients and staff, is now an integral part of quality management in the Hamilton-Wentworth Regional Dental Clinics.

The forgotten surgical foreign body.

Instruments and drains left in the abdomen following surgery may be responsible for bizarre and varied complications. The patient may remain asymptomatic for months or even years. Complications include adhesion formation, intestinal obstruction, abscesses, and erosion into the gastrointestinal tract. We report 3 patients in whom retained surgical material eroded into the duodenum and colon, respectively, and produced unusual radiologic findings and complications.