The reality Impact of non-compliant DUWL treatment is too great to ignore
Multiple incidents of mycobacterial infections and at at least one fatality from Legionnaires’ disease have all been traced back to contaminated dental unit waterlines A major infection control breach in 2016 at a Southern California pediatric dental clinic resulted in over 70 children being hospitalized and treated for Mycobacterium (NTM) infections follow- ing pulpotomies. Over 20 children required medical treatment as a result of infection acquired at an Atlanta, GA area pediatric dental clinic following a similar bacterial outbreak attributed to contaminated dental unit water in September 2015.
How Cervicofacial nontuberculous mycobacterial (NTM) lymphadenitis impacts children
Unilateral, non-tender, cervical lymphadenopathy with violaceous discoloration 3 . (Image not associated with CA or GA outbreaks.)
Prognosis for nontuberculous mycobacterial infections in children
• Most children require surgical treatment 3
• Comes with risk of damage to the facial nerve and will always result in a scar 3
• Swelling, redness and pain around the infected tooth can occur, with the bacteria often spreading to the gum and jawbone. In those cases, stopping the infection often means removing part of the jaw itself, making it a longterm issue for these children 4
Treatment continues when affected children leave the hospital
• IV antibiotic treatment frequently prescribed post-operatively 3
Child with a cervicofacial Mycobacterium haemophilum lymphadenitis presenting as a fluctuant swelling with red skin discoloration 5 . (Image not associated with CA or GA outbreaks.)
• Antibiotic treatment can last up to 24 months in some cases 5
• Comes with a risk of high-frequency hearing loss 6
• Even if infections are diagnosed early, adequate treatment may be complicated by inability to reduce immune suppression, antibiotic adverse reactions and patient allergy 5
How is your dental office treating DUWLs to minimize the potential for microbial growth?
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3 Haahr Iversen R., Illum P. Cervicofacial nontuberculous mycobacterial lymphadenitis in children. Dan Med J 59/1; 1-4 4 Dr. Matthew Zahn, Orange County Healthcare Agency 5 Jerome A. Lindeboom et al. Clin. Microbiol. Rev. 2011;24:701-717
6 Hatzenbuehler L.A., Tobin-D’Angelo M, Drenzek C., Peralta G., Cranmer L.C., Anderson E.J., Milla S.S., Abramowicz S., Yi J., Hilinski J., Rajan R., Whitley M.K., Gower V., Berkowitz F., Shapiro C.A., Williams J.K., Harmon P., Shane A.L.; Pediatric Dental Clinic–Associated Outbreak of Mycobacterium abscessus Infection, Journal of the Pediatric Infectious Diseases Society, Vol 6, Iss 3, 1 Sept. 17, P e116–e122
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