The Compliance Divas Podcast
Our podcast covers current topics such as infection prevention and control, OSHA and HIPAA compliance for dentistry. We discuss the latest regulatory information, answer frequently asked questions and give suggestions for dental practices to make compliance easy and sustainable. The Compliance Divas are a trusted source for consistent, accurate information based upon current guidelines, standards, science, and recommendations.
The Compliance Divas Podcast
# 203 Dental Water Quality Standards - Is Your State Next to Require Testing?
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The states of WA and GA have implemented rules within the state dental boards for maintaining and testing dental unit water quality. Join the Divas as they discuss this regulatory activity, and why it is so important for patient safety. Our special guest is Chanda Chatham, Director of Education for Solmetex, our sustaining sponsor.
Resources:
- WA State Legislature - Dental Unit Water Quality https://bit.ly/3DYCWyP
- Georgia Dental Association Notice of Attempt to Adopt a Rule - https://bit.ly/4l7pUzz
- Solmetex - State of GA Requirements https://bit.ly/3FS5bzN
- Sterisil Water Products https://solmetex.com/
Welcome. I'm Leslie Kenneth. I'm Mary Gavoni.
SPEAKER_03I'm Linda Harvey. I'm Olivia Juan. And together we are the compliance divas.
SPEAKER_05Welcome. I'm Leslie Cannum. I'm Mary Gavoni. I'm Linda Harvey.
SPEAKER_03I'm Olivia Wan. And together we are the Compliance Divas.
SPEAKER_02Welcome to the Compliance Divas podcast. I'm Mary Gavoni and I'll be the moderator for this episode. And we have a special guest with us today, Shanda Chatham, Director of Education for PSOMedics, who is our sustaining sponsor for our podcast. Welcome, Shanda, and we have lots of questions for you, but first a word about the Compliance Divas podcast. We bring clarity and simplicity to compliance by navigating the regulatory world to keep you on course. You can subscribe to the Compliance Divas podcast through your favorite podcast app or on our website, thecompliancedevas.com. The resources we mentioned during this episode will be in the show notes on your podcast app. You can submit any questions by email to support at thecompliancedeevas.com. And we also ask that when you're finished listening to the episode, that you scroll down to the end of your app and leave us a review or some comments. And again, please submit any questions you have to support at thecompliancedivas.com. So, Shanda, again, welcome. We're so pleased not only to have you here, but for Soul Medics to be our sustaining sponsor. We thank you for your support of the podcast. How about we have you just give us a little bit about your background? How did you become the director of education for Soul Medics?
SPEAKER_01Oh, thank you, Mary. Hello, compliance diva. So excited to be here. I am so appreciative. My background, I actually originated from Steracel, which is the Dental Unit Waterline Magic Management Manufacturer that Soul Medics acquired back in 2022, I believe it was. It's not been long ago. I was the marketing manager there and just learning all the product lines and trying to educate myself as much as I could about water lines. And I became very fascinated with infection prevention and control because it there are so many ins and outs and quirks that are related to it and affect it. So it became sort of like a challenge to just load up on as much education as I possibly could. So with the quick uh acquisition, I moved into a director of marketing strategy and again just owning that brand for Starcel and learning as much as possible. And then now I'm in the role of director of professional education for Soul Medics, again, still around the waterline primarily because it is just so fascinating and different and hard to manage.
SPEAKER_02Well, wonderful. Thank you for sharing your background. So we're going to um have each of the divas take a turn with questions for you, starting with Linda.
SPEAKER_00Well, likewise, Shanda, we're happy to have you here because we think water lines can be challenging for our listeners as well. As hard as they try to be compliant and do the right thing, there's still a lot of confusion. And speaking of confusion, there's one thing that's going on in Georgia now with their pending new law for water testing. And we'd love for you to update our listeners on that.
SPEAKER_01Yes, this is exciting because it's only the second state behind Washington to implement a rule through their Board of Dentistry. And this is great. It's pretty simple actually. It's quarterly testing that they are required to test their water quality and make sure that it they yield passing results at the EPA required limit of 500 CFU per mil. So that's our drinking water standard, and we just want to make sure that the water quality meets that or below. And that's what the rule is is basically telling practices they have to do. They also need to document all of their uh test logs, whichever test they use, they can use any type of test, but they need to document and keep those for five years. And then if there's any uh changes in plumbing or additions in plumbing and equipment, they have to test it within 30 days. And then, of course, any remediation if there are failures.
SPEAKER_00Could you talk about if there's any changes in the motor lines? Do you think that would be if they add a new operatory or a new chair or there's been some plumbing work? Are those the kind of things that people are talking about at the meetings, Shanda? Yes, absolutely.
SPEAKER_01There's actually a misnomer that a brand new chair is clean and squeaky clean and has no biofilm. But unfortunately, they have to test the machines, right? They test the chairs with water, they try to flush out as much as they can, and then they wrap it all up in plastic and it sits in a hot warehouse and it goes on a truck and sits in a practice for a few more months before it opens. Meanwhile, biofilm is growing on the inside of that. So absolutely any type of equipment change. Plumbing can change your source water, a protocol comes into play, or your SOPs also fall into play when something changes. So change means you should test it just to make sure that the new system or however you have it connected is working just as well as it was before.
SPEAKER_00We're listening to you describe that new beautiful dental chair. It reminds me of like if putting it in the same category as ultrasonic soup solution, we call it. You know, though those germ soups, like, ah, it's all good. That beautiful new chair is all contaminated. So I think one of the one of the myths or things that team members misunderstand or not sure about is they think that the water coming into the office is fine. And they they miss the point about us going through those little lines that you just talked about. So could you address those a little bit more? Because we can drink out of the faucet, fine.
unknownRight.
SPEAKER_00But why is it so concerning when it goes to the unit?
SPEAKER_01Yes, well, I say it's not the water, it's the water lines. If you put clean water through mud, you're gonna get mud on the other end, right? And those water lines have biofilm bacteria, we can't see it, it's small, especially if they haven't been maintained or managed for a regular, consistent period of time. So as soon as you put great water, beautiful water, and water from Antarctica, deep in the earth, and it's fantastic and it's clean as ever, and you put it through there. If you have biofilm bacteria, it's now contaminated.
SPEAKER_00Thanks for explaining that. And I I appreciate that. And I know that with this new law coming, it should be signed into effect in the near future. And it's my understanding from what you've told me that the Georgia Dell Association is going to be sponsoring some courses for them. So, anybody listening, if you're practicing practicing in Georgia, stay tuned for those courses. And if you're not practicing in Georgia, these are still practices that you should follow, or I should say, processes and procedures to make sure your dealing unit waterline is safe for your patients.
SPEAKER_01Yes, absolutely. Get ahead of it, start learning now so that way it's a seamless implementation once it goes into effect.
SPEAKER_02And Linda and Shanda, thank you for highlighting the law in Georgia and Washington state. But it's still important to remember that at least 40, and I think it may be a higher number than that, states in the US do require compliance with CDC guidelines. And although the guidelines we have are from 2003, they do address the issue of testing, although they say test periodically, whatever that means. We're hoping that when we get our new guidelines from the CDC that they will be a little more precise, but they do address the issue of testing. And many people are not aware they may be treating their water, but they're not validating that what they're doing is actually working. So that's a really, really critical, critical part. Olivia, I think you had a question for Shanda about where this rule came from in Georgia.
SPEAKER_04Yeah, so Shanda, if you would elaborate just a little bit, what do you think from your perspective prompted this new law in Georgia? Can you expound on some history in that state?
SPEAKER_01Yes. So unfortunately, back in 2022, there was a Mycobacterium abscessis outbreak, and that was in Georgia. It in fact prompted them to implement the rule that they have for hygienists to their continued education. It's a two-hour hygiene course that has to include dental waterline management, and that was the first step to sort of addressing this outbreak and trying to get a handle on the the latest um unfortunate event in that state. But my understanding is, and I don't have all the details because I believe it's still being investigated, but there was an outbreak last year in 2024. So a new outbreak prompted them to say, okay, now we need to do, you know, be more specific. Following the guidelines is great, but having a rule in place to say this is what we say you have to do, it was the next step. And Dr. Resnick was instrumental in championing that proposal to the board for adoption in February.
SPEAKER_04Yeah, so shout out to Dr. Resnick. He has done some amazing things and so dedicated to the profession. You know, Shonda, it reminds me of the situation of trying to get a traffic light approved, that there has to be so many fatalities and accidents, and then all of a sudden there's a traffic light. And it's unfortunate that we had these outbreaks that you spoke to that prompted this new law. So it'd be really interesting if we had a way to compare the data of what is will take place now with the education enhanced understanding in Washington and Georgia compared to these other states. So thank you for your insight.
SPEAKER_01You're welcome. Yes, it will be very interesting indeed.
SPEAKER_02It will.
SPEAKER_06So why should it be important to us?
SPEAKER_01Yes, that's a good question. You know, when I think sometimes when people hear guidelines, they hear, oh, it's a guide. Yeah, do I have to follow it? Do I not have to follow it? No one's going to check on me if I don't follow it. And and so the guidelines are there, they're fantastic. We should follow them. I even even heard that some states don't follow CDC guidelines, that that is not what they recommend, which is quite interesting. Each state can determine what they deem necessary within their state. So these rules that come into place, I think, are fantastic because they they remove the arbitrary questioning on whether I should follow it or not follow it. And a rule is going to tell you this is what you have to do. There are consequences if you don't. And there could be some monitoring and follow-up to make sure that you do do these things that are implemented in this rule. So very good distinction.
SPEAKER_06And you know, it must have been a really great recommendation from 2003 because it also showed up in the 2016 CDC best practices, where it was a safe dental care, the checklist and the summary of the original 2003 document. So back in 2003, of course, we didn't have the Georgia outbreak or the California or the other outbreak that was previously discovered. So one of the things that I think is kind of interesting and it really falls over to where Olivia's area of expertise is, is that when dentists get in trouble with a breach and infection control, it's not just the regulations that they may have broken or have been not in compliance with, but best practices for infection control. If they're not following CDC guidelines, then uh the client who is or the patient who's suing the dentist might be in a better position if they're saying, well, why aren't you following CDC guidelines for best practices in infection control? So hopefully there'll be an opportunity for dental practices to be more vigilant and to be more aware and to be more better educated on the CDC guidelines for protecting their patients and of course for protecting their practice and the reputation of their practice going forward.
SPEAKER_01Yes, absolutely. The more we can educate, the more the consultants are out there like yourself, promoting the importance of following these guidelines, I think is the way to reach our dental practices. I truly believe no one's out there maliciously thinking, oh, I just don't want to do this. They just don't know what they don't know. And so more education that's out there and provided on why they have to test their lines. I mean, I'm using this treatment, it should be working, but how do you really know? Right. So I think that a lot of that education just still needs to happen and it's in its infancy across dentistry, but it's growing.
SPEAKER_02It certainly is, and it becomes, as Linda would certainly share with us, a risk management issue. And it also becomes a matter of if you're found to be in violation and or you're not testing or you're testing and you're failing, a dental board has the ability to close your practice down. And that certainly is not good publicity for the practice. And I would guess that as this rule gets implemented in in Georgia, there will be some consumer awareness around it. And if I were a patient, especially if I had a child being treated, knowing some of the history of what's happened in Georgia and other states, I might be asking, you know, how safe is the water here? Is my child going to be at risk? So that's a that's a big concern.
SPEAKER_01It definitely is. It definitely is. I I can say just really briefly, um, I'm actually one of those patients that did get sick. I had a couple things happen with me. I had my wisdom teeth removed, and a few days later I got strepped. And no notice, I also know that I had I was given the antibiotic before I went in. But a few days later I got strepped. And I thought, okay, well, you know, you think maybe I got it at the grocery store or my kids brought it home to me, not really thinking about the dental practice. Went back three weeks later, had a follow-up, got strep again. Now I know strep is on surfaces, but it makes you wonder, right, if they're not cleaning the surfaces, how well are they cleaning the water lines and other things that are out of sight, out of mind. And then to add to that further, I went in to have a cavity filled where my wisdom twos was up against my AT molar, uh, created a cavity and had that filled. And about six months later, I had some some discomfort, wasn't really a lot of pain like you would expect with an abscess. So didn't really think much about it. Went in and had a blood panel done just for an annual checkup. And my ferritin levels were really high, which is part of your liver panel. And my doctor was like, You are going, you have some infection going on in your body, you might even have cancer. Let's let's explore it some more. And it kind of freaked me out, honestly. And ironically, I had a dental visit with my another dentist, a different dentist that I had gone to, one that I know uses stare-cell. I went to this dentist and had them check, and he's like, Oh my goodness, you have the biggest abscess and and in your mouth, and it was so bad that the tooth was basically dead, they couldn't save it, and I had to have it extracted. And now I have to have an implant. So it makes you think back, and and I was ignorant when I had the cavity filled. I was I didn't do my due diligence about the dental practice I went to. I was not in the dental industry at the time, never would have thought that that could be a component. But then now I realize the water may, I don't know for sure. But these are those cases that go under the radar. I didn't I didn't go out and I didn't file a complaint because I didn't know I could as a consumer. Like, how would I do that? I've known a lot and learned a lot since then, but it makes you wonder of those cases, what cases are out there that have gone under the radar and we don't know about. And it doesn't mean you have to get really sick and have a major illness or die, but you might have enough just like a tooth extraction. Absolutely.
SPEAKER_02That's scary. I can remember a number of years ago, one of my neighbors who had several children who kept getting strep infections all the time. They'd just keep passing it around and they couldn't figure out what the source was, why they kept getting reinfected until their pediatrician actually suggested checking the water lines in their water dispenser in their refrigerator. And so, you know, you can imagine you get saliva on somebody's got a strep infection, you refill that cup from that water dispenser, and now you're going to colonize some lovely little bacteria in there, and they just kept it going. These poor kids were like eternally on on antibiotics, and they found out it was the water dispenser in their refrigerator. So, yeah, those kinds of things can happen. So, Shanna, before we conclude our discussion here, we'd love to have you talk a little bit more about Psalmetics because we know you have a lot of waterline solutions, including your Fast Check 15 tests, which we all love. So, can you just share a little bit more information with our listeners?
SPEAKER_01Yes, we are so excited to have the Sterisol Safe Water Solution Protocol. The goal was to make it as simple as possible because as rules come down the line, we want implementation and adoption to be quick and simple because that's the best way to get people on board with it and and you know, spread the information out there about education and get them on the same page. It's not scary, it doesn't have to be difficult. Yes, there are going to be opportun chances that people fail. They shouldn't be scared of that. There are a lot of factors in water lines. So we created Fast Check 15, which is a 15-minute in-office waterline test strip. It's got a simple pass or fail. It is meant to give you clear, unobstructed pass or fail the 500 CFU. And that's what we need to know is are you above or below? Yes or no? You know, we say sometimes like you're either pregnant or you're not. There's no in between. So the FastEch 15 is a great tool to use inside your practice to monitor your water on a regular basis. It's in it's very, very affordable. It's more than half the cost of most other in-office tests that are out there. And then you do that monthly because you can, and it's simple. After the last patient on a Thursday, you just take the test, or before you even start your practice up in the morning, you can test your water. It's really great. And then every quarter, we recommend doing the staircell R2A, which is your mail-in test. That's going to give you a more conclusive report with your CFU count, gives you a great baseline to work from. And every quarter, that's a great way to have your tests documented in our My Compliance Center. That goes automatically in there, it's imported, you'll see the test results. You can print them out, put them in a binder if you'd prefer, but at least you have a good accurate count of your CFU. And then annually, using the sterosil straw, once a year, you put the straw in, and the silver ion technology keeps your um microbial loads down between below 10 CFU per mil. So quite far from the 500, it is guaranteed for 365 days. So even if you close your practice, you don't need to take the straw out. You also don't need to take it out when you shock with citrusil shock. So the the the three pieces there are so fantastic, work together, and they just make a dental assistant's life easier. You don't have to think about it all the time.
SPEAKER_02Thank you so much, Shanda, for that great information. Divas, does anyone else have any feedback questions for Shanda as we get ready to wrap up? All right. Well, thank you again, and we thank everyone at Cell Medics for being such a great sponsor for our podcast. The Compliance Divas bring clarity and simplicity to compliance by navigating the regulatory world to keep you on course. Please submit any questions you might have by email to support at thecompliancedivas.com. Resources that we've mentioned today, the CDC guidelines and the 2016 guidelines as well, we will include in the show notes on your podcast app. And when you're finished listening, please scroll down and leave us some feedback. Give us a like. We're happy to hear from you, and we'll see you next time.