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David C Coleman - One of the best experts on this subject based on the ideXlab platform.
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The role of manufacturers in reducing biofilms in Dental Chair waterlines.
Journal of Dentistry, 2007Co-Authors: David C Coleman, M.j. O’donnell, Anna C. Shore, J.s. Swan, R J RussellAbstract:Abstract Objectives This paper reviews how Dental Chair unit (DCU) manufacturers can contribute practically to resolving the problem of biofilm formation in Dental unit waterlines (DUWs). Study selection The review concentrates on how novel developments and changes in a range of specific areas have, and might contribute to DUW biofilm control. These include (i) DCU engineering and design changes; (ii) improvements to DCU supply water quality; (iii) development of automated DUW treatment procedures that are effective at controlling biofilm in the long-term, safe for patients and Dental staff, environmentally friendly and which do not exhibit adverse effects on DCU components after prolonged use. Sources The majority of the material contained in this review is based on, or supported by the peer-reviewed literature. Data The current consensus from the literature reveals that the emphasis on DUW biofilm and its control has focused on describing the problem and its control using a range of periodic and residual DUW treatment agents. Unfortunately, until recently, DCU manufacturers have provided very little specific guidance in this regard. Indeed, ensuring that DCUs provide good quality output water has generally been regarded to be the responsibility of Dental practitioners. Some recent studies have shown that novel DCUs with integral semi-automated or automated DUW cleaning systems can effectively control DUW biofilm in the long-term. However, there are other potential DCU engineering and design changes that DCU manufacturers could undertake to further improve DUW biofilm control. Conclusions DCU manufacturers can significantly contribute to controlling the problem of DUW biofilm.
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Optimisation of the long-term efficacy of Dental Chair waterline disinfection by the identification and rectification of factors associated with waterline disinfection failure
Journal of Dentistry, 2007Co-Authors: M.j. O’donnell, R J Russell, Anna C. Shore, David C ColemanAbstract:Abstract Although many studies have highlighted the problem of biofilm growth in Dental Chair unit waterlines (DUWs), no long-term studies on the efficacy of DUW disinfection using a large number of Dental Chair units (DCUs) have been reported. Objectives To investigate the long-term (21 months) efficacy of the Planmeca Waterline Cleaning System (WCS™) to maintain the quality of DUW output water below the American Dental Association (ADA) recommended standard of ≤200 cfu/mL of aerobic heterotrophic bacteria using once weekly disinfection with the hydrogen peroxide-and silver ion-containing disinfectant Planosil. Methods Microbiological quality of DUW output water was monitored by culture on R2A agar for 10 DCUs fitted with the WCS™. The presence of biofilm in DUWs was examined by electron microscopy. Results During the first 9 months a high prevalence (28/300 disinfection cycles; 9.3%) of intermittent DUW disinfection failure occurred in 8/10 DCUs due to operator omission to disinfect all DUWs (10/28 failed cycles), incorrect compressed air pressure failing to distribute the disinfectant properly (4/28 failed cycles) and physical blockage of disinfectant intake valves due to corrosion effects of Planosil (14/28 failed cycles). On rectification of these faults through engineering redesign and procedural changes, no further cases of intermittent DUW disinfection failure were observed. Independently of these factors, a rapid and consistent decline in efficacy of DUW disinfection occurred in 4/10 DCUs following the initial 9 months of once weekly disinfection. There was a highly significant difference (P Conclusions A variety of factors can contribute to failure of DUW disinfection in the long-term, including human error, disinfectant corrosion of equipment and natural selection of naturally disinfectant-tolerant bacterial species.
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a novel automated waterline cleaning system that facilitates effective and consistent control of microbial biofilm contamination of Dental Chair unit waterlines a one year study
Journal of Dentistry, 2006Co-Authors: M J Odonnell, Anna C. Shore, David C ColemanAbstract:Microbial contamination of Dental Chair unit (DCU) output water caused by biofilm growth in Dental unit waterlines (DUWs) is a universal problem and a potentially significant source of cross-infection. The microbial quality of output water from a Planmeca Compact i DCU equipped with the novel Water Management System (WMS), an integrated and automated DUW cleaning system, was investigated over a 12-month period with the hydrogen peroxide- and silver ion-containing disinfectants Planosil and Planosil Forte. Four weeks after connection to the potable-water quality mains supply the density of aerobic heterotrophic bacteria, rose from the low levels consistently found in the supply water throughout this study (mean average 77 cfu/mL) to 15,400 cfu/mL. Disinfection of DUWs once weekly with Planosil for 10 weeks resulted in a dramatic reduction in bacterial density immediately following disinfection (mean average 26 cfu/mL). Bacterial density rose steadily between disinfections and by 7 days post-disinfection, water quality failed (mean average 384 cfu/mL) the American Dental Association DCU water quality standard of
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A novel automated waterline cleaning system that facilitates effective and consistent control of microbial biofilm contamination of Dental Chair unit waterlines: a one-year study.
Journal of Dentistry, 2006Co-Authors: M.j. O’donnell, Anna C. Shore, David C ColemanAbstract:Microbial contamination of Dental Chair unit (DCU) output water caused by biofilm growth in Dental unit waterlines (DUWs) is a universal problem and a potentially significant source of cross-infection. The microbial quality of output water from a Planmeca Compact i DCU equipped with the novel Water Management System (WMS), an integrated and automated DUW cleaning system, was investigated over a 12-month period with the hydrogen peroxide- and silver ion-containing disinfectants Planosil and Planosil Forte. Four weeks after connection to the potable-water quality mains supply the density of aerobic heterotrophic bacteria, rose from the low levels consistently found in the supply water throughout this study (mean average 77 cfu/mL) to 15,400 cfu/mL. Disinfection of DUWs once weekly with Planosil for 10 weeks resulted in a dramatic reduction in bacterial density immediately following disinfection (mean average 26 cfu/mL). Bacterial density rose steadily between disinfections and by 7 days post-disinfection, water quality failed (mean average 384 cfu/mL) the American Dental Association DCU water quality standard of
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Bacterial contamination of Dental Chair units in a modern Dental hospital caused by leakage from suction system hoses containing extensive biofilm.
Journal of Hospital Infection, 2005Co-Authors: M.j. O’donnell, C M Tuttlebee, F.r. Falkiner, David C ColemanAbstract:Summary Within six months of opening of the new Dublin Dental Hospital in September 1998, areas of corrosion were observed on many of the baseplates of the hospital's 103 Dental Chair units (DCUs) at the site of attachment of the suction hoses. The corroded areas were heavily contaminated with Pseudomonas spp. and related genera posing a risk of cross-infection, particularly for immunocompromised patients. These species were used as marker organisms to investigate the source of the contamination. P. aeruginosa was the predominant species recovered from 41 selected DCU baseplates (61% prevalence), whereas P. putida (46% prevalence) and P. aeruginosa (43% prevalence) were predominant at the attachment ends of 37 selected high-volume suction hoses. Forty-one selected isolates of P. aeruginosa from 13 DCU baseplates, 16 high-volume suction hoses and 12 coarse filter housings (another suction system site) from 19 separate DCUs were serotyped to determine the similarity of isolates at each site. The majority of isolates (68.3%) belonged to serotype O:10, while the remainder belonged to serotypes O:6 (7.3%), O:11 (7.3%), O:14 (9.8%) and O:5/O:16 (7.3%). Of the isolates from DCU baseplates, additional isolates with the same serotype were recovered from other suction system sites in 10/13 (77%) cases. Isolates of only one serotype were recovered from each of the 19 DCUs investigated. Forty-one serotyped isolates were also subject to computer-assisted analysis of Spe I-generated DNA fingerprint profiles, and similarity coefficient ( S AB s) values were calculated for each pairwise combination of isolate profiles. The data obtained showed that the isolates consisted of two distinct main populations, each containing separate clades corresponding to specific serotypes. Serotype O:6 (three isolates), O:11 (three isolates) and O:5/O:16 (three isolates) belonged to a single strain in each case. Serotypes O:14 (four isolates) and O:10 (28 isolates) belonged to two strains in each case. The two serotype O:10 strains, termed fingerprint groups I (four isolates from three DCUs) and II (24 isolates from 10 DCUs), were the most distantly related of all the strains identified. These findings demonstrated that the hospital DCUs had become colonized with a small number of P. aeruginosa strains, one of which (serotype O:10, fingerprint group II) predominated. These results also confirmed that DCU baseplate contamination was most likely to be due to leakage from suction system hoses at the baseplate attachment sites, probably due to loosening during use. Replacement hose connectors that firmly retained the suction hoses in the attachment sites so that they could not be loosened by movement of the suction hoses solved this problem, and eliminated further contamination of the DCU baseplates.
Takeshi Yokoyama - One of the best experts on this subject based on the ideXlab platform.
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Usefulness of a stool to stabilize Dental Chairs for cardiopulmonary resuscitation (CPR)
BMC Emergency Medicine, 2019Co-Authors: Norimasa Awata, Takashi Hitosugi, Yoichiro Miki, Masanori Tsukamoto, Yoshifumi Kawakubo, Takeshi YokoyamaAbstract:Cardiopulmonary resuscitation (CPR) requires immediate start of manual chest compression (MCC) and defibrillation as soon as possible. During Dental surgery, CPR could be started in the Dental Chair considering difficulty to move the patient from the Dental Chair to the floor. However, all types of Dental Chairs are not stable for MCC. We previously developed a procedure to stabilize a Dental Chair by using a stool. EUROPEAN RESUSCITATION COUNCIL (ERC) guideline 2015 adopted our procedure when cardiac arrest during Dental surgery. The objective of this study was to verify the efficacy of a stool as a stabilizer in different types of Dental Chairs. Three health care providers participated in this study, and 8 kinds of Dental Chairs were examined. MCC were performed on a manikin that was laid on the backrest of a Dental Chair. A stool was placed under the backrest to stabilize the Dental Chair. The vertical displacement of the backrest by MCC was recorded by a camcorder and measured by millimeter. Next, the vertical displacement of the backrest by MCC were compared between with and without a stool. In all 8 Dental Chairs, the method by using a stool significantly reduced the vertical displacements of the backrest by during MCC. The reduction ratio (mean [interquartile range]) varied between nearly 27 [20] and 87 [5] %. In the largest stabilization case, the displacement was 3.5 [0.5] mm with a stool versus 26 [5.5] mm without a stool (p
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Usefulness of a stool to stabilize Dental Chairs for cardiopulmonary resuscitation (CPR)
2019Co-Authors: Norimasa Awata, Takashi Hitosugi, Yoichiro Miki, Masanori Tsukamoto, Yoshifumi Kawakubo, Takeshi YokoyamaAbstract:Abstract Background: Cardiopulmonary resuscitation (CPR) requires immediate start of manual chest compression (MCC) and defibrillation as soon as possible. During Dental surgery, CPR could be started in the Dental Chair considering difficulty to move the patient from the Dental Chair to the floor. However, all types of Dental Chairs are not stable for MCC. We previously developed a procedure to stabilize a Dental Chair by using a stool. EUROPEAN RESUSCITATION COUNCIL (ERC) guideline 2015 adopted our procedure when cardiac arrest during Dental surgery. The objective of this study was to verify the efficacy of a stool as a stabilizer in different types of Dental Chairs. Methods: Three health care providers participated in this study, and 8 kinds of Dental Chairs were examined. MCC were performed on a manikin that was laid on the backrest of a Dental Chair. A stool was placed under the backrest to stabilize the Dental Chair. The vertical displacement of the backrest by MCC was recorded by a camcorder and measured by millimeter. Next, the vertical displacement of the backrest by MCC were compared between with and without a stool. Results: In all 8 Dental Chairs, the method by using a stool significantly reduced the vertical displacements of the backrest by during MCC. The reduction ratio (mean [interquartile range]) varied between nearly 27 [20] and 87 [5] %. In the largest stabilization case, the displacement was 3.5 [0.5] mm with a stool versus 26 [5.5] mm without a stool (p < 0.001).
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Usefulness of a stool to stabilize Dental Chairs for cardiopulmonary resuscitation (CPR)
2019Co-Authors: Norimasa Awata, Takashi Hitosugi, Yoichiro Miki, Yoshifumi Kawakubo, Takeshi YokoyamaAbstract:Abstract Background: Cardiopulmonary resuscitation (CPR) requires immediate start of external chest compression (ECC) and cardioversion as soon as possible. During Dental surgery, CPR could be started in the Dental Chair considering difficulty to move the patient from the Dental Chair to the floor. However, all types of Dental Chairs are not stable for ECC. We previously developed a procedure to stabilize a Dental Chair by using a stool. ERC guideline 2015 adopted our procedure when cardiac arrest during Dental surgery. The objective of this study was to verify the efficacy of a stool as a stabilizer in different types of Dental Chairs. Methods: Three health care providers participated in this study, and 8 kinds of Dental Chairs were examined. ECC were performed on a manikin that was laid on the backrest of a Dental Chair. A stool was placed under the backrest to stabilize the Dental Chair. The vertical displacement of the backrest by ECC were compared between with and without a stool, and recorded by a camcorder. Results: In all 8 Dental Chairs, the method by using a stool significantly (p < 0.001) reduced the vertical displacements of the backrest by ECC. The reduction ratio varies varied between nearly 39 and 85%, and the overall mean was 62 ± 11%although it was different by Chairs. Conclusions: Our procedure to stabilize Dental Chairs by using a stool reduced the displacement of a backrest against ECC in all Chairs. Clinical relevance: Effective ECC could be performed in Dental Chairs by using a stool when sudden cardiac arrest occurs during Dental surgery.
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Usefulness of a stool to stabilize Dental Chairs for external chest compression
2019Co-Authors: Norimasa Awata, Takashi Hitosugi, Yoichiro Miki, Yoshifumi Kawakubo, Takeshi YokoyamaAbstract:Abstract Objectives: Cardiopulmonary resuscitation (CPR) requires immediate start of external chest compression (ECC) and cardioversion as soon as possible. During Dental surgery, CPR should be started in the Dental Chair considering difficulty to move the patient from the Dental Chair to the floor. However, all types of Dental Chairs are not stable for ECC. We previously developed a procedure to stabilize a Dental Chair by using a stool. ERC guideline 2015 adopted our procedure when cardiac arrest during Dental surgery. The objective of this study was to verify the efficacy of a stool as a stabilizer in different types of Dental Chairs. Materials and methods: Three health care providers participated in this study, and 8 Dental Chairs were examined. ECC were performed on a manikin that was laid on the backrest of a Dental Chair. A stool was placed under the backrest to stabilize the Dental Chair. The vertical displacement of the backrest by ECC were compared between with and without a stool, and recorded by a camcorder. Results: In all 8 Dental Chairs, the method by using a stool significantly reduced the vertical displacements of the backrest by ECC. The reduction ratios were between nearly 39~85%, although it was different by Chairs. Conclusions: Our procedure to stabilize Dental Chairs by using a stool significantly reduced the displacement of a backrest against ECC in all Chairs. Clinical relevance: Effective ECC could be performed in Dental Chairs by using a stool when sudden cardiac arrest occurs during Dental surgery.
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The Effect of the Use of a Stabilizer and Different Height Settings on the Stability of the Dental Chair when Performing High-Quality Chest Compressions
Emergency Medicine: Open Access, 2015Co-Authors: Shinichi Ito, Noriko Karube, Jun Hirokawa, Saori Sako, Takeshi YokoyamaAbstract:Background/Aim: In the case of sudden cardiopulmonary arrest (CPA) in a patient in a Dental practice, Dental professionals have to perform cardiopulmonary resuscitation (CPR) in the Dental Chair. However, not all Dental Chairs are stable enough for performing chest compressions, as some do not contain steady support under the backrest. We investigated methods for stabilizing the Dental Chair to increase the efficacy of chest compressions performed in the Chair. Materials and Methods: Chest compressions (with a depth of 5.0 to 6.0 cm) were performed on a CPR manikin that was laid on the backrest of a Dental Chair. The movement of the chest of the manikin and the displacement of the backrest caused by the chest compressions were recorded as video data, and the mean amplitude of the movement of the backrest at each compression depth was analyzed. We investigated the effect of three different height settings of the Dental Chair and the use of a round stool as a stabilizer under the backrest on the stability of the Dental Chair during CPR. Results: Differences in the height settings of the Dental Chair did not significantly affect the vertical movement of the backrest caused by chest compressions. The mean amplitudes of the movements of the backrest with and without a stabilizer were 1.99±0.74 cm and 0.43±0.18 cm, respectively. Conclusion: The placement of a round stool as a stabilizer under the backrest of a Dental Chair might increase the effectiveness of chest compressions.
M J Odonnell - One of the best experts on this subject based on the ideXlab platform.
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a novel automated waterline cleaning system that facilitates effective and consistent control of microbial biofilm contamination of Dental Chair unit waterlines a one year study
Journal of Dentistry, 2006Co-Authors: M J Odonnell, Anna C. Shore, David C ColemanAbstract:Microbial contamination of Dental Chair unit (DCU) output water caused by biofilm growth in Dental unit waterlines (DUWs) is a universal problem and a potentially significant source of cross-infection. The microbial quality of output water from a Planmeca Compact i DCU equipped with the novel Water Management System (WMS), an integrated and automated DUW cleaning system, was investigated over a 12-month period with the hydrogen peroxide- and silver ion-containing disinfectants Planosil and Planosil Forte. Four weeks after connection to the potable-water quality mains supply the density of aerobic heterotrophic bacteria, rose from the low levels consistently found in the supply water throughout this study (mean average 77 cfu/mL) to 15,400 cfu/mL. Disinfection of DUWs once weekly with Planosil for 10 weeks resulted in a dramatic reduction in bacterial density immediately following disinfection (mean average 26 cfu/mL). Bacterial density rose steadily between disinfections and by 7 days post-disinfection, water quality failed (mean average 384 cfu/mL) the American Dental Association DCU water quality standard of
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effective control of Dental Chair unit waterline biofilm and marked reduction of bacterial contamination of output water using two peroxide based disinfectants
Journal of Hospital Infection, 2002Co-Authors: C M Tuttlebee, M J Odonnell, C T Keane, R J Russell, Derek J Sullivan, F Falkiner, David C ColemanAbstract:Abstract Bacterial biofilm in Dental unit waterlines (DUWs) is a widespread problem, and poses a potentially significant risk of infection to Dental staff and patients, particularly those who are medically compromised or immunocompromised. The purpose of the present study was to investigate the level of bacterial contamination of Dental Chair unit output water in the Dublin Dental Hospital, and to investigate the efficacy of two hydrogen peroxide-based disinfectants in reducing bacterial loads to ≤200cfu/mL as recommended by the American Dental Association. The chemical quality of Dental Chair unit input and output water was well within the limits recommended for potable water. Water supplied to the units yielded an average aerobic heterotrophic bacterial cell density of 184cfu/mL. However, the corresponding density in output water was considerably higher; the average cell density in water from the three-in-one air/water syringes and cup fillers in 12 Chairs was 8200 and 4300cfu/mL, respectively. Dental unit water obtained from 18 separate reservoir-supplied units in general practices in the Dublin area yielded an average of 66000cfu/mL. The bacterial species found were predominantly environmental organisms, which were also present at low levels in the input water. Some of the species identified (e.g., Burkholderia cepacia and Pseudomonas fluorescens ) are known opportunistic pathogens. The capacity of two disinfectants, Sterilex Ultra and Sanosil, to reduce bacterial contamination to safe levels was compared. In a controlled study, once weekly overnight (15h) disinfection using either agent reduced the bacterial density to below the American Dental Association recommended level of 200cfu/mL. However, once disinfection ceased the bacterial loads increased to unacceptably high levels within three weeks. Electron microscopic analysis showed that both disinfectants markedly reduced biofilm in the DUWs, but the biofilm rapidly became extensive again when once weekly disinfection ceased. While both disinfectants were equally effective in lowering the bacterial counts to acceptable levels, Sterilex Ultra was associated with clogging of DUWs in some Dental Chair units after repeated usage, suggesting that Sanosil is a more suitable agent for routine use.
Norimasa Awata - One of the best experts on this subject based on the ideXlab platform.
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Usefulness of a stool to stabilize Dental Chairs for cardiopulmonary resuscitation (CPR)
BMC Emergency Medicine, 2019Co-Authors: Norimasa Awata, Takashi Hitosugi, Yoichiro Miki, Masanori Tsukamoto, Yoshifumi Kawakubo, Takeshi YokoyamaAbstract:Cardiopulmonary resuscitation (CPR) requires immediate start of manual chest compression (MCC) and defibrillation as soon as possible. During Dental surgery, CPR could be started in the Dental Chair considering difficulty to move the patient from the Dental Chair to the floor. However, all types of Dental Chairs are not stable for MCC. We previously developed a procedure to stabilize a Dental Chair by using a stool. EUROPEAN RESUSCITATION COUNCIL (ERC) guideline 2015 adopted our procedure when cardiac arrest during Dental surgery. The objective of this study was to verify the efficacy of a stool as a stabilizer in different types of Dental Chairs. Three health care providers participated in this study, and 8 kinds of Dental Chairs were examined. MCC were performed on a manikin that was laid on the backrest of a Dental Chair. A stool was placed under the backrest to stabilize the Dental Chair. The vertical displacement of the backrest by MCC was recorded by a camcorder and measured by millimeter. Next, the vertical displacement of the backrest by MCC were compared between with and without a stool. In all 8 Dental Chairs, the method by using a stool significantly reduced the vertical displacements of the backrest by during MCC. The reduction ratio (mean [interquartile range]) varied between nearly 27 [20] and 87 [5] %. In the largest stabilization case, the displacement was 3.5 [0.5] mm with a stool versus 26 [5.5] mm without a stool (p
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Usefulness of a stool to stabilize Dental Chairs for cardiopulmonary resuscitation (CPR)
2019Co-Authors: Norimasa Awata, Takashi Hitosugi, Yoichiro Miki, Masanori Tsukamoto, Yoshifumi Kawakubo, Takeshi YokoyamaAbstract:Abstract Background: Cardiopulmonary resuscitation (CPR) requires immediate start of manual chest compression (MCC) and defibrillation as soon as possible. During Dental surgery, CPR could be started in the Dental Chair considering difficulty to move the patient from the Dental Chair to the floor. However, all types of Dental Chairs are not stable for MCC. We previously developed a procedure to stabilize a Dental Chair by using a stool. EUROPEAN RESUSCITATION COUNCIL (ERC) guideline 2015 adopted our procedure when cardiac arrest during Dental surgery. The objective of this study was to verify the efficacy of a stool as a stabilizer in different types of Dental Chairs. Methods: Three health care providers participated in this study, and 8 kinds of Dental Chairs were examined. MCC were performed on a manikin that was laid on the backrest of a Dental Chair. A stool was placed under the backrest to stabilize the Dental Chair. The vertical displacement of the backrest by MCC was recorded by a camcorder and measured by millimeter. Next, the vertical displacement of the backrest by MCC were compared between with and without a stool. Results: In all 8 Dental Chairs, the method by using a stool significantly reduced the vertical displacements of the backrest by during MCC. The reduction ratio (mean [interquartile range]) varied between nearly 27 [20] and 87 [5] %. In the largest stabilization case, the displacement was 3.5 [0.5] mm with a stool versus 26 [5.5] mm without a stool (p < 0.001).
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Usefulness of a stool to stabilize Dental Chairs for cardiopulmonary resuscitation (CPR)
2019Co-Authors: Norimasa Awata, Takashi Hitosugi, Yoichiro Miki, Yoshifumi Kawakubo, Takeshi YokoyamaAbstract:Abstract Background: Cardiopulmonary resuscitation (CPR) requires immediate start of external chest compression (ECC) and cardioversion as soon as possible. During Dental surgery, CPR could be started in the Dental Chair considering difficulty to move the patient from the Dental Chair to the floor. However, all types of Dental Chairs are not stable for ECC. We previously developed a procedure to stabilize a Dental Chair by using a stool. ERC guideline 2015 adopted our procedure when cardiac arrest during Dental surgery. The objective of this study was to verify the efficacy of a stool as a stabilizer in different types of Dental Chairs. Methods: Three health care providers participated in this study, and 8 kinds of Dental Chairs were examined. ECC were performed on a manikin that was laid on the backrest of a Dental Chair. A stool was placed under the backrest to stabilize the Dental Chair. The vertical displacement of the backrest by ECC were compared between with and without a stool, and recorded by a camcorder. Results: In all 8 Dental Chairs, the method by using a stool significantly (p < 0.001) reduced the vertical displacements of the backrest by ECC. The reduction ratio varies varied between nearly 39 and 85%, and the overall mean was 62 ± 11%although it was different by Chairs. Conclusions: Our procedure to stabilize Dental Chairs by using a stool reduced the displacement of a backrest against ECC in all Chairs. Clinical relevance: Effective ECC could be performed in Dental Chairs by using a stool when sudden cardiac arrest occurs during Dental surgery.
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Usefulness of a stool to stabilize Dental Chairs for external chest compression
2019Co-Authors: Norimasa Awata, Takashi Hitosugi, Yoichiro Miki, Yoshifumi Kawakubo, Takeshi YokoyamaAbstract:Abstract Objectives: Cardiopulmonary resuscitation (CPR) requires immediate start of external chest compression (ECC) and cardioversion as soon as possible. During Dental surgery, CPR should be started in the Dental Chair considering difficulty to move the patient from the Dental Chair to the floor. However, all types of Dental Chairs are not stable for ECC. We previously developed a procedure to stabilize a Dental Chair by using a stool. ERC guideline 2015 adopted our procedure when cardiac arrest during Dental surgery. The objective of this study was to verify the efficacy of a stool as a stabilizer in different types of Dental Chairs. Materials and methods: Three health care providers participated in this study, and 8 Dental Chairs were examined. ECC were performed on a manikin that was laid on the backrest of a Dental Chair. A stool was placed under the backrest to stabilize the Dental Chair. The vertical displacement of the backrest by ECC were compared between with and without a stool, and recorded by a camcorder. Results: In all 8 Dental Chairs, the method by using a stool significantly reduced the vertical displacements of the backrest by ECC. The reduction ratios were between nearly 39~85%, although it was different by Chairs. Conclusions: Our procedure to stabilize Dental Chairs by using a stool significantly reduced the displacement of a backrest against ECC in all Chairs. Clinical relevance: Effective ECC could be performed in Dental Chairs by using a stool when sudden cardiac arrest occurs during Dental surgery.
R J Russell - One of the best experts on this subject based on the ideXlab platform.
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Optimisation of the long-term efficacy of Dental Chair waterline disinfection by the identification and rectification of factors associated with waterline disinfection failure
Journal of Dentistry, 2007Co-Authors: M.j. O’donnell, R J Russell, Anna C. Shore, David C ColemanAbstract:Abstract Although many studies have highlighted the problem of biofilm growth in Dental Chair unit waterlines (DUWs), no long-term studies on the efficacy of DUW disinfection using a large number of Dental Chair units (DCUs) have been reported. Objectives To investigate the long-term (21 months) efficacy of the Planmeca Waterline Cleaning System (WCS™) to maintain the quality of DUW output water below the American Dental Association (ADA) recommended standard of ≤200 cfu/mL of aerobic heterotrophic bacteria using once weekly disinfection with the hydrogen peroxide-and silver ion-containing disinfectant Planosil. Methods Microbiological quality of DUW output water was monitored by culture on R2A agar for 10 DCUs fitted with the WCS™. The presence of biofilm in DUWs was examined by electron microscopy. Results During the first 9 months a high prevalence (28/300 disinfection cycles; 9.3%) of intermittent DUW disinfection failure occurred in 8/10 DCUs due to operator omission to disinfect all DUWs (10/28 failed cycles), incorrect compressed air pressure failing to distribute the disinfectant properly (4/28 failed cycles) and physical blockage of disinfectant intake valves due to corrosion effects of Planosil (14/28 failed cycles). On rectification of these faults through engineering redesign and procedural changes, no further cases of intermittent DUW disinfection failure were observed. Independently of these factors, a rapid and consistent decline in efficacy of DUW disinfection occurred in 4/10 DCUs following the initial 9 months of once weekly disinfection. There was a highly significant difference (P Conclusions A variety of factors can contribute to failure of DUW disinfection in the long-term, including human error, disinfectant corrosion of equipment and natural selection of naturally disinfectant-tolerant bacterial species.
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The role of manufacturers in reducing biofilms in Dental Chair waterlines.
Journal of Dentistry, 2007Co-Authors: David C Coleman, M.j. O’donnell, Anna C. Shore, J.s. Swan, R J RussellAbstract:Abstract Objectives This paper reviews how Dental Chair unit (DCU) manufacturers can contribute practically to resolving the problem of biofilm formation in Dental unit waterlines (DUWs). Study selection The review concentrates on how novel developments and changes in a range of specific areas have, and might contribute to DUW biofilm control. These include (i) DCU engineering and design changes; (ii) improvements to DCU supply water quality; (iii) development of automated DUW treatment procedures that are effective at controlling biofilm in the long-term, safe for patients and Dental staff, environmentally friendly and which do not exhibit adverse effects on DCU components after prolonged use. Sources The majority of the material contained in this review is based on, or supported by the peer-reviewed literature. Data The current consensus from the literature reveals that the emphasis on DUW biofilm and its control has focused on describing the problem and its control using a range of periodic and residual DUW treatment agents. Unfortunately, until recently, DCU manufacturers have provided very little specific guidance in this regard. Indeed, ensuring that DCUs provide good quality output water has generally been regarded to be the responsibility of Dental practitioners. Some recent studies have shown that novel DCUs with integral semi-automated or automated DUW cleaning systems can effectively control DUW biofilm in the long-term. However, there are other potential DCU engineering and design changes that DCU manufacturers could undertake to further improve DUW biofilm control. Conclusions DCU manufacturers can significantly contribute to controlling the problem of DUW biofilm.
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effective control of Dental Chair unit waterline biofilm and marked reduction of bacterial contamination of output water using two peroxide based disinfectants
Journal of Hospital Infection, 2002Co-Authors: C M Tuttlebee, M J Odonnell, C T Keane, R J Russell, Derek J Sullivan, F Falkiner, David C ColemanAbstract:Abstract Bacterial biofilm in Dental unit waterlines (DUWs) is a widespread problem, and poses a potentially significant risk of infection to Dental staff and patients, particularly those who are medically compromised or immunocompromised. The purpose of the present study was to investigate the level of bacterial contamination of Dental Chair unit output water in the Dublin Dental Hospital, and to investigate the efficacy of two hydrogen peroxide-based disinfectants in reducing bacterial loads to ≤200cfu/mL as recommended by the American Dental Association. The chemical quality of Dental Chair unit input and output water was well within the limits recommended for potable water. Water supplied to the units yielded an average aerobic heterotrophic bacterial cell density of 184cfu/mL. However, the corresponding density in output water was considerably higher; the average cell density in water from the three-in-one air/water syringes and cup fillers in 12 Chairs was 8200 and 4300cfu/mL, respectively. Dental unit water obtained from 18 separate reservoir-supplied units in general practices in the Dublin area yielded an average of 66000cfu/mL. The bacterial species found were predominantly environmental organisms, which were also present at low levels in the input water. Some of the species identified (e.g., Burkholderia cepacia and Pseudomonas fluorescens ) are known opportunistic pathogens. The capacity of two disinfectants, Sterilex Ultra and Sanosil, to reduce bacterial contamination to safe levels was compared. In a controlled study, once weekly overnight (15h) disinfection using either agent reduced the bacterial density to below the American Dental Association recommended level of 200cfu/mL. However, once disinfection ceased the bacterial loads increased to unacceptably high levels within three weeks. Electron microscopic analysis showed that both disinfectants markedly reduced biofilm in the DUWs, but the biofilm rapidly became extensive again when once weekly disinfection ceased. While both disinfectants were equally effective in lowering the bacterial counts to acceptable levels, Sterilex Ultra was associated with clogging of DUWs in some Dental Chair units after repeated usage, suggesting that Sanosil is a more suitable agent for routine use.