Colonization of Dental Unit Waterlines by Helicobacter pylori: Risk of Exposure in Dental Practices.

Giacomuzzi Giacomuzzi,Zotti Zotti,Ditommaso Ditommaso

doi:10.3390/ijerph16162981

Giacomuzzi Giacomuzzi, Zotti Zotti + Show 1 more

Open Access

https://doi.org/10.3390/ijerph16162981

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Abstract

Dental unit waterlines (DUWLs) can be considered one of the possible routes of H. pylori transmission, although its presence in DUWLs has not yet been investigated thoroughly. The present study aimed to discover the prevalence of H. pylori and oral streptococci (S. oralis and S. mutans) in DUWLs to evaluate the risk of exposure to human pathogens in dental practices. We collected the output water from 60 dental chair units (DCUs) in 26 private dentistry settings in Turin, searching for H. pylori and oral streptococci (OS) DNA, with a polymerase chain reaction (PCR) technique. At the same time, dentists completed a questionnaire about their DCUs, their main activities, the presence of anti-retraction devices, their attitudes about disinfection, etc. No dental chair unit tested was contaminated with H. pylori or S. mutans; only one dental chair was contaminated with S. oralis (1.7%). Considering the results, we can state that: (i) the lack of H. pylori DNA in water samples analyzed, suggests that municipal water is presumably treated with a sufficient chlorine level to inactivate DNA over time; (ii) the aspiration of oral fluids is limited by anti-retraction valves fitted distally to hand pieces; (iii) propidium monoazide qPCR (PMA-qPCR) could be a good technique to investigate and monitor potential environmental sources of infections such as DUWLs.

Highlights

Thirty-four years after the first confirmed cultivation and identification of Helicobacter pylori by the Australian physicians Robin Warren and Barry Marshall [1], the scientific community is still attempting to find out the transmission dynamics of this gastric pathogen.Many pathways of transmission have been hypothesized, mainly based on epidemiological and microbiological data: five of the suggested routes are characteristic of direct person-to-person transmission [2,3,4,5] that, based on the intrafamilial clustering observed, appears to be the main route
No dental chair unit tested was contaminated with H. pylori or S. mutans; only one dental chair was contaminated with S. oralis (1.7%)
Over time; (ii) the aspiration of oral fluids is limited by anti-retraction valves fitted distally to hand pieces; (iii) propidium monoazide quantitative real-time polymerase chain reaction (qPCR) (PMA-qPCR) could be a good technique to investigate and monitor potential environmental sources of infections such as Dental unit waterlines (DUWLs)

Summary

Introduction

Many pathways of transmission have been hypothesized, mainly based on epidemiological and microbiological data: five of the suggested routes are characteristic of direct person-to-person transmission (breastfeeding, iatrogenic, oral-oral, gastro-oral, and fecal-oral pathways) [2,3,4,5] that, based on the intrafamilial clustering observed, appears to be the main route. Lower socioeconomic status (i.e., level of hygiene, density of living, and educational opportunities) correlates with an increased prevalence of H. pylori infection.

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