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Guidelines for Dental Offices During a Boil Water Advisory

When a boil water advisory (BWA) is issued it is unsafe to drink or use tap water to brush teeth, gargle or rinse dentures and tap water should not be used for dental treatments.

 
Post “Do Not Drink” signs at all water taps at all sinks.
 
Commercially bottled water or boiled water can be used instead of tap water. Boiled water is water that has been brought to a rolling boil for at least one (1) minute and then cooled and stored in clean, covered containers until served or used.
 
Ensure thorough hand washing by all staff using disinfected water. Post hand washing posters in washroom areas reinforcing the importance of proper hand washing technique and provide disinfected water for this purpose.
 
Dental offices must follow the guidelines below.
 
Before treatment:
  • Explain to all patients the impact of the boil water advisory on dental care and indicate what procedures your office is following.
  • Warn your patients before treatment that they are at greater risk for water-borne illness if they are immunocompromised and allow them to reschedule appointments if desired.
  • Reschedule appointments for known immunocompromised patients, such as HIV-positive individuals, chemotherapy and transplant patients, and congenitally immunocompromised individuals.
  • Reinforce that patients use only boiled or commercially bottled water for tooth-brushing or other dental care in their own homes if they are under a boil water advisory as well. 
During dental procedures:
  • Use only boiled or bottled water for patients to drink and rinse in your office.
  • Ensure that any ice chips are made from disinfected water sources.
  • Turn off the water supply to high-speed headpieces. Using disinfected water, flow water out of a bulb syringe when using high-speed headpieces, or; run your high/low speed turbines dry and use a hand syringe of boiled or bottled water for cooling and rinsing.
  • Use a hand syringe of boiled or bottled water in place of the air/water syringe. 
During dental procedures:
  • Use only boiled or bottled water for patients to drink and rinse in your office.
  • Ensure that any ice chips are made from disinfected water sources.
  • Turn off the water supply to high-speed headpieces. Using disinfected water, flow water out of a bulb syringe when using high-speed headpieces, or; run your high/low speed turbines dry and use a hand syringe of boiled or bottled water for cooling and rinsing.
  • Use a hand syringe of boiled or bottled water in place of the air/water syringe.
When the boil water advisory is rescinded
  • Restart and flush any water-using fixture or piece of equipment in accordance with the manufacturer’s specifications. This may vary from fixture to fixture. Consult your facilities engineer and/or the manufacturer when restarting the equipment
  • Managers of large buildings with water-holding reservoirs should consult with their facility engineer and health department about draining the reservoir.
  • Run cold water faucets for one minute before using the water.
  • Run drinking fountains for one minute before using the water. 
Other:
  • Exclude all employees with diarrheal illness from work following standard rules of exclusion

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