CDC warns of rare bacterial infections from dentists’ water lines

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By Steven Reinberg

Health Day Reporter

MONDAY, Nov. 7, 2022 (HealthDay News) — The US Centers for Disease Control and Prevention is warning that a number of US children have contracted serious infections from contaminated water pipes at the dentist’s office.

Although rare, eruptions of nontuberculous mycobacteria (NTM) infections have been reported in children seeing dentists, a cluster in 2015 and another in 2016, according to the CDC. A third cluster, identified in a children’s dental clinic last March, is under investigation.

These harmful bacteria settle in the narrow water lines of dental equipment.

“NTM infections after dental procedures are very serious,” said Dr. Michele Neuburger, dentist in the CDC Division of Oral Health. “These infections can be resistant to antibiotic treatment and are difficult to treat.”

In all cases of NTM infection following dental work, surgical procedures were required to clear the infections, she said.

“These infections can be persistent, worsen over time, and may not respond to initial treatments such as incision and drainage and routine antibiotics,” Neuburger said. The most common symptom is swelling in the jaw or throat. Pain or fever, she said.

The CDC notice appears here.

In 2016, an outbreak happened in California that left 71 patients being treated for rotting baby teeth sick. A year earlier, 24 children in Georgia were infected.

In addition to hearing loss, complications of the infections included permanent tooth loss, facial nerve palsy, and incision scars. According to American Dental Association spokesman Dr. Shannon Mills, all but one of the two outbreaks were hospitalized.

Adults can also get infected, said Neuburger. NTM infections in adults are common after wisdom tooth extractions and root canals, she said. Infection isn’t always immediate — problems can develop within weeks or months after a dental procedure.

NTM infections after dental work require surgical removal of the diseased tissue, Neuburger said. “These surgeries can result in the loss of jawbone and deciduous or permanent teeth. They may also require intravenous antibiotic therapy, which consists of multiple drugs. Adverse side effects of antibiotics can include skin rashes, gastrointestinal symptoms, hearing loss, and strain on the liver and kidneys,” she said.

The best way to prevent these infections is to regularly use chemical germicides in the water pipes, Neuburger said.

“However, if dental waterlines are not properly maintained and regularly treated with germicides, these bacteria along with other microorganisms in the water attach themselves to the inner surfaces of the waterline tubing and form a biofilm that serves as a reservoir where microorganisms can grow and multiply,” she explained.

“Pieces of the biofilm can break off into the water system and then get into the patient’s mouth,” Neuburger said.

Fortunately, outbreaks of NTM infection after dental procedures are very rare, Neuburger said.

“Parents and patients should continue to seek routine dental care. Most oral diseases like tooth decay and gum disease are preventable,” she added.

Contact your dentist right away if you suspect you or your child have developed an infection, Neuburger said.

Mills believes most dentists have heard of NTM infections. “They may have heard about it and didn’t think it was meaningful or important, but they heard about it,” he said.

Dentists must maintain their equipment and follow procedures to ensure the water they use is free of high concentrations of bacteria and microfilm on which bacteria grow, Mills said. “Water used for health care should be safer than the water we drink,” he said.

Patients should discuss the steps their dentist is taking to prevent these infections, Mills said.

“The doctor should be able to explain in some detail what he’s doing,” he added.

More information

Learn more about nontuberculous mycobacteriasee US Centers for Disease Control and Prevention.

SOURCES: Michele Neuburger, DDS, Dental Officer, Division of Oral Health, US Centers for Disease Control and Prevention; Shannon Mills, DDS, spokesman for the American Dental Association; CDC Health Advisory, press release, October 31, 2022



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