Dental Unit Waterline Safety
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Guidelines for Maintaining Clean Water Supply

Maintaining clean water supply in dental practices is essential for patient and staff safety. The CDC (Centers for Disease Control and Prevention) recommends dental unit waterlines should contain no more than 500 colony-forming units (CFU) per milliliter of water.  This level is the same as the standard set for drinking water by the EPA (Environmental Protection Agency).

To ensure that dental waterlines meet these guidelines, it is essential to follow a set schedule for waterline maintenance, to perform regular waterline safety testing (including recording results for future reference), and designate responsibility for these tasks within your office.

Read on for an overview of waterline safety protocols and supply options to perform the tasks necessary to maintain clean waterlines.

Office with Municipal Water Supply Only (no self-contained water bottles in each operatory)

1. Daily Treatment with built in Shock Treatment options:

  • Sterisil® 365 Day Straw: For Municipal Water. straw is connected directly to the main water supply. First releases an initial shock treatment, then daily treatment is released for ongoing maintenance.  Good for 365 days. For use with municipal water at 101-250 TDS (Total Dissolved Solids).
  • DentaPure™ Cartridges: For Municipal Water, cartridge continuously provides one-year or 240L of compliant procedural water that exceeds EPA standard for waterline safety. Daily Treatment maintains safe CFU levels, no routine shocking required. If the test fails, call Crosstex for guidance.

2. Testing – see “Test” below for information on waterline testing.

Office with Self-Contained Water Bottles in EACH operatory

1. Daily Treatment – reduces and inhibits re-growth of bacteria in the water lines. It’s important to note that Daily Treatment is a MAINTENANCE step.  Offices still need to shock and test the waterline as well. Daily treatment options include:

  • BluTab® Waterline Maintenance Tablets: Add a tablet to the reservoir at every water bottle refill. Specially formulated to be continuously present in dental waterlines to keep them clean. Weekly shock treatments not necessary.
  • Sterisil® 365 Day Straw for Water Bottles: One iodine release straw lasts for 365 days to eliminate the need to drop daily tablets into the water bottle. Includes a built-in shock treatment, which releases automatically after installation.
  • BluTube® Dual-Cartridge System: Works just like Sterisil Straw but includes 2 cartridges (straws), which are changed every 6 months vs one time (1) per year to ensure the iodine doesn’t run out. Includes a 6-month time indicator that sticks on bottle to remind when it’s time to change cartridge. A complimentary Dummy Straw is included to ensure you can safely and easily shock your lines as recommended.
  • Citrisil All-in-One Tablets: An all-in-one maintenance solution that includes two shock tablets to ensure complete compliance is achieved.  The shock treatment should be administered once a month as an added measure for dental water compliance.
  • VistaTab™ Dental Waterline Cleaner Tablets: After initial treatment of 2 VistaTab Tablets for every 750mL of potable water, use one tablet as a regular weekly (or as needed based on bacteria count) maintenance treatment.
  • DentaPure™ Independent Water Bottle Cartridge: Iodine release provides continuous maintenance of waterline safety for individual water bottles – choose between 365-day (240L) or 60-day (40L) cartridge options.
  • Monarch Lines Cleaner: A ready-to-use shock and maintenance treatment that controls microbial contamination while cleaning dental unit supply tubing. No mixing or diluting is required and its noncorrosive. Weekly treatment replaces daily dropping of tabs into bottles.

2. Shock – rids your water lines of bacteria and allows maintenance products to work more effectively. It is recommended to Shock at least once a quarter, whenever a test fails or when you are changing treatment products. Shock treatments include:

  • Liquid Ultra™ Solution: A powerful dental unit waterline shock treatment for external bottle systems. Dental City recommended best option.
  • Citrisil® Shock Tablets: An effective shock treatment to clean & maintain waterlines along with maintenance protocols. The shock treatment should be administered once a month as an added measure for dental water compliance.
  • Diluted Bleach is an efficient and economical shocking option (1:10 Ratio). As with other methods, there are steps that must be taken to guarantee the process is effective. ProEdge provides a resource for shocking with bleach here.

3. Water Testing. The only way to ensure that your water meets CDC safety guidelines is to test monthly to quarterly. See your State Dental Board Rules to determine if testing is recommended or required.

  • QuickPass™ In Office Dental Water Test: Designed specifically for dental unit waterlines. It has easy to read paddles that provide test results within 48 -72 hours.
    • Available in 4 pack, 8 pack, 12 and 24 pack
  • Flo Dental Waterline Testing Kit: is a Mail in system that requires no incubation time to deliver results within minutes—rather than weeks–upon receipt at ProEdge Dental Water Labs. Flo provides third-party verification of CDC compliance and provides access to the ProEdge dashboard for historical test results.
    • Available in a single pack or 4, 6, 8 or 16-pack

If you have any questions about when to shock or when to test or need more guidance on the CDC guidelines for your dental unit water lines? Email Dental City DUWL expert Kim Krueger, RDH at or give her a call at 1-800-353-9595, and she’ll walk you through 3 easy steps to keep your water lines clean and your patients safe.