The January 9 chemical spill in West Virginia resulted in the shutdown of over 180 dental offices in a nine-county area serviced by the West Virginia American Water Company, according to a news report from the American Dental Association (ADA). While dental offices with their own self-contained water systems using distilled water were able to continue providing services, Governor Earl Ray Tomblin ordered a ban on drinking, bathing, or cooking with tap water, effectively shutting down most area businesses.

In an email advisory to local dentists, Richard Stevens, executive director of the West Virginia Dental Association, said the Health Department has advised dental offices to remain closed until the water company can flush all its supply lines. “Individuals and businesses will then be instructed how to flush their water lines, hot water heaters and storage units before beginning normal use. The president of WV American Water Company said flushing lines before the company flushes all of its supply lines is of no benefit to homes or businesses.”

The leak of 4-methylcyclohexane methanol (MCHM), a chemical used to clean coal, into the Elk River, caused the association’s 2014 semi-annual session to be moved from Charleston to a resort 90 miles north of the city because the hotel needed time to flush its system. There is little data available on the human health affects of the chemical.