With the October 31 CDC Health Advisory Alert to the dental community on dental waterlines, orthodontic practices where reminded of the importance of best practices when it comes to dental waterline maintenance. While the alert concerned outbreaks of non-tuberculosis mycobacteria infections related to dental waterlines in pediatric dental clinics., it rightly is a wake up call to make sure your orthodontic practice is doing the right thing to protect patients and staff.

To learn more about best practices when it comes to maintenance and testing of dental waterlines, Orthodontic Products Chief Editor Alison Werner spoke to Kellie Thimmes and Mike Rust from ProEdge Dental Water Labs. Thimmes is a senior consultant and education specialist at the company, while Rust is a regional sales manager. Both have extensive experience working with dental and orthodontic practices to help them maintain safe dental waterlines.

In this episode, they talk about why orthodontic practices should pay attention to the CDC alert, the need for more awareness on the issue of dental waterline safety in general, and the risks to the patient, the practice, and the doctor’s license if dental waterlines are not maintained properly. As Thimmes and Rust point out, often, inspectors come to the practice to investigate a complaint unrelated to waterlines; but, once there, they’ll ask to see the practice’s latest water test results. And if those aren’t in order, the practice could have fines levied against it, while the doctor could face actions against their license.

They then take a deep dive on best practices for maintaining dental waterlines in the orthodontic practice and explain that while this is about protecting the health and safety of the patient and practice staff, it is also about ensuring equipment, such as handpieces, aren’t needlessly damaged. Rust and Thimmes explain what it means to have a compliant dental unit waterline, needed documentation, and the three main steps to dental unit waterline maintenance: shocking, treating, and testing. They breakdown how often you should be testing, testing options, and what to use to treat your waterlines between testings. And if your practice fails a waterline test, Rust and Thimmes say don’t panic. Address the problem and reach out to the experts if you need help. OP

Podcast Transcript

Alison Werner:

Hello, I’m Alice Werner and I’m the chief editor of Orthodontic Products. Thank you for joining me for this episode on the Medcor Podcast Network.

Now in our last episode, we talked to infection prevention expert and orthodontic industry consultant Jackie Doris about the CDC’s October 31st Health Advisory Alert to the dental community regarding dental waterlines.

To follow up on that episode and really drive into dental unit waterline maintenance, I’m joined by Kellie Thimmes and Mike Rust from ProEdge Dental Water Labs.

ProEdge not only offers products to treat and test dental unit waterlines, but they also offer a number of resources to help educate and support the dental community on keeping their water safe.

Now, Kellie is a senior consultant and education specialist at ProEdge Dental. A former nurse with a passion for infection control and prevention, Thimmes holds multiple certifications in infection control, including the OSAP, DANB, Dental Industry Specialist Infection Prevention and Control.

Since joining the ProEdge team six years ago, she has helped thousands of dental healthcare professionals establish and maintain a safe water protocol.

Thimmes has made it her mission to arm as many people as possible with the knowledge needed to keep their patients and establish a culture of safety.

Now Mike is regional sales manager for ProEdge Dental. Mike has spent over 31 years in the dental industry, spending much of his time working one on one with dental professionals, sales reps, and industry educators to help them learn how vital safe waterlines are to protecting their patients, practice and reputation.

Mike has lectured for multiple hygiene associations on infection control and his insight into the dental waterline safety is relied on by many of the movers and shakers in infection control compliance.

So Kellie, Mike, thank you so much for joining me today.

Now, the reason we’re talking about this is the CDC issued a rare Health Alert Advisory to the dental community, October 31st, and the alert concerns outbreaks of non-tuberculosis mycobacteria infections related to dental waterlines.

Now, according to the CDC notice, these infections have occurred in children who receive pulpotomies, and I’m going to slaughter that word, in pediatric dental clinics where the dental treatment waterline contain high levels of bacteria.

So let’s start off with, what are your thoughts on this advisory and what are you hearing from the dental or even the orthodontic community who you work with?

Kellie Thimmes:

I think it’s created definitely a panic, but maybe stirring people into, “Oh my gosh, I need to get things under control or make sure that I’m okay.” Yeah.

Mike Rust:

I agree.

So the awareness accumulates. Awareness accumulates, right? They had their dental sales people in there saying, “Are you testing your water yet? Are you treating your water yet? Maybe are you using a tablet or a straw and you’re testing it to make sure it’s worth maybe … ? Maybe you’re just getting started.”

So they knew that other dentists are doing this and maybe they saw some other stories of previous infections, or maybe they have friends that got inspected. But when this comes out, every single dentist gets it from the CDC, they get it from the ADA morning huddle.

I tell you, in Vermont, every dental health provider and every medical health provider got a voicemail from the state reiterating what the CDC said.

So the government’s being proactive in saying that, “I think that it’s time for dentistry as a profession,” as Shannon Mills said, “To take this seriously.”

Alison Werner:

So what historically has kind of been the attitude towards dental waterline maintenance in dentistry as a whole, but maybe even just specifically to orthodontics? Is there kind of a different way of looking at this topic?

Kellie Thimmes:

I think for me, talking to orthodontics, orthodontics staff.

There may be a misconception that we’re not doing really invasive procedures, there’s not been an outbreak or infection that we know of that’s linked back to an orthodontist, so we don’t have to test, we don’t have to treat, we don’t use that much water. And that’s just not true.

And there’s also some that are really on top of it that go above and beyond to make sure that everything is clean and testing and they’re doing well.

But I think there’s just misconceptions around it, as well as, “I’ve been doing this for 35 years, I’ve never had an infection”, or, “I don’t use that much water. I don’t need to test”, or, “I’m plumbed to the city. The city tests the water and it’s a good quality, so I should be fine.”

Mike, do you have anything that you would add to that?

Mike Rust:


You know, Kellie, it’s because you talk to the people who are in the trenches and calling you asking for help, guidance and cheating on their water test results or whatever.

But from my perspective, which is the far end of it, I’ve been impressed with orthodontists in general, their willingness to not blink at the cost of adding a water testing and treatment regimen to what they’re doing. If it’s the right thing, they just say, “Let’s do it.” They’re business people more so than some of the people that Kellie talks to on a day-to-day basis.

And I think I’ve been impressed also; a lot of them have the smarts to hire someone like Jackie Doris to help them with all things compliance. There’s other people that do what Jackie does. I think there’s Andrea Cook in another part of the country.

So they want to make sure that they’re buttoned up and they take pride in it.

But you’re right, Kellie, they use less water. They use a lot less water. So you think they’d be later adapters to the technology, but a lot of them use tablets in their water bottles like Blue Tab, or ICX is another product. You just drop a tablet in. And with that, you pay as you go and you only use as much as you need based on how much water you need. And as we know, ortho offices use 10% of the water of a general dentist. But that also means that the water is even more stagnant when it’s in there.

So they’re smart to pay attention to it. And this CDC advisory is just reminding everybody to maintain their diligence, I think.

Alison Werner:

Well, you kind of mentioned it there, but one of the things that’s at risk if they’re not taking care of their dental waterlines is their license could be at risk.

Now I’m curious, as all orthodontists … If you own a private practice and you’re the sole doctor, it’s very easy to be on top of that. But what about if you’re in a group or a corporate structure? Are there any special considerations? Because I know in talking to you, I know you had some stories about some dentists actually in this case who kind of got screwed because they were in a larger practice and the complaint came against them.

Can you kind of talk about that?

Kellie Thimmes:


So like I said, there’s so much in the realm of infection control, and so waterline maintenance is important, but it’s a small part; there’s so much other things to do.

And yeah, the dentist that called was a local, and dentist here at a group practice, but got a random inspection, not for waterlines, but waterline test results are one of the first things that an inspector will ask for.

Mike Rust:

And the most expensive, right, Kellie?

Kellie Thimmes:

Yes. I think the fines were over … At that time … I think they’ve gone up since then, but the fines were over $10,000 per day that he could prove that he had passing test results.

And it’s his license. It may be part of a larger practice, but it was his license. And so it was just a devastating …

Mike Rust:

It was a potential $70,000 fine. He called you, you went out, shocked his waterlines, grabbed his water samples, brought them back to our flow cytometer, got him results in two hours, saved him 70 bucks.

What did you get out of it, Kellie?

Kellie Thimmes:

He came and gave a hug, and a [inaudible 00:08:33] sandwich, which is [inaudible 00:08:35].

You could just see the defeat and just the … I think there’s just some misconceptions around waterlines in general, whether it’s orthodontic, regular dentists, and I don’t think that he had any malicious intent. So it was just really sad [inaudible 00:08:55] his license that ended up taking the hit. He ended up moving to a different state. But …

Mike Rust:

I was going to say, what else we got out of it was this cautionary tale, right?

So to answer your question, Allison, the risks are higher. Or the risks are the same, but the reward is not. I mean, it’s your license that can be in jeopardy even though it’s not your name on the door.

Kellie Thimmes:

I think now with turnover and just kind of the world we’re living in, there’s so many jobs available, and so you can kind of pick and choose. And so there’s a lot of turnover I think in dentistry in general, but even more so now. And I think that mainly complaints are driven from maybe a disgruntled employee or whatever it might be.

Again, waterlines are probably not going to be what gets public health or OSHA, whoever, in the door, but once they are, you have to prove that you have water test results [inaudible 00:09:59].

Yeah, and I think the awareness has gone up, enforcement’s gone up. And I think this newest infection, like I said, it’s not surprising to me that it happened. It’s sad. Of course, I don’t want it to happen, because it’s preventable. But I think it’s an eye opener to maybe people who didn’t see the other infections that happened, whether it be Anaheim or Atlanta, or whatnot.

Alison Werner:

Hmm-mm. Yeah.

Well, you mentioned it there a little bit; staffing. And you talked about how it might be a disgruntled employee that’s filing a complaint that has nothing to do with dental waterlines, but it gets state regulators in or an inspector in.

But can you talk a little bit about how just staffing is a big issue right now? A lot of practices are short or they’re seeing a lot of turnover. Can you talk a little bit about how just that issue is creating some inconsistencies or letting things slip through the cracks?

Kellie Thimmes:


Mike kind of touched on this earlier, but usually we would recommend tablets for orthodontic practices because they don’t go through that much water. But I think with the staff turnover, things getting busy, not being able to maybe hire enough people just because of the times we’re in, we find that they are going to straws because it does take out that extra, “Are they putting a tablet every time we refill the bottle?” It takes out that micromanaging piece because they know that antimicrobial is in there.

So definitely seeing a shift that way.

And then just having something that’s written, a simple easy procedure that’s easy to follow is so, so important. So the standard operating procedure for waterline, something that’s, “This is what we do in the morning, in between patients, at the end of the day.”

Because legacy errors can come into play where a new staff or a temp … There’s a lot of temp employees that people will get for the day. They have to know your protocol, and honestly, people are so busy, it’s like, do they get that training or are you taking the time?

And so we always recommend just keep it as simple as possible, let everyone know and just do what you can to take steps to reduce contamination and injury.

Alison Werner:

So let’s kind of break down, what are the consequences of not maintaining your dental unit waterline? We talked about infections, and that’s what prompted the CDC Health Alert Advisory, but what are some of the other consequences of not doing proper maintenance?

Mike Rust:

I’d say probably a relatively common occurrence can occur.

Every dental technician around the country that works on dental units has horror stories, and so does Kellie, of what neglected dental waterlines can look like and do.

So generally speaking, when everything’s working fine, you’re just cruising along; when that hand piece starts sputtering, when that air water syringe starts sputtering or gets clogged, clogged lines might be nature’s way of saying, “Hey, something’s happening here.”

It might be mineral, it could be inorganic material, but it could be organic material. That’s some pretty mature biofilm in there, having a party, clogging up your waterlines.

So that’s probably the easiest, least expensive fix. Have that dental technician come out, take a look at it, clean it out. And that’s probably a good indicator it’s time to start testing and treating your waterlines so that doesn’t happen again.

But even that’s not that common. I mean, it does happen, but it doesn’t happen all the time. It varies widely with your source water.

But the next worst thing that can happen is the inspection. And that can be caused by a disgruntled employee, as you guys mentioned, ex-employee or patient.

And there’s a lot more anxiety at every level these days. Ever since the pandemic, there’s more anxious patients. We’ve heard some stories of patients freaking out, whatever. There’s just lots of stuff going on. Who’s wearing a mask, who’s not wearing a mask? There’s just anxiety in the world. There’s too much anxiety in the world.

And so this is one thing that, regardless of what caused the complaint, Kellie always says this; one of the first three questions inspectors ask is, “Show us your water test results.” The other thing is, “Show us your autoclave test results and show us that you’re up to date on your continuing education.”

So that’s the next thing.

And then the worst thing that could happen is an infection. And usually you don’t know about those unless it’s more than one kid. That’s what triggers it.

And it’s been mostly children, because in these cases, a mycobacterium abscess is particularly nasty and it happens by and large … So most of these cases have been pulpotomies that take place in pediatric dental clinics. But what we learned is that a reasonable dental professional, whether it’s a dentist, a dental assistant or a hygienist, would follow the CDC guidelines. If you’re not following the CDC guidelines, it’s not that big a deal to start. We can help you.

Kellie Thimmes:

Yeah. I mean, I took a call … I’ve taken separate calls, but this one sticks out, and Mike was here; kind of going to the clogged lines. A hygienist called and she thought that she was squirting worms into her patient’s mouths because it was dark brown, shaped like the water line, but it was just a biofilm.

But devastated. I mean, hysterically crying, didn’t really know what to do. And so it was like, “Ah.”

So you just kind of get a whole range of emotions.

Mike Rust:

People who are very scared, they want to do the right thing for the right reasons, they’re worried that they’re making healthy people sick, and they’ve been scared … Our competitors use these pictures of worms coming out of dental waterlines.

In our experience, the worms are almost always not worms, but these stream of biofilm or some kind of inorganic and organic material. And it’s usually discolored or colored by some sort of cleaner that they put in that’s got some dye in it or whatever.

We’ve seen pink. We’ve seen lots of pink worms. They’re not worms, it’s just a lot of gooey biofilm. They just are in a long skinny strand.

But yeah, I think Kellie does deal with … She’s a therapist as well as a waterline expert. People call and they are distraught.

Kellie Thimmes:

I think it’s hard to … People are like, “I’m OCD clean, I’m doing everything right.” And man, bacteria grows just so quickly in waterlines and so fast. And so they could be doing everything right and still have failing test results.

And I think another part of it is I think sometimes dental professionals might be scared to test because they don’t want to know the results. Because if they know, then they have to do something about it.


Mike Rust:

And they believe that having no results is better than having a failed result.

Kellie Thimmes:

And it’s just not true at all. It’s way better to have failed results and working on a solution than no results at all. Because that’s kind of like, “Oh, I knew I was supposed to do this for decades, but I just am not going to do it.”

But if you have results and you’re working on it, that’s going to be different.

Alison Werner:

Okay. Okay.

Mike, you mentioned there that these compliance guidelines stem from the CDC. Can you guys talk about, what does it actually mean to have a compliant dental unit waterline with these guidelines?

Mike Rust:

Oh, that’s a great question for clarification.

My answer … Kellie might have a better one, but my answer might be that the ADA and the CDC says that the water that we treat patients with for non-surgical procedures should meet the standard for drinkable water, potable water, meaning 500 CFUs per milliliter of water or less.

Sounds reasonable, doesn’t it? That you should be able to swallow the water that you’re rinsing with?

That’s the standard. Shannon Mills will remind us that that’s not a health standard, it’s an engineering standard.

And if you think about it, Allison, it’s an engineering problem. The reason bugs grow [inaudible 00:19:23] waterlines is because they’re small and the water sits stagnant for 23 and a half hours a day. The engineering fix would be to make bigger lines, but it wouldn’t be very ergonomic to use a fire hose to clean someone’s … Or to have them rinse as an air water syringe. So that’s kind of the issue.

But that’s a reasonable standard. And we do say that, if you pass a water test, if your water’s under 500 CFUs per milliliter of water, your water’s safe and you can sleep good at night. Your patients are safe. And then when you document it, your practice is safe, your reputation is safe, your exit strategy is safe.

Kellie Thimmes:

I think also making sure that … and [inaudible 00:20:10] I guess this wouldn’t necessarily for orthodontics, but using sterile water for any kind of surgical procedures is just so important.

I think what some offices are doing is maybe opening up a bottle of sterile water and pouring it into their regular dental unit, which is not sterile.

Alison Werner:

Oh, yeah.

Kellie Thimmes:

So that just is no longer sterile.

And it’s hard to get people to understand it’s not the water. The water itself, yes, it was sterile before you put it in there, but now it’s not because you poured [inaudible 00:20:42] container, yeah.

Or even just in general, like, “Oh, I used distilled water. Shouldn’t that be good enough?” And we often find that distilled water is kind of even worse than just regular tap water because there’s nothing in it, and so we kind of call it a hungry water, kind of grab onto bacteria quicker. But a lot of people will just use distilled water thinking that’s enough, and it’s just not. It’s not an antimicrobial.

Alison Werner:


So let’s talk about what dental unit waterline maintenance looks like for an orthodontic practice. What are the key steps for maintaining waterlines?

Kellie Thimmes:

Yeah, so there’s three main steps to dental unit waterline maintenance.

So shocking would be the first step, where we’d always recommend people to shock. Shock is using just a strong chemical. Because like Mike said, we can’t get in there with a scrub brush and really clean out the insides of the waterline, so we have to rely on a strong chemical to really get in there and break up that biofilm and then flush it out.

So shocking is just a strong chemical; not safe to use on your patients. There’s a couple of different protocols that we recommend that we see good results with. We have a large dental unit water lab that we have tons of data from.

So we recommend a strong shock. That’s step one.

And then treating is the step two. So a daily maintenance product, whether it be a tablet-like blue tab, ICX, those are daily maintenance tablets that are designed to be continuously present in your water lines, in your water bottle all the time. They’ll keep your patients clean, keep your lines clean in between that shocking period.

And then testing. I love how Mike says it; shocking and treating protects your patients, protect you as a dental professional. Testing protects your reputation. That’s that documentation to protect your license, to protect your practice.

But all three together are the three we like to call it ‘the three steps to save water’ or ‘the proven protocol.’

Alison Werner:


So with testing, first, how often should you be doing it? And then what are the kinds of tests that are available, or how do you test?

Kellie Thimmes:

So depending on … We always like to refer to the manufacturers’ instruction [inaudible 00:22:53]. Some will say, “Hey, do two months back to back, get passing test results. And you can push it out to quarterly.”

You don’t want to go past quarter. So we want you to test at least four times a year. That way, if you have clean [inaudible 00:23:09] all four times, you know you have had clean water that whole year.

And Mike, I like how you talk about shocking on the first day, testing on the last one. Talk about that. You talk about that so much better than me.

Mike Rust:

No, but Kellie’s right; most of the equipment manufacturers are now protecting their liability by saying … By adding this to their instructions use, they now say, “It’s on you, doctor. You need to test your water every 90 days.”

Quarterly water testing; John [inaudible 00:23:40] said it is an understandable interval. And it’s one that, if you pass those tests every 90 days, you can sleep good knowing that your water’s been safe. You do that four times a year, no one can say your water wasn’t safe. It’s kind of nice. You don’t have to test it every week like your autoclave, right?

But yeah, a buttoned up procedure for an ortho office is, “January 1st, let’s shock all our waterlines.” You can use one to 10 bleach, leave it in for 10 minutes. You can buy a commercial product and leave it in overnight or follow the instructions for use on it. All right?

You might want to test your water right away and validate that the shock worked, but then you go 90 days. And then every day you put in a tablet or a straw, whatever you prefer.

To Kellie’s point, the tablets were always popular, particularly with orthodontists, because they use less water and you could pay as you go. And that’s kind of a nice way to go, especially for a new guy just getting started. You don’t have to buy a year’s worth of product. But now they like the straws. And they really do make sense.

And they are as cheap as the tablets really when they’re on special, and they’re occasionally on specials, you know, like buy two, get one free or whatever; cheaper than a tablet.

So whatever you use, a tablet or a straw, every day.

And then 90 days later, let’s say March 31st, you want to test your water. If you pass, that proves your water was safe for 90 days because you just tested it on the worst case scenario.

Alison Werner:


Mike Rust:

Then the next day, you shut off your water lines if you’re using a tablet. If you’re using Bluetooth, you can go another six months and then test again and then replace the Bluetooth every six months.

Oh, two things.

The only other thing I would say is fill your water bottles with your municipal tap water. You don’t need to use commercially bottled distilled water.

And don’t use an in-office distiller or reverse osmosis unit unless you test it frequently, because those things have caused more problems for Kellie than anything else. People think that they’re … Because they’re expensive. They cost $6,000 and they’re supposed to treat the water.

And they do. They remove all the total dissolved solids, they make water that’s perfect for an autoclave, but not great for patient treatment, because the water sits in a car buoy, it sits in a reservoir, it sits in a pond. It sits in this little pond and then you fill it from that little pond, fill your water bottles from the little pond, and it’s a great place to produce biofilm, it turns out.

So we don’t like those things. If you’re going to use them, just validate that it’s part of the solution and not part of the problem.

But it’s just easy [inaudible 00:26:31] Municipal tap water works all the time. If you hate your municipal tap water, there are other choices. ADEC has the best guidance on that. But they say don’t use … They don’t say don’t use distilled water, they say use commercially bottled drinking water. It tastes better, [inaudible 00:26:46] less corrosive.

Alison Werner:


And then in terms of the testing options, what are the in-office options and then what if they want to do something beyond an in-office option?

Kellie Thimmes:

So there’s a couple different in-office tests.

We have QuickPass. So it’s the only in-office test that’s designed specifically for dentistry. It’s a little paddle test. It’s got germicidal neutralization built into the membrane itself, which just means it’s going to make your test accurate. So it’s going to neutralize out silver or iodine, any of the products that are used in dental.

And you get results within 48 to 72 hours, easy to read. It’s a white membrane. If there’s any bacteria, it shows up as red colonies, red orange, sometimes yellow.

Easy to read. It’s not going to give you a precise CFU count, but it’s going to give you a good idea of where you’re at.

And they’re really cool, really easy to do. And you do it in the privacy of your own office, and a lot of people like to do that maybe the first test.

There’s also mail-in testing options, which give you a report from a third party lab.

We have R2A testing method, which is kind of known as the gold standard for testing. You send it in to us. We have a test kit, you get sterile vials, you send your samples overnight to us, to our lab. It takes seven days to get those test results back.

And we also have Flo, which is just … Love it. It seems like we just got it, but it’s been a few years now. It uses flow cytometry, so you get your results so quick.

So you overnight them to us, we’ll have your test results the same day we receive them. So you can celebrate early, take corrective action if needed, and we can walk through steps together.

So Flo is another mail-in, you get that report. But the in-office QuickPass …

There’s also a red panel that’s available and there’s other mail-in labs.

But just as long as people are doing something quarterly is just so, so important. And keeping the documents.

Alison Werner:

Yeah. Well, I want to get to that in a second, but before I do … Now, if a practice fails a waterline test, they shouldn’t immediately freak out, correct? Because I mean, it can be hard to get rid of bacteria, it can be stubborn. Correct?

Kellie Thimmes:

Absolutely. And I think that, like Mike said, I’m kind of like a therapist, I feel like, sometimes.

Because we get all over the spectrum of, “Oh, I think it’s fine. I think you guys contaminated”, or, “I think we contaminated it.” And it’s like, “Hmm. I think it’s just a stubborn biofilm. So let’s work together.”

But definitely, yeah, don’t want anyone to panic. We always offer free consultations no matter if you test with us or if you don’t, if you’re using our products or not. We want to help. We don’t want one other inspection for fines, and for sure, we don’t want any other infections to happen.

So definitely don’t panic. We can use that knowledge as power and go through what to do next. And we love, we’re passionate about that.

You know, this infection is just … It’s heartbreaking because it is something that’s preventable and we don’t want it to happen again.

But yeah, never panic.

And people kind of do, and it’s like, “Should I stop practicing?” And again, that would be a decision on their end, but I think as long as they meet with someone, they work on it rather than, “Well, I failed, I’m going to just pretend that didn’t happen.” Of course, we don’t want to do that.

But again, knowing; that gives us a good place to start.

And I like how Mike talked earlier; make sure your shock was effective. If not, hey, we maybe need to be a little more aggressive with the shocking or just really flushing.

And I love Flo for the mail-in test, Flo, because it gives us more information on what’s going on inside the line. So it shows us live bacteria, dead bacteria, damage. It’s a lot of science, but it’s really helpful for us doing consultations because it all kind of plays a part.

So that dead bacteria, and this is gross, but it becomes food for live bacteria. So it can start this whole process really quickly of growing. And it already grows fast.

So yeah, definitely don’t panic, but address it and let us help you. We know that most dentists, hygienists, assistants didn’t get into dentistry to treat or test water, but we did. So we want to help any way that we can.

Alison Werner:


Okay. So now, in terms of documentation, what kind of records should an orthodontic practice be keeping?

Kellie Thimmes:

So Standard Operating Procedures is a huge one I think people skip, especially for waterlines.

So anytime you have an infection control policy, it’s really important to have it written. So written Standard Operating Procedure for waterlines.

And then proof that you’re doing that. So those documentations, whether it’s the QuickPass log that Mike showed of … You actually do the test yourself, you write the results, you read them. We have people that take pictures and email them to us for our interpretation. But it is that in-office test where you do it yourself. And then there’s the mail-in, where you get that third party report.

We recommend keeping all of those for five years at least. But [inaudible 00:32:03] check with the dental board to make sure, because some states are a little bit longer. But for the most part, it’s five years to keep those results.

And if you do have a failure, you want to take corrective action, shock and then retest. But again, reach out to us because we always want to help.

Alison Werner:

Before we kind of conclude this, I want to circle back to the reason we’re doing this podcast episode and why I’m talking to you guys is that CDC Health Alert Advisory.

You know, when Jackie reached out, Jackie Doris, who I spoke to last week, we did an episode on what it meant for orthodontic practices. And she talked about one of the big risks was the fact that this could hit the media. And it did. NBC News did do a story on it. And so she wanted practices to be aware that patients might be coming to them saying, “Is your practice safe?”

What do you think orthodontic practices should be taking away, in your opinion, on this Health Alert Advisory?

Mike Rust:

Great question.

First of all, orthodontic patients don’t know that orthodontists don’t use a lot of water. If they see this NBC News story, they’re taking … And how that works; Ortho practices, they see 110 patients a day. Kids come in, moms are in the waiting room, and moms are chatting amongst themselves, “Did you see that NBC News story?”

I think it’s more likely … Even though … It’s more likely that they’ll have awareness, that the patients will have awareness. And Jackie is prescient to recognize the fact that this is probably the first time since the Anaheim case hit the news that patients would start asking about dental waterlines and the safety of a dental practice.

So I would say, and Kellie, please help me out here, but I would say it’s a great idea for ortho practices to get ahead of this.

We have a favorite ortho office who’s Jackie’s client; [inaudible 00:34:09]? [inaudible 00:34:10] the greatest.

Kellie Thimmes:


Mike Rust:

Yeah. They did a happy dance on Facebook after they passed their water test. And the reason they did a happy dance is because they worked hard to get there. They worked. It was not easy. They had to learn how to shock, they had to …

So it’s worth celebrating. And it might be worth having something in your waiting room that says, “We tested our water.” I think that might be a great internal marketing piece.

And then when those moms are talking to each other, they’re going to say, “Oh, go see Dr. Reed. He’s got a sign in his office that says the water is safe.”

So I think that it’s smart to get ahead of this and it’s smart to show off that you’re ahead of this. It’s smart to brag a little bit about all of your infection control procedures. Yeah, this is just the smallest part of it, but it’s also the most recent, relevant and kind of scary part of it. So …

Kellie Thimmes:

And I think just making sure everyone is aware that patients may ask and you want to make sure that everyone can confidently answer what you’re doing and that, “Yes, we are testing and we go above and beyond because we care about you.”

Because I think the worst part would be not having an answer for someone. Like, “Do you test?” “Well, I think we do.” You know, you want to be really confident and, “Yes, we do, and we go out of our way. We put an antimicrobial in the water to make sure you’re safe. We shock, we test, we’re in line with what the state dental board says; ADA, FDA, CDC, OSAP, OSHA.”

And just knowing what that protocol is, is key. I mean, I think people are going to ask and I think it would be worse to kind of be like, “I’m not sure”, or to give not the correct answer. Because you never know … At my dentist, when I asked, “What do you guys do to treat your water?”, they said they shock every day. I’m like, “Mm-mm. Lying. They’re lying. I know they’re lying.” It was just …

Mike Rust:

But misconception; they’re probably shocking their evacuation lines every day.

Kellie Thimmes:

Totally. Exactly.

Now I think we got them all on board with testing.

But it’s so important to know, and just going above and beyond, because parents are going to ask. And I think now with social media … I mean, I guess 2015 with Anaheim, there was, but I don’t think it’s like it is now, and it’s just … People know about it more than I think they did with Anaheim.

Alison Werner:

Yeah. It could really damage your reputation as a practice, the reputation you’ve built.

Kellie Thimmes:


Alison Werner:


Well, before we close out, I wanted to ask you guys … So ProEdge Dental is kind of … You guys definitely have shown that you have some expertise here. So I’m just curious for our listeners, what are some of the resources you have available and what kind of services are you offering?

Kellie Thimmes:


So we always offer free consultations. Again, no matter what, if you’re testing with us, if you’re not, if you’re just getting started, don’t know where to start, we’d love to help you get set up with a protocol.

We also have a live webinar the first Friday of every month where we offer a live CE credit.

And then we do some just in-office trainings. Whether it’s virtual or if you’re in Colorado; love to come and see you. But virtual trainings where we can offer a training certificate just going through the basics of … I mean, we’d go through a presentation and kind of go over why this is so important, what it is about.

But just having that certificate; you could put it in your waiting room and let people know that, “Hey, we do care. This is what we’re doing.”

So we do offer all of that. But I think what I just truly love about ProEdge is, again, we don’t care what product you’re using, who you’re testing with, it doesn’t matter. Just call us. We want to help.

Mike Rust:

We have the largest team of water experts in the world, and it’s expanding all the time as needed because people are asking questions.

And they are so great. Kellie takes as much time with the smallest offices as she does with the biggest offices. And she talks to the biggest offices, I’m pretty sure.

But I would say, also, if you’re a younger person and you want to do it yourself, our website has a brand new learning center that is so robust. It has just so much new content that you can’t get anywhere else. You can really get lost in there and find what you’re looking for fast.

We have lots of videos starting, Kellie and Kelly, that are very well done and very popular and super helpful, because they’re short and sweet and they get right to the point; here’s how to shock, here’s how to test, here’s how to use QuickPass, here’s how to do it yourself, here’s how to install stuff. Very simple, all that.

But our new website … So the timing is really good because we put a lot of work into the new website. Our marketing people remind us, me and Kellie, all the time about how much work it’s been for them. So they’d be mad at us if we didn’t steer people there, because it’s pretty good: proedgedental.com. There’s just tons of new …

Oh, just go to resources, resources, and then find your way around. There’s so much.

And it’s all non-commercial until you get to the products page. But it’s all …

Kellie Thimmes:

Yeah. They can set up consultations on there as well or sign up for webinars or just get some information.

And again, like I was telling you, I think, earlier, everything’s confidential. We always want to just make sure that offices know it’s confidential. We just want to help.

Mike Rust:

Yeah, that’s a good point.

So yeah, I was just going to say, when you do a mail-in test with us, it’s confidential. It’s completely confidential. We won’t send it to anyone else without your permission.

But we recommend that, if you’ve got in a compliance specialist consultant who you trust, like Jackie or any of those folks, that you include them on the results, because they like helping out with that stuff and they’re pretty good at it.

So that’s kind of a neat idea. It doesn’t hurt to have a trusted advisor in the loop with you.

We also have a dashboard that is recent, and what that allows is compliance across multiple sites and multiple levels. So there can be an administrator who can look at a thousand offices and see the results; who’s passing, who’s testing, who’s failing, who’s not testing, who needs a reminder; time to test. Things like that. And they love that. The compliance people love the automation of having help with compliance.

We’re trying to wrap this up.

Well, we were talking about confidentiality, and all of our water tests are confidential, but there’s nothing more confidential than doing it yourself with an in-office water test. And even John [inaudible 00:41:43] and Jackie love the fact that people …

And that’s why it’s popular, because people go, “I don’t want anyone to know. I don’t want anyone to know. Until I’m passing, I just want to see how I’m doing.”

Kellie Thimmes:

[inaudible 00:41:57] QuickPass on our website as well.

So I’d love to give samples, if not reach out.

Mike Rust:

You can get a free QuickPass sample on our website. That’s a cool idea.

Alison Werner:

All right.

Well, thank you, Kellie and Mike so much for going really in depth here. I so appreciate it and I’m sure our listeners will too.

And to our listeners, be sure to subscribe to the Medcor Podcast Network to keep up on the latest episodes related to orthodontic products. And to keep up with the orthodontic industry news, check out orthodonticproductsonline.com.

Until next time, take care.