biostream® ZERO: Water hygiene in the dental practice is often underestimated.
biostream® ZERO ensures perfect quality of water in dental treatment units.
An underestimated problem in dental units are the hoses inside the dental chair. And if there is no end piece connected to these hoses, massive contamination can occur here. Although this problem is known in some practices and the employees work on solving this problem according to the hygiene plan, the result found by externally commissioned laboratories often looks like this: Germs (CFU) and also Legionella, Pseudomonads and E.Coli germs have been officially detected, although disinfection was carried out with exactly the products recommended by the manufacturer of the dental units. How can this be?
The disinfectants recommended by the manufacturers often contain only the active ingredient hydrogen peroxide paired with some less important additives as the active ingredient. However, hydrogen peroxide, unlike biostream® ZERO, is only a weak oxidizing agent and must be dosed 25 times higher to have the same effect. Since the effectiveness of hydrogen peroxide is strongly dependent on the pH value of the drinking water, it is only mentioned in the drinking water regulations as an „oxidizing agent“ and not as a „disinfectant“.
There is therefore a risk that some bacteria will survive this hydrogen peroxide-water mixture and become resistant to it. Then, the longer a biofilm lives in the dental unit, the more resistant this biofilm structure becomes. Finally, the germs living in the biofilm are then detected in water tests – or not.
Appearances are deceptive: Germ-free despite dangerous germs
The effect of hydrogen peroxide can be fatal: Disinfection with hydrogen peroxide fights the so-called „lawn“ on the biofilm and also kills the germs floating freely in the water. If a sample is then taken, no germs can be detected and everyone involved thinks they are safe. But this can be deceptive. If a biofilm is already present, under which numerous bacteria live in a protected environment, it has not been removed with hydrogen peroxide and can break open at any time and cause fatal contamination of the dental unit. Then all your work was in vain and a shutdown of your dental unit(s) by the health or trade inspectorate may be imminent.
The solution: biostream® ZERO
The active ingredient chlorine dioxide in biostream® products effectively kills the germs floating freely in the water and even combats biofilm that has already grown up! In addition, the above-mentioned formation of resistance has not been proven once with the active ingredient chlorine dioxide. The material compatibility of a disinfectant plays a special role from an economic point of view when disinfecting objects with a high material value. And here, too, biostream® ZERO scores highly:
The optimized pH value virtually eliminates corrosion. This outstanding material compatibility, coupled with its extraordinary disinfection effect without the formation of germ resistance, makes biostream® ZERO the agent of choice when it comes to effective disinfection of treatment units.
Fungi, algae, viruses and pathogenic germs are effectively combated and killed by the drinking water-approved active ingredient. In technical terminology, these germs are called pseudomonads (Pseudomonas), E.Coli and Legionella.
In numerous orthodontic and dental practices, biostream® ZERO has been used successfully for years – as confirmed by numerous before-and-after comparisons.
- ready for use within only 3 hours
- effective over the entire drinking water pH range
- suitable for aluminum tanks
- suitable for disinfection of drinking water in times of crisis, for emergency preparedness in case of blackout, power failure and other disaster situations
- 25 times stronger than hydrogen peroxide (according to DVGW worksheet W291)
- highly effective against:
Pseudomonas aeruginosa (Pseudomonads, Pseudomonas)
Escherichia coli (E.coli) and coliform bacteria
Legionella / Legionella pneumophila
- without heavy metals (silver, copper)
- no germ resistance formation known
- Euro standard DIN EN12671 "Chlorine dioxide"
- EU drinking water regulation
- compliant with Article 95 (2) (EU) No. 528/2012 / Biocide Directive
- DVGW worksheet W291 and is thus approved for disinfection of water distribution systems
- Guideline No. 5 of the AK of the coastal countries for ship hygiene
- DVGW worksheet W224 "Dosing of a chlorine dioxide solution prepared on site"
- DIN 2001-2 / DIN 2001-2:2009-04 "Drinking water supply from small systems and non-potable systems - Part 2: Non-potable systems - Guidelines for requirements for drinking water, planning, construction, operation and maintenance of systems; Technical rule of the DVGW"
- Active ingredient approved by the United States Environmental Protection Agency (EPA) for disinfection of drinking water
- The active ingredient has been used to disinfect drinking water in waterworks since the mid-1950s
biostream® ZERO für Zahnärzte
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Hygiene requirements for the reprocessing of medical devices:
The recommendations for drinking water in dental treatment units are defined by the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute (RKI) and the Federal Institute for Drugs and Medical Devices (BfArM) and are clear. The dangers of germs in treatment units are well known.
As early as May 2015, the State Dental Association of Thuringia published an information sheet entitled „Hygiene inspections and controls in accordance with medical product legislation in dental practices“ – among other things, this addresses the water-carrying systems of treatment units. The Baden-Württemberg State Health Office (BW) also addresses the problem of germs and biofilm formation in its leaflet „Information on water-carrying systems in dental treatment units (dental units)“.
Based on the health authority’s own experience (LGA BW), it is recommended to have water samples taken about every six months to a quarter, depending on previous findings, and to have them tested not only for colony-forming germs – but also for Pseudomonas aeruginosa, since this germ is held responsible for biofilm formation. „Examinations for Legionella need not be carried out more often than once a year if the previous findings did not provide corresponding evidence of germs,“ the LGA BW also informs.
Against these dangerous biofilms, biostream® ZERO has already been used in (dental) practices for years. You too can effectively combat germs, viruses and bacteria in your dental practice. The active ingredient of biostream® ZERO is also approved for use in so-called bottle care systems.
FEEDBACK FROM THE DENTIST’S PRACTICE:
Dentists regularly inquire with biostream® GmbH when findings of e.g. Legionella have been detected in the treatment units and ask how to effectively combat these viruses. The treatment unit must be disinfected as quickly as possible to avoid interruption of operation. Unfortunately, often the support from the dental depots does not bring the expected solution to the problems, because precisely there is not the understanding and knowledge on the subject of „disinfection of drinking water in treatment units“. And if you take a closer look, hydrogen peroxide solutions are recommended, for example, which, however, are not even mentioned as disinfectants according to the current drinking water regulations.
Our cooperation with dentists has shown that there are numerous problems in the area of disinfection of treatment units. In the following, we report on some cases that may also be familiar to you. (We will regularly add to these examples).
A dentist from Göttigen, who has been dealing with the topic of „disinfection of treatment units“ for years, had a problem with Legionella after switching to the Bottle Care system. After using biostream® ZERO according to our dosage recommendation, no more legionella could be detected. The dentist was very satisfied and informed us of this at short notice. After one week, however, a recontamination of the treatment unit was detected and the dentist’s feedback was accordingly negative. The effectiveness of biostream® ZERO for disinfecting dental treatment units was questioned.
Since this recontamination with Legionella within one week after application of biostream® ZERO is extremely unusual and has never occurred before, our assumption was that there must be so-called dead lines directly in the treatment unit. Dead lines are line sections at the end of which no pick-up device is connected.
The dentist then contacted his dental depot and asked whether there were dead lines in his dental unit (treatment chair). The answer from the dental lab was „No!“. The dentist then requested a detailed on-site examination of his unit and agreed that if NO dead lines were detected, he would cover the cost of the examination of his dental unit. If dead lines were detected, the dental depot was to cover the cost. The dental depot agreed and a complete examination took place on short notice. It was discovered that there were 2 x 30cm water lines in the dental unit that had been installed for the operation of a second treatment unit. However, since the dentist did not need a second treatment unit on the chair, this had not been installed, but the 2 x 30cm water hoses were still present.
And it was precisely these hoses that had ensured that disinfection did not work: perfect disinfection of the treatment centers can only work if ALL lines carrying drinking water can be wetted with disinfectant.
Disinfection is not possible with dead lines! Why?
In the case of dead lines, a disinfectant cannot enter the water line. It is therefore a dead end. There is no flow that can flush a disinfectant into this dead line. For this reason, even biostream® ZERO could not control Legionella in the dead lines in the case just described.
In accordance with the agreement between the dentist and his dental depot, the dental depot naturally assumed the costs for the inspection of the treatment unit. After removal of the 2 x 30cm dead lines, no more legionella could be detected.
GERMS IN DRINKING WATER AT THE DENTIST DESPITE REGULAR DISINFECTION BY DENTALDEPOT
Have you ever wondered why you contact your dental depot contact person for disinfection of your dental units / dental chairs at regular intervals, why he then carries out the disinfection at your premises and why, nevertheless, during an official inspection or test by the health department or the trade supervisory office, objections are found which result in the decommissioning of your dental units?
Our experience with some (not all!) dental depots has shown that they rely only on the disinfectants recommended by the dental unit manufacturers. These disinfectants are 80% based on the active ingredient hydrogen peroxide. However, hydrogen peroxide is only mentioned in the drinking water regulations as a weak OXIDANT and from a purely chemical point of view – according to DVGW guideline W291 – it can only be as effective as the active ingredient used in the biostream® products if it is used in a concentration 25 times higher.
Then it’s a simple math problem: multiply the current price of your disinfectant by 25 and see how much you pay for a 250ml bottle of biostream®-ZERO.
PERMANENT DISINFECTION OF WATER AT THE DENTIST
Surely you have ever wondered if the problems with water disinfection at dental units could not be solved simply by permanent disinfection. Here, however, the legislator and other institutions concerned with the valuable commodity of drinking water took a stand early on:
- The German Technical and Scientific Association for Gas and Water (DVGW) says in its information magazine (Link) e.g.:
„A permanent, prophylactic, chemical/electrochemical disinfection of drinking water in drinking water installations that are set up and operated according to the rules of technology is neither necessary nor sensible. Permanent chemical disinfection of drinking water […] does not comply with the generally accepted rules of technology. It also contradicts the minimization requirement of the Drinking Water Ordinance (TrinkwV 2001) .“
- In the Drinking Water Regulations (Link) , the following is written about permanent disinfection, among other things:
„Treatment substances that are added according to letters b and c and remain in the drinking water as intended must be limited in the quantities of treatment substances used to the extent necessary to achieve the treatment objective, in accordance with the minimization requirement.“
The question then arises as to how you are to prove which dosage must be dosed in order to achieve the treatment objective. If the same quantity is constantly added, it may happen that disinfectant is added even though contamination is NOT present, which would not correspond to the above-mentioned definition.
- In the S2k recommendation (Link), which was developed by the professional societies German Society for Hospital Hygiene (DGKH), German Society for Dental, Oral and Maxillofacial Medicine (DGZMK), German Society for Oral and Maxillofacial Surgery (DGMKG) and also the German Dental Association (BZÄK), German Working Group for Hygiene in Dentistry (DAHZ) and others, the following key sentence can be found:
„Even when operating a central disinfection system, the manufacturer’s specifications of the treatment unit regarding the compatibility of the external and internal disinfection system, the material compatibility and the „minimization requirement“ of the Drinking Water Ordinance must still be observed. The latter states: „Treatment substances should only be added to the drinking water during treatment for compelling hygienic or technical reasons, and always only to the extent absolutely necessary (minimization requirement) and under optimum conditions.“
Permanent disinfection or permanent disinfection in dental chairs can be problematic
As you could read, there are clear statements about permanent disinfection. The German Dental Association (BZÄK) as co-editor of the S2k recommendation underlines the statement „Aufbereitungsstoﬀe should only be added to drinking water during reprocessing for compelling hygienic or technical reasons, always only to the extent absolutely necessary (minimization requirement) and under optimal conditions.“
And now, as a dentist, you can ask yourself how you are going to argue to the health department or the trade supervisory office that you are STILL adding a disinfectant (e.g., machine-controlled by a BLUE* system), although at the same time you CANNOT STILL prove that you have regular contamination that makes the continuous use of chemicals necessary.
Our solution for you: Without the use of expensive dosing technology, you can effectively disinfect your dental units quite simply with the mostly existing rinsing programs! Here, it is only necessary to replace the existing products or those recommended by the manufacturer (mostly based on hydrogen peroxide) with biostream® ZERO.
Although we do not actively advertise in dentists‘ media and are not a participant in the „International Dental Show (IDS)“, we were able to convince numerous dental depots and also dentists – without advertising – of the effectiveness of our product biostream® ZERO.
SUSTAINABLE CONTROL OF LEGIONELLA AND BIOFILMS
Legionella (e.g. Legionella pneumophila) are a water hygiene problem that is often underestimated. They are also the cause of legionnaires' disease (legionellosis).
Legionella settle in the so-called biofilms, which can only be combated poorly or not at all by e.g. disinfectants containing hydrogen peroxide. Chlorine also has less disinfecting power than the active ingredient chlorine dioxide present in our products.
According to the current Drinking Water Ordinance, biostream® products are approved as disinfectants for drinking water. In addition, our products comply with the current requirements of the Biocide Directive.
Mit den biostream® - Konzentraten auf Basis von Chlordioxid haben Sie jetzt die Möglichkeit, Trinkwassertanks, trinkwasserführende Leitungen und Trinkwassersprudler - Flaschen zuverlässig zu desinfizieren. Benutzen Sie den Wirkstoff der Wasserwerke ohne teuren Technikaufwand.
Der aktive Wirkstoff in den biostream®-Produkten (Chlordioxid) wird bereits seit Mitte der 50er-Jahre zur Desinfektion von Trinkwasser in Wasserwerken genutzt. Zur Herstellung werden dort aufwendige und teure Anlagen eingesetzt, die jetzt nicht mehr nötig sind. Stellen Sie das effektive Chlordioxid ganz einfach selbst her und profitieren Sie von der perfekten Wirksamkeit gegen E.Coli, Pseudomonaden und Legionellen!
Desinfizieren Sie gesetzeskonform Trinkwasserleitungen, Schankanlagen und Tanks in Wohnmobilen, Campingfahrzeugen und auf Booten und Jachten. Keimfreies Trink- oder Prozesswasser für Industrie und Handel lassen sich mit den Konzentraten der biostream® GmbH problemlos umsetzen - sprechen Sie uns an. Unsere Produkte sind ebenfalls geeignet zur Desinfektion von Trinkwasser in Krisenzeiten, zur Notfallvorsorge bei Blackout, Stromausfall und anderen Katastrophenfällen.
WASSERSTOFFPEROXID UND SILBERHALTIGE MITTEL SIND KEINE ALTERNATIVE
Die biostream®-Produkte ZERO und asepticaPRO entsprechen der DIN 2001-2:2009-04 (Trinkwasserversorgung aus Kleinanlagen und nicht ortsfesten Anlagen) und sie sind über den gesamten Trinkwasser-pH-Bereich wirksam. Wasserstoffperoxid wird in der DIN nicht als Desinfektionsmittel genannt – auch in der aktuellen UBA-Liste des Umweltbundesamtes wird Wasserstoffperoxid nur als Oxidationsmittel – nicht jedoch als Desinfektionsmittel genannt.
Schauen Sie mal auf das Etikett des von Ihnen zur Zeit verwendeten Desinfektionsmittels: Wenn Sie dort Wasserstoffperoxid als Wirkstoff finden, dann nutzen Sie nach Angaben des Umweltbundesamtes KEIN DESINFEKTIONSMITTEL, sondern ein Oxidationsmittel, welches nach DVGW-Arbeitsblatt W291 25 X stärker dosiert werden muss, um die gleiche Wirksamkeit zu erreichen, wie der Wirkstoff in den biostream®-Produkten.
Und falls Ihr Produkt zusätzlich noch Silber enthält: Silber ist auch nicht als Desinfektions-, sondern nur als Konservierungsmittel genannt. Außerdem findet sich folgende Anmerkung dazu in der DIN: „Nur im Ausnahmefall bei Lagerung von Trinkwasser ohne Verbrauch über eine längere Zeitspanne. Die Konservierung ersetzt nicht eine erforderliche Desinfektion von nicht einwandfreiem Trinkwasser.“
Biozidprodukte vorsichtig verwenden. Vor Gebrauch stets Etikett und Produktinformationen lesen.
Sämtliche Aussagen zur Wirksamkeit beziehen sich auf die langjährige Erfahrung der biostream® GmbH, auf Angaben aus der Fachliteratur, Gesetzen, Regelwerken und auf positive Kundenreferenzen.
Gendersprache: Wie bereits 04/2019 mitgeteilt: Auf unseren Websites verwenden wir das Wort „Mitarbeiter/Kunde/Anwender“ zur einfacheren Formulierung. Als „Mitarbeiter/Kunde/Anwender“ definieren wir jedoch nicht nur die männliche Form sondern die aktuell gebräuchliche Definition (m/w/d).