Dental unit waterlines (DUWL) can promote bacterial growth due to their small diameter, long tubing, and periods of low or no flow. These conditions create an environment where bacteria can develop and flourish, impacting water quality if not properly managed.
A consistent protocol is essential. Follow these six steps to support effective dental waterline maintenance.
1. Start with the right water source
Whether your system uses a self-contained bottle or connects directly to municipal water, water quality is an essential part of dental unit waterline maintenance.
Best water quality practices for dentistry:
- Use potable drinking water (tap or bottled) that meets local regulations.
- Clean and dry self-contained bottles before refilling—never “top off.”
- Follow manufacturer recommendations for bottle disinfection and maintenance.
A controlled water source reduces microbial introduction and supports ongoing treatment.
Note: A‑dec does not recommend the use of distilled, deionized, or reverse osmosis water, as long-term use may degrade system performance.
2. Maintain with continuous treatment
For daily waterline maintenance, use A‑dec ICX waterline treatment tablets.
Simply add one ICX tablet to an empty self-contained water bottle before each fill. ICX continues working in the system with each treatment, helps maintain dental unit waterlines, and is used as part of a daily waterline maintenance protocol.
Continuous waterline treatment:
- Maintains dental unit waterline effluent (≤10 CFU/mL under proper use)
- Reduces accumulation of microbial contamination and deposits
- Remains active in water for up to two weeks
ICX tablets are compatible with restorative procedures and do not affect bonding performance.
Built-in tubing protection from A‑dec
Did you know A‑dec waterline tubing is made with AlphaSan? AlphaSan is an antimicrobial agent added during the manufacturing process. The silver ions in AlphaSan protect the tubing against bacteria and other microbes that cause foul odors, discoloration, corrosion, and other problems on untreated surfaces.
3. Monitor water quality regularly
Monitoring measures bacterial levels in dental unit waterlines. The CDC recommends ≤500 CFU/mL using quantitative heterotrophic bacteria testing. Test regularly during initial implementation and, if results consistently meet your action level, adjust testing frequency based on manufacturer recommendations.
If test results exceed your established water quality action level, shock the waterlines. Ask your dealer to recommend a water monitoring test kit or laboratory service to help monitor your water quality.
4. Shock dental waterlines when indicated
Shock treatments are used to remove deposits and contamination from dental unit waterlines.
Perform dental waterline shock treatment before the first use of a new system, when changing DUWL treatment protocols, and when test results exceed your established action level.
ICX Renew: when it's blue, it's working
A‑dec ICX Renew works as a two-part liquid shock treatment that penetrates and removes odor-causing and foul-tasting microbial contamination. ICX Renew is non-corrosive and gentle on equipment, formulated without added odor, and provides a convenient blue visual confirmation during circulation.
How to shock dental unit waterlines with ICX Renew
1. Prepare the system
Turn off the delivery system, remove and empty the water bottle, and remove syringe tips, handpieces, motors, and ultrasonic instruments.
2. Mix the solution
Add the contents of both ICX Renew bottles (solutions 1 & 2) and swirl to coat all surfaces. Re-attach the water bottle and turn the delivery system on.
3. Circulate through lines
Run the solution through the dental unit waterlines until blue water appears through all outlets. Let the product sit in the DUWL for 12–96 hours.
4. Flush and resume maintenance
After completing the shock treatment, turn on the delivery system and flush the lines with water. Rinse the water bottle thoroughly, refill it with fresh water, and resume your daily ICX waterline maintenance protocol.
5. Follow recommended flushing procedures
Waterline maintenance depends on consistent flushing practices. Flushing helps refresh water lines with new ICX tablet chemistry.
- Flush for 2 minutes at the start of each clinical day
- Flush for 20–30 seconds between patients
Hands-free flushing
The A‑dec Flush Dock is a hands-free solution for flushing waterlines. With specified slots to hold handpieces and A‑dec syringes, you can flush, purge, and consistently follow recommended waterline protocol while leaving your hands free for other important tasks (when used with timed flush feature on Pro products).
Integrated delivery system flushing
Most A‑dec delivery systems include timed flush features to support flushing procedures. Depending on the system, flush timers can start the flushing process and run for the selected amount of time.
6. Establish a written protocol and train your team
Effective waterline management depends on consistency and good record-keeping.
- Maintain a written dental unit waterline protocol
- Assign clear responsibilities
- Keep logs of treatment changes, shock procedures, and test results
- Train all clinical staff on dosing and flushing procedures
Get waterline maintenance solutions from A-dec
When used in conjunction with regular testing and adherence to protocols, A‑dec ICX and ICX Renew support dental unit waterline maintenance.
- Maintain — ICX continuous treatment tablets.
- Monitor — Call your A‑dec dealer for information about in-office water monitoring test kits or water quality testing services.
- Shock — ICX Renew for shock treatment.
- Flush — Flush Dock and A‑dec delivery system features.
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