The factors that define the success of a product in any given marketplace are numerous and when we define success in these circumstances it normally relates to commercial achievement. But within science, success is measured in terms of the ability to reproduce the methods employed under controlled conditions in the laboratory, in commercial practice. Success is achieved when the results can be replicated under the variable conditions found in a practical environment.
The very nature of research and development requires the employment of strict processes that ultimately create a product that fulfils predefined conditions. Adhering to strict scientific protocols is important within the infection control industry and should be of value to dentists, who after all are themselves from a scientific background. So it follows that proving the value of a specific piece of research and having the products that are brought to market as a consequence, externally validated by third party organisations, lends weight to a company’s scientific credentials. This value is recognised by dental professionals who choose to use materials that have their efficacy founded in scientific fact as opposed to marketing hype.
In terms of infection control in particular, the need for new and more innovative products has been driven to a large extent by the publication of decontamination guidelines. Since the first issue of HTM 01-05 in 2009, there has been a significant growth in companies and products within the sector. But amidst the scramble to take advantage of the opportunity created by the guidance, it is vital that companies acknowledge their responsibility in providing the market with credible, effective products, designed and developed with the support of robust scientific documentation.
As a scientist, my belief in the viability of evidence-based products comes from the heritage established for over 80 years by Dentisan’s parent company Quadralene. This ethos is underpinned by the employment of a dedicated research and development team, which includes several research chemists. This team has had great success in developing new formulations and technologies that meet many of the market’s most demanding scenarios.
Ongoing research is an important part of the scientist’s remit and we are constantly exploring new data to support or dismiss a particular theory. Part of our work to improve the quality of water in dental unit water lines is now concerned with the results we have harvested from practices that have submitted water samples to our laboratory as part of the free water testing kit, which is supplied with the product.
The results have confirmed that despite what practices may like to think, many of them are continuing to operate with water that falls below the “best practice” limits demanded in HTM 01-05.
The testing we undertake is based on scientific methodology, which gives credibility to the results. We ask for samples of both input and output water to be submitted. The testing of input water is important as this enables us to assess whether contamination is present in the water used to fill the DUWL system or being caused by biofilm contamination in the water lines. In practice, it is almost impossible to prevent bacteria entering the water system at some point and it should be remembered that bacteria will be present in low numbers in the distilled or RO input water supply.
The methodology used to test the samples follows recognised scientific protocols. Testing is carried out under laboratory conditions and samples containing biocides are neutralized before testing to ensure that biocides are deactivated and do not interfere with the test results. When present, biocides continue to exert their action and be effective after a sample has been taken. Since the purpose of the sample is to enable the presence, or absence, of bacteria to be determined, allowing the biocide to continue its action after the sample has been taken may cause a false result and according to recognised protocols should be avoided..
Once the samples have been collected they are tested to determine the numbers of viable bacteria present. Of the samples we have analysed so far we have calculated the following results:
• 58.6% of input water samples passed and 41.4% failed
• 64.1% of output water samples passed and 35.9% failed
• 49.3% of samples passed (where both input and output water met the required standard)
This data reveals that despite national guidelines and a campaign of awareness, half of practices submitting samples are still failing to comply with the safe limits for water line contamination.
Our data revealed that practices are using a variety of methods and products to control the growth of biofilm and prevent the possibility of water line contamination. Some are using a two-stage product, which to be fully effective requires the use of a concentrated solution to purge the water line, followed by an infiltration of a dilute solution of a second biocide, which is fed constantly through the system.
PB note: Bleach was used as offline treatment not continuous. HTM 01-05 allows this.
I believe that scientific credibility is vital for a profession such as dentistry, and products which are backed by academic support, have such credibility. In 2009 Dentisan established a Knowledge Transfer Partnership with Nottingham University School of Biosciences in order to add integrity and evidence to our research and development of Bioclear. Having worked alongside the University for over 12 months we were presented with the Lord Stafford Award in 2010, in recognition of our role in this successful collaboration between academia and industry.
I believe such external validation should be the cornerstone of any manufacturing business as it provides evidence that the products reaching the market are designed and manufactured to strict tolerances, under controlled conditions, to meet a specific need.
The collation of data and statistical evidence to support the efficacy of products is particularly important in the arena of infection control, in which practices must document use of compliant products in order to satisfy the appropriate guidelines and regulations. In these areas it is incumbent on those responsible persons within the practice to select appropriate products that are fit for purpose and which can play a positive role in securing patient outcomes. To do so with confidence requires trust in the integrity of the brand, which is nurtured through evidence of the value of their research heritage and manufacturing strength.