The Storm Is Coming Because Of Your Water: Waterline Safety, Current Lawsuits & New Technology

Welcome to the Dr. Phil Klein Dental Podcast. I'm Dr. Phil Klein. Today we'll be discussing dental waterline safety. Dental unit waterlines are the ideal place for dangerous biofilm growth. We all know that. If this growth continues to go untreated, it will make patients sick and leave your office liable. So the question is, is your office vulnerable to this risk? Our guests are Dr. Robert Martino and Owen Boyd. Dr. Martino owns and operates a seven-office group practice in West Virginia. He is well-versed in disinfection technologies and the health risks associated with biofilms in the dental practice, not only from dealing with these issues in his own practices, but also as the CEO and co-founder of OraCare. Owen Boyd is Chief Technology Officer for Toppin Dental. He is considered an expert on mercury, arsenic, and disinfection technologies and their uses and holds patents on remedial technologies. He studies, speaks, and writes about water and healthcare -related topics. So it's a pleasure to have both of you on the show. Hey, thank you, Phil, for having us. Phil, pleasure to be here. Yeah, we're happy to have you. Before we get started, I'd like the audience to know that Dr. Martino and Owen have a CE webinar, The Storm is Coming, and it's because of your water. waterline safety, current lawsuits, and new technology. So I hope you all tune into that. As always, there's no charge for these webinars on Viva Learning. It’s up as a searchable archive. So we welcome you to that. So let's begin with you, Dr. Martino. How did you get involved with water treatment? Well, I have seven dental offices. And anytime you have it, you look for things that... can affect your whole office and or your whole organization and and i you know just was doing some research and heard about all these patients that were getting sick from dental line water and i had you know never heard of that you know i'm like you know i've you know been practicing for 20 some years and you know we always thought you know well we have to the bottled water we use uh you know distilled water and we think okay well we're we're safe and and that's just not true and you know and and i think owen can go in and tell you why that's not true but as as again as a dentist we don't know a lot about dental water so i you know i started doing research and of course the first thing i did as i talked to you know my dental rep and and and she's she's like yeah you should be using this this this stuff and and and basically it was like put chemicals in our water and i'm like doesn't water have chemicals in it already you know and so i i tried that for a couple years and you know my water would i was testing it and it wouldn't pass and and and it was costing me a lot of money i have 70 some operatories and So it was costing me upwards of $15,000, $18,000 a year. So I was doing some research and I found this company, Toppin, and they have a completely different technology where they don't use chemicals. They use what's called nanofiltration, really small. And again, Owen can talk to you a little bit about that. But the great thing for me is, you know, it kept my water clean because it didn't let bacteria and viruses in the line. and it saved me over $10,000 a year. Yeah, the fact that you have seven offices, so from the standpoint of patient safety, there's no question you wanted to optimize your system, but financially, based on the bills you were getting with the current systems you were using, you were looking for something better, especially more cost-effective, I should say. Let me address Owen for a second. And again, Owen, I introduced as chief technology officer, and I don't mean that in the standpoint he's running websites. He's actually someone who really understands the technology of water, probably as well or better than anybody in the country. In fact, many years ago, he talked to me offline and he was working on artificial intelligence. So we have to assume that Owen is quite a bright guy and he could tell us about the dangers of biofilm. We all know biofilm builds up in these water lines. We've seen pictures of it. So Owen, how does it get there in the first place? Well, biofilm is just a process of bacteria sticking to... water lines, plumbing, copper piping, where it will divide and multiply. It likes to multiply. It's what bacteria has been doing since the planet was born. Biofilm essentially is bacteria's method of protecting its children and then expanding its presence in your water. So it has what are called stages of adhesion to water lines. So you go into, you know, what's an initial attachment, you know, because a bacteria has an outer wall that's kind of sticky. It'll stick to the surface of a wall. And in ideal conditions, which unfortunately dental, you know, water lines provide to bacteria, it'll start to divide and multiply. And then it creates a, it's a polymeric shield, an exopolymeric shield that sits over the bacteria to protect it from chemicals. I mean, it's quite clever. This is why bacteria still remains a problem in water lines globally. I mean, it's why you get boil orders constantly. Right. So even with the motion of the water, the movement of the water through these lines and chemicals that are being applied into these lines by dentists all over the world, you're saying that this protective shield can protect the dangers of this bacteria. And what are the dangers to the actual patient? Well, you know, to a human being, you're loaded with gram-negative and gram-positive bacteria that have to remain in balance constantly. And when, you know, when that sort of microbiome, this is, you know, you have an oral biome and a gut biome. Those things, we've learned how important they are to overall human health. If bacteria gets into wounds or gets inside the oral cavity. It starts to do what it does in piping. It's going to start dividing and multiplying, creating biofilms, putting your body out of balance, causing all kinds of diseases and illnesses. Yeah, that sounds like you want to avoid that. Dr. Martino, as a dentist, what is your biggest concern about the dangers in the offices that you own as far as the water? My patients would get sick from something that I do. You know, hey. These patients are our friends, our families. I want to make sure I provide them something that's safe. Isn't that what we're supposed to be doing? And so it really scares me. And, you know, and then, you know, you worry about lawsuits. You know, I know in California, there's a big lawsuit. 200 kids got sick and there's one in Georgia, you know, and you just, you know, you worry about that. But I think the bottom line is. You want to make sure that what you're doing to a patient is helping them and not hurting them. And I think that's what I fear. So what did you do to assure yourself that you're in a safe zone right now? So, you know, the great thing is I didn't know what to do. But Toppin, they have a water program. So they assign me a water expert. They have a program. They send me free shock. offices and shock the lines and and then you know that happens every they keep me up to date because you know listen there's a lot of things going on in office my number one thing isn't water uh but it is for them and so they kind of hold our hand along the way and and i think so it you know and then we test our water and and i feel i feel a lot safer now yeah so owen tell us about the current methods that dentists are using the office where they're you know, they feel confident that they're doing something correctly to make sure the water that's going through those lines are clean and safe to the patient. And what does Top and Dental do that's different? Well, the main difference is, you know, dentists are trying to accomplish what water treatment plants do to treat water. And that's to add a chemical, whether it's chlorine, you know, silver, you know, iodine, you can add all kinds of things to water. Because those chemicals, they're typically oxidants that will kill bacteria and kill virus. The only issue that causes failure is before you add a chemical to any water source, if you don't know the other things that are in the water, the chemical can do two things. One, not be concentrated enough to kill the bacteria because it's reacted with other organisms in the water like tannins, tannic acid. Iron, copper, lead, zinc, you know, creates oxide forms of those. So now there's nothing left over to kill the bacteria. That's a serious issue because bacteria like Legionella, which has a very high expansion rate, a single colony forming unit untreated left for a day can grow from one colony forming unit to over 100 million colony forming units in a single day. So the other thing you get is unwanted. reactions, you know, so you can create things like disinfection byproducts, chlorinated dioxins, furans, and these are all carcinogens. So you really should know what you're doing and have a very good chemical knowledge of the input water, how much to dose so you get the effect that you want, whether you need further treatment before you move on. What does your company offer to the dentist if they were to get involved with? Top and Dental. I know Dr. Martino mentioned he's got a lot on his mind, and as much as he wants the water safe, that's not his priority with his everyday routine. So he relies on your company to handle that. So what would our audience be interested in learning about Top and Dental that could help them achieve consistently clean water and safe water for their patients? Well, the first thing is, you know, we don't add chemicals. You know, we filter the bacteria and virus out. I'm not going to explain the technology because it's a little complicated, but we do it in a very cost-effective, inexpensive way. And then we maintain contact with the dental offices to ensure that the systems are performing. We also, by not adding chemicals, I don't have to worry about all these disinfection byproducts. I don't have to worry about my dose rate. I mean, I can literally remove bacteria out of rivers and streams with this same technology that I'm treating municipal water. So it's very effective. We are also taking the food groups out. One of the things that you get with chemical treatment is you kill a bacterial cell. The inside of the cell disperses in the water because you typically tear apart the outside wall. Those are nutrients. So other bacteria eat those up and grow and form biofilms. So what you want to do is filter out the bacteria, the virus, and the food groups. Don't tear the bacterial walls apart. Where does this filter go in the system? Well, sort of the good news is depending on what your dental office looks like, we have systems that can go into a chair-side water bottle. It can go in just a standard single water line going to a single chair, although we really filter the whole office. because it makes sense to have all your water clean, not just a single chair or a dental unit water line. Get everything clean. Is that how it operates on your side, Dr. Martino? Yes, and that's what saved me time and money. It's where the water comes in, that's where the filtration starts. So all my water coming into my office is now bacteria and virus-free. How long have you been using this system, Dr. Martino? I've been using it for about eight months now. Before, I wasn't shocking enough. uh i wasn't and again that's what i'm i'm talking about with popping is they they send me the shock they say hey now's the time to shock so so before i would never know and and and so they shock and then we test the water and you know if anything happens i got i got an expert on the line and and but i think the great thing is you know we now we now protect the whole office instead of just the you know just in the water bottles and one thing that i think a lot of people get excited about we don't have to use distilled water anymore you don't have to use distilled water anymore in your office oh and but he's still shocking it so you're still using chemicals okay so the uh the shocking um you know is a treat and then rinse rinse the uh the solution out of the lines Although we use a chemical, we use a chemical, it's actually the same chemical that your body produces to kill pathogens. So the idea that being safe for your body makes it pretty safe in a dental unit waterline. The dental unit waterline is about the most ideal environment for bacterial growth. Even though you filter, you can take 10 billion cells, colony forming units, out of the water. If one slips by and there's food in the water, sufficient for it enough to grow, it will grow. So this is just preventative. It's also, Phil, it's following the guidelines that the ADA, the CDC, the FDA is kind of telling us, you know, hey, you should shop every quarter. Right. Again, Owen explained to me one time, he said, listen, if we started from your water lines, we just built your office, you probably wouldn't have to shop. But he said, you know, There's always stuff in your lines. He said, there's also this thing about suck back, you know, like you might have some suck back, like if it's in the patient's mouth. He said, that's what you're shocking for. And like he explained to me, the chemical that you use is really, really safe, but does a really good job of killing the bacteria. Yeah, this has been very helpful, guys. We really appreciate your input. I guess if our audience wants more information, they can look up Toppen Dental, T-O-P-P-E-N. dental. You can Google that and do some research and find out more information from the company itself. And thank you again to you both, for your insights. Thank you, Phil.