AIR WATER SYRINGE

The air water syringe is one of the only dental devices that are used on every patient for every procedure.

The two basic functions for this device is irrigating and drying. Seems like a harmless device, right? Wrong. The air water syringe has a design flaw that has not been addressed for over 40 years. The simplicity of this device has left many dentists, orthodontists, and hygienists to underestimate the cross-contamination risks. These risks are found in many of the current air water syringe designs. In the USA there are two versions of the air water syringe. These two air water syringes have stayed the same for over 40 years. 40 years is a long time for an air water syringe to still be relevant with no enhanced features. Times change, technology improves, and science institutes new ideas on how to make things safer. Yet with all the technological advances and scientific improvements, we have yet to see a change in a device that is used for all dental procedures.

What Is The One Device That Is Used On Every Patient, For Every Procedure, But Never Sterilized?

THE AIR WATER SYRINGE!

That’s right. This simple device is never sterilized. Once an air water syringe is attached to the chair delivery system, it is never removed. 10, 15, 20 years of patients this device was used on, but never removed and never put through a sterilizer.

What does this mean? This means that thousands of patients have been treated with an air water syringe that was never sterilized. How can this be? Most dental devices attached to the chair system can be removed to sterilize, but not the air water syringe. It’s shocking to think after 40 years of scientific and technological breakthroughs that this still could be the case. But it is. And this fact should raise a lot of concern to you and your family. Dentistry has come a long way in developing safer devices, yet archaic air water syringes are still being overlooked.

When will dentistry wise up and see the inherent flaws that are associated with the air water syringe?

If You Go To Your Dentist, Orthodontis, Or Hygienist And See Any Of The Following Air Water Syringes…

RUN OUT OF THE OFFICE! DO NOT WALK.

Each of the air water syringes shown below should strike fear into you and your family. If you see these devices in a dentist or orthodontist office, you will know that it has never been removed to go through a sterilization process.

Do You Know How Hygienists Currently Clean Their Air Water Syringe?

DISINFECTING WIPES

The majority of dental offices clean their air water syringe with a simple disinfecting wipe.

After blood, tissue, and contaminated aerosol sprays onto the air water syringe from one patients’ treatment, a hygienist simply wipes down the syringe with a disinfecting wipe. After the quick wipe down, the next patient is then brought in and the next treatment begins. The problem with this procedure is that there are cavities in the air water syringe that cannot be cleaned by a simple wipe down. The aerosolized spray back also gets into the internal parts of the air water syringe. These parts are not removed to inspect let alone wiped down. Yet this has become the standard cleaning protocol for an air water syringe.

Would you feel safe knowing that this device was not properly cleaned for 10 years worth of patients? How would you feel if a high-risk patient was seen right before you? Would you still accept your treatment?

A dentist, orthodontist and hygienist simply do not have the time to properly go through and clean the air water syringe between patients.

BARRIER
SLEEVES

The other protective measure that is most commonly used for an air water syringe are barrier sleeves. These sleeves are put over the syringe as a protective barrier from the splash back and contaminated aerosol.

A dentist, orthodontist, and hygienist feel that this is safe and that air water syringes do not get contaminated when implementing barrier sleeves. The reality is that an air water syringe still gets contaminated. There is no way to remove the barrier sleeve without contaminating the air water syringe. Because barrier sleeves go below the air water syringe holder, you would have to hold the syringe with one hand (that is wearing a dirty glove) to remove the sleeve. You can test this process yourself and see there is no way to not contaminate the air water syringe. The amount of times you would need to change gloves to ensure the air water syringe is not contaminated is something that a dentist, orthodontist, or hygienist would not do. Barrier sleeves also have a slit for inserting air water syringe tips into the air water syringe, which leaves an opening for splashing debris (blood, saliva, and tissue) to get inside the barrier sleeve.

As you can see, barrier sleeves are a false sense of safety. But a dentist, orthodontist, and hygienist feel this is safe dentistry?

TIME CONSTRAINTS

The overall lack of proper sterilization protocols for an item that is used on every patient is a scary truth.

Manufacturers have manuals on how to clean an air water syringe, but due to the intricate steps needed, most offices do a simple wipe and call it a day. The time in which it would take a dentist, orthodontist, or hygienist to complete the steps given by manufacturers is also not possible. The time constraints with seeing the next patient do not allow the necessary cleaning steps to be completed. If you cannot remove an air water syringe and you cannot follow the manufacturer’s cleaning methods, you begin to see where the issues lie.

DID YOU KNOW?
Every handpiece that is attached to the dental chair can be removed to put through a sterilizer except for an air water syringe.

LACK OF TRANSPARENCY

Now lets go back a step. Some air water syringes have been designed to include a safety feature to remove the head of the air water syringe or the outer sleeve to be sterilized. The problem is, a dentist, orthodontist, and hygienist are not aware their device has this safety feature.

What good is a safety feature if the companies who make and sell the product do not teach or inform a dentist, orthodontist, or hygienist how to use it? On top of that, the items needed in order to make the safety feature viable are considered optional. This is when it becomes apparent why offices, even if they know their air water syringe has this safety feature, still do not do it. It costs money! In order to maintain a safe air water syringe, offices must have a minimum of ten replacement sleeves or heads to swap out between patients per surgery. The manufacturer is the person who in turn creates the issue by labeling items as optional with the distributor, who in turn makes the dentist, orthodontist, and hygienist feel these optional parts are unneeded in daily functions.

It’s an industry problem that needs to be fixed immediately. If a part makes an air water syringe safer, it should be standard, not optional.

OPTIONAL EQUIPMENT?

Lets give an example of how this sounds. You and your family go to a car dealership to buy a car. You find the car you like but it is a little too expensive. So to save money you ask the dealership to remove the airbags and seatbelts. This is optional equipment right?

Not if your life depended on it. Manufacturers have portrayed their safety add-ons as optional. What manufacturers should do is teach a dentist, orthodontist, and hygienist about the increased safety these parts can add to an air water syringe. A dentist, orthodontist, and hygieniest should also be informed on how it will help reduce risks and add more protection for their patients as well as their staff. But the disconnects created by manufacturers, dental distributors, and dental offices create a lack of understanding that is needed to safely sterilize an air water syringe. When items are deemed optional, offices in turn conceptualize these items as unneeded perks.

When it comes to the safety of you or your family, safety should not be optional, it should be standard.

WORKING WITH A BUDGET

Money in the majority of dental offices is very tight and a dentist, orthodontist and hygienist are trained to watch what they spend.

Due to restricted budgets, offices purchase only the necessities needed to perform their daily tasks and duties. Spending money on optional equipment that is not deemed to be a necessity is very rare. You would be surprised at what certain dental offices do to cut costs. There have been cases where a dentist, orthodontist, and hygienist reused latex gloves, reused disposable air water syringe tips, matrix bands, saliva ejectors, and many other items trying to cut their spending costs. These “shortcuts” create risky dental procedures that could end up harming patients. This risky behavior is caused by a dentist, orthodontist, and hygienist trying to work within a tight budget.

When offices are trying to cut costs, what other safety items are deemed unnecessary?

CURRENT AIR WATER SYRINGE SYSTEMS ARE FLAWED

Why Can’t a Dentist Just Remove Their Current Air Water Syringe?

If a dental office were using one of the air water syringes that are shown in the beginning of this page, they would need to do the following steps after each patient’s treatment.

Turn off the dental chair power (located on the chair or main power box) depending on office setup.
Unscrew the head of the air water syringe.
Slide handle down from the head of the air water syringe.
Use dental scissors to cut the air and water tubes from the head of the air water syringe.
Use pliers to remove the plastic tubing stuck on the air and water barbs.
Set aside the contaminated air water syringe.
Have a sterilized air water syringe ready to install.
Unscrew the head of the air water syringe.
Insert the air and water tubes into the air water syringe handle.
Connect the air and water tubes into the correct air and water barbs.
Screw the air water syringe head into the air water syringe handle.
Screw the air water syringe head into the air water syringe handle.
Test to make sure air water syringe works properly.
Begin next treatment.

Do you think this 14-step process is practical in a busy dental office?

The answer is no. A standard dental office is very busy. After one patient is treated the next patient is seen. The amount of time needed to implement this process would cost the office valuable treatment time and money, while limiting the number of patients they could see in a day.

Do you think a dentist, orthodontist, or hygienist have enough replacement air water syringes to accommodate sterilizing their air water syringe between patients?

The answer is no. A standard air water syringe costs anywhere from $250 to $2500. Each surgery would need at least 10 spare air water syringes to make the sterilization process feasible. In reality, the majority of dental offices have zero spare air water syringes. With no spare air water syringes, there is no way an office can complete a sterilization process. Unless they wait hours between each patient, which is not practical, there is no way an office can claim their current air water syringe is clean.

PUBLIC AWARENESS

We at Dentistry’s Dirty Secret are warning the public of this problem in order to raise awareness that the air water syringe contains grossly unreported risks.

These risks are not explained to patients, which breaks informed consent. There is no way as a patient you would know about these inherent risks and a dentist, orthodontist, and hygienist are not divulging this information as most of them are unaware as well. We are simply bridging the gap of information needed for you to become educated with the unknown risks when visiting a dental office.

The air water syringe is only half the problem. Metal air water syringe tips, which are inserted into the air water syringe, have many infection controls issues as well.