George Green, DDS, Drinkable Air Technologies

1 You are a practicing dentist and a trained microbiologist. When did you first become aware of a problem with dental operatory waterline contamination?

I believe it was in dental school, when the students first entered the dental clinic. We were introduced to the proper protocol for the morning startup when entering the dental operatory. In those days, the water in the cuspidor was to be turned on and run continuously for a few minutes. The doctors’ and assistants’ air/water syringes were to be flushed (usually into the same cuspidor) for at least one minute. A solution of bleach was to be suctioned from a gallon jug through the HVE line and the saliva ejector line.

We were told that due to the fact that bacteria from trace contaminants in tap water were particularly well suited to inhabiting and multiplying in the small hoses utilized in the dental operatory, these morning exercises would reduce the amount of bacteria the patient would be exposed to. It would not eliminate the problem, but after the exercises were completed, the operatory would be ready to treat an immune, healthy individual.

Any patient who was considered to be less than immune healthy was to be considered for antibiotic prophylaxis before treatment. We were also advised that the bacterial contamination problem was due to the design of the
dental operatory, where continuous constriction along the waterline route gave bacteria an excellent niche for infestation of the line. Any attempt to correct this problem would require a redesign of the equipment by the manufacturer. In other words, the problem was outside the reach of the practicing dentist.

2 What has been done to reduce contamination in recent years?

Since the source of the problem was considered to be the tap water, during the last 20 years, we have seen a redesign for the dental operatory where the water used during dental procedures is drawn from a reservoir. This reservoir is usually a heavy-gauge plastic bottle of 1- or 2-L volume and charged with compressed air used to drive the dental drills. The compressed air drives the water out of the system. The reservoir bottle is filled
with distilled or spring water, usually bottled.

3 Has this solved the problem since tap water is no longer involved in supplying the operatory?

No. The problem is not from the water source alone. You see, complete sterility is an absolute—difficult to achieve and harder to maintain. The source of the problem, the continual reduction in size of the waterlines, is the real problem, and caution must be taken or the bacteria once inhabiting a waterline can multiply regardless if the water source is.

George Green, DDS, has practiced general dentistry in Coral Springs, Fla, for the past 28 years, providing services in orthodontics, endodontics, oral surgery, and implantology as well as general and cosmetic dentistry.

He has a degree in microbiology from the University of Miami and is a graduate of the Georgetown University dental school. The spokesperson for Drinkable Air Technologies, based in Lauderdale Lakes, Fla, he can be contacted via e-mail at

tap, spring, well, or distilled water. Any water kept stagnant is subject to this property. The chlorine in our drinking water at 4 ppm allows trace bacterial contamination ready for colonization.

4 Why has this subject surged to the forefront of dentistry recently?

In February 2012, the journal Lancet reported on a case of fatal Legionnaires Pneumonia acquired by an 82-year-old woman from a contaminated dental waterline. The infection was transmitted during a dental procedure. Despite hospitalization and treatment, she succumbed within 2 days. The CDC, the ADA, and the EPA as well as other regulatory and advisory agencies are now urging more attention be paid to this problem and regular water monitoring.

5 What is the Chameleon 8 machine?
The Chameleon 8 is an atmospheric water generator manufactured by Drinkable Air Technologies that draws water vapor out of the ambient air and condenses the water in a tank, to be

held and refrigerated for drinking or other consumptive purposes. Since it is derived from water vapor, it yields the purest water available. 6How is this water source different from other available water sources?
The secret lies in the process by which the Chameleon 8 keeps the water sterile. The water within the tank undergoes a patented ozonation process where ozone gas is aerated through the water at a level that is 100% bactericidal, fungicidal, and viracidal. The ozone level is then stepped down before the water is dispensed to a
level that has no odor or taste. The antimicrobial property of the water is maintained for 22 minutes after being dispensed.

7 How is this machine used in dentistry to improve patient safety?

The water is dispensed from the Chameleon 8 directly into a dental reservoir bottle, which is then hooked to its respective station, and a water flush through the air/water syringe and high-speed handpieces is run for 60 seconds. This should sterilize anything but the oldest, most contaminated of hoses. After that, the water source is sterile and will remain sterile as long as the system remains sealed. Replenishment of the reservoir
water is repeated from water dispensed from the Chameleon 8.

8 Is it safe to be used with dental equipment?
Yes. The ozone has no effect on the dental equipment in its diffused form within water. And it has no effect we can find on polypropylene waterline hoses, handpieces, or dental operatory head units.

9 Are there any precautions to take with the machine or its use?

Since the machine acquires water vapor from the ambient air, the atmosphere around the machine should be humid and free of particulate matter. We keep one unit in the sterile area, where it acquires water vapor created by the steam sterilizer, and one in the waiting room where patients can see us using it. The patients waiting enjoy drinking its water as well.

10 What is the cost in electricity to produce a gallon of water?
Good question. That would depend on your utility company’s cost-per-kW hour, but generally it’s between 16 to 29 cents per gallon. That’s much cheaper than bottled water, which you now don’t have to store or move around.
To order the Chameleon 8 or to obtain more information, call (954) 536-6426 or visit the Web site