An Interview With Scott Snyder of Solmetex

Inside Dentistry (ID): Why is managing dental water quality and safety a more important issue now than ever?

Scott Snyder (SS): The public is increasingly aware of this issue, and simultaneously, it is becoming increasingly challenging for dental practices. Dental staff members say they want clean, safe, well-maintained water—not just for regulatory purposes but for patient and practitioner safety and well-being. People are realizing that water is the most used instrument in the practice, and that it is getting harder to manage due to quality issues and other factors. The average dental office uses 57,000 gallons of water per year. The quality of municipal water is decreasing; the water we consumed decades ago was vastly better than the water today in many places. We have all seen what infrastructure problems can lead to in certain places where there have been horrible issues of water quality and pollution. Also, in general, as water supplies are depleted, we are dealing with the bottom of the barrel from aquifers, so managing water quality and safety is harder, and that does not make dental professionals’ job any easier.

ID: How many offices are struggling with this, and how many even know how much they’re struggling with it?

SS: One thing that really gets everyone’s attention is dental unit waterline testing. Obviously, it is required and there are guidelines. In tens of thousands of dental offices every day, the microbial load in a dental unit fails to meet the minimum drinking water standard of 500 CFUs. It happens on approximately one in three tests across all dental offices. You cannot always be sure why. You can test it again. You may still face problems even after shocking the lines, which is standard protocol. It could be water chemistry. It could be biofilm that was never removed from a previous cleaning. Some products require more steps than others, and a step might get missed or a mistake may be made by a new team member due to staff turnover. Bacteria doubles every 4 to 20 minutes, so your dental unit can be beyond the drinking water standard in a matter of hours if pathogens are in there and multiplying. You are constantly fighting nature inside these plastic tubes that protect the system that puts water in your patients’ mouths and aerosols in the practitioner’s face. One in three tests failing highlights a fundamental challenge. We at Solmetex feel that practices deserve whatever we can do to help their teams be more efficient and successful in addressing this challenge.

ID: What are you seeing in terms of increased local and state regulation of dental office water safety?

SS: Guidelines for dental unit waterline safety suggest quarterly testing and certain steps to be taken if for any reason you fail a test due to bacterial load. Washington state requires quarterly testing by law, along with documentation, and several other states have similar legislation pending. The states that are typically out front in terms of safety and environmental legislation are the ones coming first, but more likely will follow. Solmetex is keeping a close eye at the state level and working with associations to ensure awareness and knowledge of what will be required.

ID: What impact will the first-ever ADA Water Safety Guidelines next year have?

SS: The ADA Standards Committee is reviewing both dental unit waterline safety as well as amalgam capture and recycling—the issue of neurotoxic-heavy metals, such as mercury, going into the waterway from amalgam fillings. They formed subcommittees, and Solmetex representatives have participated in their meetings. OSAP’s guidelines for dental unit waterline safety are being reviewed, and I anticipate that those best practices will be strongly considered by the committee.

ID: How is Solmetex uniquely positioned to help practices overcome these challenges?

SS: Solmetex now has multiple companies rolled up into one. We are unique in dentistry in that we cover all the needs of treating water and ensuring safe water in, through, and out of the dental practice. That is our sole focus. The reason we are doing this is that dental water is a connected system; each part can affect the next as water flows through the practice. And a connected system benefits from a connected solution. We are about safe, quality water in, through, and out. This end-to-end solution that we have includes arguably the best products for each step in the chain. For dental unit waterline safety, we are particularly proud of the Sterisil line because it really does make the process easier for the practice and better for the system because it is not oxidizing; oxidizers cause corrosion and can wreak havoc on metal parts such as high-speed handpieces. Products such as iodone, bleach, and peroxide that practices are using to treat their dental unit waterlines to kill the bacteria are actually causing problems downstream. You may not see it immediately, and those are the problems that are hardest to identify. We have endeavored to piece together the products that are most beneficial and least harmful. In terms of treating dental unit water in a way that is less laborious and more likely to be compliant, we are really pleased to have the silver ion technology. I would argue that, if iodine came on the market today, nobody would buy it. Yet, it is used frequently because it is what people know. Silver is 20 times more effective and provides a much greater margin of safety so that one in three tests will not fail because you have more margin for error when the bugs accumulate. It takes 258 steps every year to maintain one chair of one dental unit waterline when you use an iodine straw, which, per its IFU, requires more daily maintenance. Sterisil’s technology requires just one step per year. It is a 365-day silver straw. Dental practices are telling us they are glad they found out about it, and that it is one of those processes that can be taken for granted; you just keep doing what you have been doing. We are pleased that we are able to help make this a whole lot easier, simpler, and more effective.

ID: What else makes Sterisil such a helpful product?

SS: You set it and forget it. Obviously, you need to test. But the simplicity makes a real difference. If you miss a step with one of the other products, contamination can enter. Many people use distilled water and have a false sense of security that it will be safer, and they might not be as vigilant; the minute you open that bottle, you are introducing bugs, and you could be over 500 CFUs within hours. In terms of efficacy, iodine starts depleting the minute you put it into the bottle. Over the course of the year, the efficacy drops dangerously close to the bacterial count limit; let’s hope nothing else goes wrong that day to push you over the limit. With staff turnover and impending regulatory changes, you do not want to risk being on the edge of disaster and you do not want to have to be doing all these steps. Sterisil exists because they figured out how to make silver—which is commonly used in a lot of water systems in industry—work for dentistry. It needs a certain level of stability, and it needs to be delivered consistently over time. It maintains approximately 10-CFU protection—one-fiftieth of the standard people will be held to—throughout the year. That is why I believe people would not use iodine if it were introduced today. Old habits die hard. We could create campaigns and public awareness and everything, but in the end, it is about dentistry choosing to make the smart choice for patients and practices. They will get there. It matters.

ID: In what other ways to Solmetex’s products and solutions help practices deal with challenges involving source water quality, increasing regulation, and staffing shortages?

SS: If you ask us what we do, the answer is not necessarily just, “We provide products that help you keep your water safe and well maintained.” We are about trying to make your job easier. We know there are a lot of moving parts. We want to help you manage the connected dental water system in your practice in the simplest, most efficient way possible. In the end, it is about making your lives easier in dealing with the most used instrument in the practice and the one that is very easy to take for granted. When something goes wrong, the practice is shut down if you cannot run water through a chair. If someone gets sick, you have a problem. We are here to make the maintenance process, from end to end, simpler and easier. Beyond products that are simpler and easier, we are really about customer support. There are a lot of products in dentistry, and a lot of them are “me-too,” lower-priced alternatives, which is fine for certain things. However, when something breaks and you have a question, or when there is an inspector at your door, we are all set up for that. Solmetex was built on a service model for ensuring that you had a compliant amalgam separation system in place and that you could document it. So, we do that across the board.

ID: How does the end-to-end nature of Solmetex’s solution improve the offering?

SS: When something is not working within the system and you are not sure what part of the system it is, there is no finger pointing. You want to get your practice back up and running, so it helps to deal with one company. We choose the high road on quality, with no exception. We are the high-touch, high-support, high-quality manufacturer, and what I am proud of is, when you boil it all down, we usually cost the same or less, and rarely much more, than “bargain” products.