An interesting email dropped into my inbox yesterday showcasing the latest in DUWL treatment….another re-packaged, weekly product with tall claims but no mention of clinical back up.
Normally, as these things come and go, they get ignored, but I thought it might be worth breaking down some of the marketing fluff and discussing some of the claims especially as our market leading product Alpron is often used as a comparison!
So what are they claiming?
Broadly speaking , all weekly products claim to work to some degree for a week…. they claim to be “effective” against bacteria/fungi, to remove biofilm and are in some cases “ready to use” and “as mild as water”. They also often make claims to be much much cheaper then the market leading product – so let’s take a look and see if we can verify what they are saying!
Claim 1 – Weekly application
Weekly products work by using chemicals once a week, to “kill” the bacteria within the dental unit waterlines. This is often done after hours when patients have left requiring staff to stay and complete the procedure. The chemicals used can include Quaternary-ammonia compounds which is a generic, multi-use disinfectant, normally used as a surface disinfectant…
So a weekly flush is done with a large amount of the ready to use chemical (200ml or enough to fully flood the entire internal tubing) in an attempt to remove the bacteria. This is then removed from the chair and flushed with a large amount of water to make it safe for use with the next patient. This process can take 30 minutes to over an hour to complete depending on the weekly product chosen.
Great! It’s Monday and your ready to see a patient, with the knowledge that your dental unit is now “clean”, but for how long? If you do a purge on day one, by day 3/4/5 is your chair still clean? Given that biofilms reform within 72 hours, are your patients booked in for Thursday as safe as those you’re seeing today?
Suppliers will of course be able to supply you with independently conducted clinical and infield research that verifies the claims of efficacy for an entire week. This will have been published in a well trusted journal to give you the peace of mind that the product works in a lab and in the real world. Or will they? Having tried to view the clinical research of many weekly products, its something that appears to be absent in many cases – check yourself – google the product name and “clinical research” – should be easy to find, they wouldn’t want to make it difficult for you to verify their claims would they? I am sure if you cannot find it published online – the supplier will be happy to email you over a copy of it to read for yourself.
Claim 2 – Effective against bacteria/ fungi?
Fantastic! This is what we want it to be effective against! But hang on, which bacteria? How effective, and for how long? Which tests have been done to provide the evidence to make this claim? The bacteria load in a DUWL is complex and multi-specied, with some nasties floating about in the water and some protected within the slimly layer of biofilm adhered to the plastic tubing. So does your product deal with the floating bacteria, the biofilm or both? More importantly does your DUWL product have any proven efficacy against legionella bacteria – a very high risk bacteria in our industry?
Again, the detailed and easily available clinical research will be able to clearly demonstrate this – just ask them to provide it! 🙂
Claim 3 – Remove Biofilm
As above, the biofilm is a complex habitat, constructed in order to provide bacteria including legionella with a protected environment. In order to remove this, a different approach is required from that used to remove the bacteria just floating in the water (planktonic). The two environments are constructed differently, have different qualities and therefore require different treatments! One size fits all, is not the case and should not be relied upon. Given that 98% of bacteria within a dental unit exists within the biofilm, the weekly products could be effective against the planktonic bacteria but this only accounts for 2% of the total – not exactly 99.9999% effective?
That being said, I’m sure the suppliers of these DUWL products will be able to demonstrate with clinical research that the product is effective against both bacteria risks and this will be backed up with independantly peer reviewed work. They will also be able to show you the product meets the newly published ISO standard – ISO 16954:2015 “type test methods for evaluating the effectiveness of treatment methods intended to prevent or inhibit the formation of biofilm or to remove biofilm present in dental unit procedural water delivery systems under laboratory conditions” or will they?
Claim 4 – They are much much cheaper
Lets finish this with a little bit of maths:
|Weekly DUWL Biocide||£25.00 a Bottle *as per email||200ml Approx||5 Weeks||£5.00|
|Alpron DUWL Disinfectant||£45.37 RRP||50ml per 5 Ltrs||3 Months||£2.26|
So on the face of it – yes one bottle is around “50% cheaper” (or 45% to be exact)…however
One bottle of Alpron provides 100 doses, thats a weekly cost of £2.26 and 3 MONTHS supply of a proven, effective and high quality product.
One bottle of weekly cleaner provides 5 doses (200ml), thats a weekly cost of £5.00 and 5 WEEKS supply….
Now, I’m not a highly qualified mathematician, but I can see that the maths don’t add up.
50% cheaper? or 100% more expensive and 100% less compliant?
Do the maths and verify the claims!
Originally posted 2016-02-29 16:45:22. Republished by Blog Post Promoter