Georgia Dental Pros, Let’s Talk About New Waterline Regulations Coming Your Way

Updated on: February 11th, 2025If you're a dental professional in Georgia, you've likely heard about the new regulations coming from the Georgia Board of Dentistry. In late 2024, the Board announced its Notice of Intent to Adopt Rule 150-8-.05, and on February 7th, 2025, with overwhelming support from the public, the Board unanimously passed the rule with no amendments or changes. Next, the rule is heading to the Governor of Georgia to be signed and published. We understand these changes might feel overwhelming or like they're adding more to your already full plate. But don't worry, we're here to walk you through these changes together, ensuring you're well-prepared for how they'll impact your practice. It’s important to highlight the reason the Georgia Board of Dentistry is implementing new regulations in the first place. Contaminated dental unit waterlines have been tied to some serious infections across the country, and in Georgia alone, there have been 47 confirmed cases of Mycobacterium abscessus outbreaks in 2015¹, 2022², and 2024³, many of which involved children. The Board is looking to better empower dental pros by defining how you can protect your patients from harmful bacteria in your waterlines.

Key Requirement 1: Waterline Testing

First things first, we're going to need to get cozy with the idea of regular waterline testing. Dental pros will now be required to prove that the water they use meets EPA standards of 500 CFU/ml or less, meaning all dental unit waterlines must be tested quarterly. We know, we know - it sounds like just another task that will need to get checked off your list but think about it this way: regular testing is like a check-up for our waterlines. Without it, there’s no way to verify that your waterline maintenance protocol is working, and it helps catch any potential issues before they become big problems. Georgia is outlining a few ways to accomplish this testing standard. The new regulations say you can pool your sample, which we can teach you to do because it saves your team time and money, or you can test individual lines. Georgia uniquely outlines that up to 10 lines can be tested in a single pooled sample, but must:

1. Be from the same operatory.
2. Use an equal amount of water from each line (i.e., a/w syringe, handpiece, scaler, etc.).
3. Include clear documentation of which lines were tested.

Let’s back up here for a minute- how do you even achieve a 500 or less CFU count in your waterlines? We’ve tested hundreds of thousands of waterlines, and we know that the most successful offices follow the 3-step proven protocol: shock, treat, and test. We also recommend completing the Dental Unit Water Quality portion of the CDC’s Infection Prevention Checklist.

Key Requirement 2: Proper Documentation  

Document, document, document. We want to underline, bold, star, and highlight in glittery paint that documentation is essential! Too often practices are doing the right stuff, but in the rare case of inspection, they don't have the necessary documentation to prove it. The Georgia Board of Dentistry is now effectively saying if it wasn’t documented, it didn’t happen. Dental pros must be sure to properly document their results and make them accessible for a minimum of 5 years. Remember, good documentation isn't just about compliance- it's about protecting yourself and your patients. Tracking your efforts and showing that you're doing everything you can to maintain safe water mitigates risk and helps keep everyone on your team aligned. Whether you’re using an in-office test, like QuickPass, or mail-in tests, like flow cytometry or R2A, you can log your results using a digital compliance platform, like ProEdge Clear™ , to capture and store your in-office results, monitor trends, and improve pass rates over time. You also can use an office binder to manually log your results.  

Key Requirement 3: Remediation

Finally, if you happen to fail a waterline test, Georgia regulations state that it’s your responsibility to immediately remediate and retest to ensure a passing result of 500 CFU/ml or less. "Remediate” is just a fancy word for taking action to fix the problem and reduce the number of harmful bacteria in your water to 500 CFUs or less, ensuring the water used in your office is as clean and safe as drinking water. Don’t feel intimidated, though! We understand that failures happen. In fact, did you know that 31% of treated waterlines fail⁴? If you experience a failed test, we recommend:

• Reaching out to our team! We’ll help walk you through the steps of remediation and troubleshooting if your waterlines fail so you don’t have to do all the research on your own.
• Shocking the failed operatory immediately. This involves using a strong antimicrobial solution (like diluted bleach or Liquid Ultra) to eliminate the biofilm in the dental unit waterlines. Be sure to follow the manufacturer's IFUs.
• Retesting the waterlines after shocking. This step is crucial to ensure that the shock treatment was effective in reducing bacterial counts to acceptable levels.
• If the retest fails again, contact our team. You might need support identifying the root cause, like a dead leg or issues with your source water. Regardless of the cause, we’ll help you get to the bottom of repeated failures!

Looking Ahead

If you’re new to waterline maintenance, these new regulations might seem daunting at first. Heck, if you’ve known about the importance of waterline maintenance for a long time, this all might still feel a little bit overwhelming. We don’t blame you, and we’re here to help. Remember, every time you test your waterlines, maintain your equipment, or update your records, you’re reaffirming your commitment to your patients' health and safety. This level of dedication is commendable! So, if you’re ready to take the first step in your safe water journey, know that you have a partner right by your side. Our team of Safe Water Specialists are ready to meet you wherever you are to help get you going.  Reach out to us here- we can’t wait to help you get started! For additional ways to drive success, check out the links below:

• Discover effective solutions to achieve safe water for your office with our live or on-demand Safe Water Webinar
• Visit our Learning Center for in-depth answers to all your waterline related questions
• Explore our state-by-state Waterline Compliance Map to learn what your state says about waterline compliance
• Learn on the go with our safe water Video Library

Sources: ¹Peralta, Gianna, Melissa Tobin-D'Angelo, Angie Parham, Laura Edison, Lauren Lorentzson, Carol Smith, and Cherie Drenzek. "Notes from the Field: Mycobacterium abscessus Infections Among Patients of a Pediatric Dentistry Practice — Georgia, 2015." Morbidity and Mortality Weekly Report 65, no. 13 (April 8, 2016): 355-356 ²Centers for Disease Control and Prevention. "Outbreaks of Nontuberculous Mycobacteria Infections Highlight Importance of Maintaining and Monitoring Dental Waterlines." Health Alert Network (HAN) Health Advisory. October 31, 2022. https://www.cdc.gov/han/2022/han00478.html. ³Georgia Board of Dentistry. "Minutes of the October 4, 2024 Board Meeting." October 4, 2024. https://proedgedental.com/wp-content/uploads/2024/12/October-4-2024-Minutes-OPEN-SESSION-Websitev2-1-1.pdf. ⁴Nancy Dewhirst and John A. Molinari, "Treating & Monitoring Dental Water," Compendium of Continuing Education in Dentistry (2018): 11-21