Navigating Dental Challenges: Reprocessing Dental Burs, Endodontic Files, and Waterline Safety

Session Description: Dental settings present unique infection prevention challenges that differ significantly from those in acute care or ambulatory environments. This session is designed for infection preventionists who may be unfamiliar with dental-specific practices but are increasingly called upon to support dental clinics, surgical centers, or educational institutions.

We will explore the complexities of reprocessing dental burs and endodontic files—critical instruments that, according to Spaulding classification, require thorough cleaning and sterilization. Despite Centers for Disease Control and Prevention (CDC) recommendations to treat these items as single-use due to their intricate design and cleaning difficulty, recent data show they are often reused. This presentation will unpack the risks associated with reuse, including vague or incomplete manufacturer instructions for use (IFUs), and highlight U.S. Food and Drug Administration (FDA) classification nuances that impact reprocessing decisions.

In addition to instrument sterilization, we will address another high-risk area often overlooked: dental unit waterline management. Dental waterlines harbor biofilms which often include pathogenic microorganisms if not properly maintained, posing a serious risk to patient safety. Improperly maintained waterlines have been implicated in clusters of infections with Mycobacterium abcessus among pediatric dental patients. Attendees will learn how to identify common gaps in waterline maintenance and apply evidence-based strategies to mitigate contamination.
This session will equip infection preventionists with foundational knowledge and practical tools to support dental teams, improve compliance, and enhance patient safety in oral healthcare environments.

Hillary Hei

Infection Preventionist, ECRI

Hillary Hei, MPH, CIC, LSSGB, FAPIC, is a Senior Infection Preventionist at ECRI and adjunct faculty at Drexel University School of Public Health. With expertise spanning pediatric care, sterile processing, long-term care, and dental infection control, she leads outbreak response efforts, develops educational programs, and performs consultations for a variety of healthcare settings. A Fellow of APIC, Hillary has served on its Research Committee and as a peer reviewer for AJIC. She holds certifications in Infection Control and Lean Six Sigma. For local APIC Chapter 15 - Philadelphia/Delaware Valley, Hillary has served as the Director of Communications and currently serves as the Director of Professional Development.

Eve Cuny

Professor Emeritus, University of the Pacific School of Dentistry

Professor Cuny is a former chairperson of the ADS (previously OSAP) board of directors, where she currently serves on the foundation board. She is the chair of the ADS Institute for Safety and Science, a newly formed organization dedicated to providing evidence-based guidance on safety and infection prevention to oral health care providers. She was a member of the National Occupational Research Agenda (NORA) Council at NIOSH, and a member of the Healthcare Infection Control and Prevention Advisory Committee (HICPAC) to the CDC until both were disbanded in spring, 2025. She has been a consultant to the ADA Council on Dental Practice, and the ADA Council on Scientific Affairs. She is a current member of the Healthcare Acquired Infections and Antimicrobial Stewardship advisory committee to the Washington State Department of Health. Professor has lectured and published extensively on the topics of infection control and patient safety.

Austin Penna

Epidemiologist, Centers for Disease Control and Prevention

Austin R. Penna, MPH, CIC, is an Epidemiologist in the Division of Healthcare Quality Promotion (DHQP) at the Centers for Disease Control and Prevention (CDC). In his role, he provides support to health departments, healthcare facilities, and other federal partners in the investigation of suspected outbreaks involving healthcare-associated infections and infection control breaches across healthcare settings. He also serves as the CDC Liaison for the APIC Annual Conference Committee.