Legionella risk assessment template for dental practices
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Key points
- A dental practice runs two water systems: the building hot and cold supply, and the dental unit waterlines (DUWLs) feeding the handpiece, air-water syringe and ultrasonic scaler on every chair. A template that only covers the building misses the higher-risk half.
- The building side follows ACOP L8 and HSG274 Part 2, the same as any commercial premises. The waterlines sit under HTM 01-05 chapter 2, with HTM 04-01 as the healthcare water standard the CQC expects.
- Bottle-fed and mains-fed units need different controls, not a different duty. Work out which you have before you write the scheme.
- The daily flush, dosing and purge records are what a CQC inspector can actually ask to see. An unrecorded flush cannot be evidenced.
- A template — free or paid — is an indicative starting point that records and structures your controls. It never certifies the water as safe.
A legionella risk assessment for a dental practice has to cover two systems in one document: the building's hot and cold water, and the dental unit waterlines on every chair. A generic template covers the first. This page explains the second — what the CQC expects, how bottle-fed and mains-fed units differ, and the daily routine — and how the Pro Pack's dental practice worked example structures both halves together. For the wider duty, our legionella guide for dental practices sets out the full picture.
Two systems, one duty
The building side of a dental practice is unremarkable. It is a small commercial premises with hot and cold water, and it is assessed exactly like one: hot water reaching at least 50°C at outlets within a minute (55°C in healthcare settings working to HTM 04-01), cold water below 20°C within two minutes, any calorifier storing at 60°C or above, weekly flushing of little-used outlets, and records kept for at least five years. The free risk assessment builder walks through this side, and a small practice with a straightforward system can usually do it in-house. The temperature checker benchmarks your readings against the HSG274 thresholds.
The waterlines are where dental practices differ. The narrow-bore tubing inside each dental chair unit runs at roughly surgery temperature, carries water to instruments that spray it directly into a patient's mouth as a fine aerosol, and stands still for most of the day. Those are ideal conditions for biofilm, and published studies have found legionella in dental unit waterlines at practices whose building water was otherwise well managed. A building-only assessment, however thorough, says nothing about this system at all.
The legal frame has two layers. Underneath sits the ordinary duty: the Health and Safety at Work Act 1974 and ACOP L8. On top, because the practice is CQC-registered under the Health and Social Care Act 2008, the CQC expects compliance with HTM 01-05 on decontamination — chapter 2 of which covers dental unit waterline management specifically — and HTM 04-01 on safe water in healthcare premises.
What the CQC expects to see
There is no legionella certificate for a dental practice, and nothing you can buy that “makes you compliant”. What the CQC regime rewards is evidence that the risk has been thought about and is being managed: a written risk assessment that names both systems, a written scheme of control setting out tasks and frequencies, a named and trained decontamination lead, and the day-to-day records that show the scheme actually runs — flush logs, dosing records, bottle maintenance, sampling results where sampling is part of the scheme.
That framing matters when you choose a template. A document can structure all of this, but it is the regime, carried out and written down, that an inspector is shown — not the folder it sits in.
Bottle-fed vs mains-fed units
Before writing the scheme, establish which type of unit each chair has, because the controls differ. Many practices have a mix.
| Bottle-fed (self-contained reservoir) | Mains-fed (connected to the plumbing) | |
|---|---|---|
| Source water | You choose it; many practices use distilled or reverse-osmosis water | Whatever the building system delivers |
| Main weakness | Water warms to surgery temperature and stands in the reservoir | Inherits building water quality; lines stagnate between sessions |
| Daily controls | Empty, clean and dry bottles per the manufacturer's instructions; flush lines each session | Flush each line at the start and end of every clinical session |
| Periodic controls | Disinfect bottles and lines on the manufacturer's schedule; weekly purge | Approved dosing system; weekly purge; backflow protection on the supply maintained |
| What to record | Bottle changes and cleaning; flush log; disinfection dates | Flush log per chair; dosing checks; any sampling results |
Neither type is inherently safer. Bottle-fed units give you control over the source water but add a daily maintenance burden that is easy to let slip; mains-fed units remove the bottles but tie your water quality to the building system, which brings the building assessment back into scope. The duty and the record-keeping are identical either way.
The daily waterline routine
The regime most practices run, in line with HTM 01-05 chapter 2 and their unit manufacturer's instructions, looks like this. Treat the durations and products as placeholders — the figures that belong in your written scheme are the ones your unit manufacturer specifies.
- Start of the session: flush every line on every chair that will be used, before the first patient.
- Between patients: short runs on the lines used, as the manufacturer instructs.
- End of the session: flush every line again; on bottle-fed units, empty, clean and dry the reservoirs rather than leaving water standing overnight.
- Weekly: purge and disinfect the system with an approved product, on the schedule the manufacturer sets.
- Periodically: sample where the written scheme calls for it, and record the result and any action taken.
Each of these is a line in a log: date, chair, task, initials. The flushing guide explains the principle — run to fresh water, not to a guessed number of seconds — and the log book guide covers a recording format that works for both the waterlines and the building checks.
Free legionella risk assessment template
A structured Word document following the five-step approach in ACOP L8. Covers risk identification, written scheme, monitoring, and records. If it isn't written down, you can't evidence it.
Follows ACoP L8 and HSG274 Part 2. Free. No spam.
What the £29 Pro Pack adds for a dental practice
The free template is a solid ACOP L8 structure for the building system, and for many practices that half is genuinely all it needs to do. What it cannot do is show the waterline half written up, because the waterlines are not a generic problem. The Pro Pack is the same honest idea — a structured starting point, not a certificate — and for a dental practice it includes:
- A complete worked example assessment for a dental practice: the building system and the dental unit waterline routine written up in full, so you can see how a finished dual-system assessment reads.
- A dental practice preset log book, pre-filled for the practice — open it and the register is half done.
- The editable risk assessment and written scheme of control documents, so you adapt a drafted structure for your own practice rather than starting from a blank page.
It is an indicative starting point: it records, it never certifies. It does not replace the unit manufacturer's instructions, staff training, or a competent specialist where the system is complex — and a practice with anything unusual in its water supply should take advice rather than work from any template.
Get the Pro Pack for your practice
A complete worked example assessment for a dental practice, a dental preset log book, and the editable risk assessment and written scheme of control documents. One-off £29, no subscription.
An indicative starting point: it records, it never certifies. Follows ACOP L8, HSG274 and HTM 01-05.
The template is the filing system, not the control. What a CQC inspector is shown is the flush log with last Tuesday's entries in it — not the folder it sits in.
Keeping the records
Records should be kept for at least five years, and they should be checkable at a glance: anyone — an inspector, a new practice manager, a water hygiene contractor — should be able to pick up the log and see what was done, when, and by whom. Keep the waterline logs and the building logs together so the dual system reads as one managed whole. If a flush is missed, a unit is taken out of service, or a sample comes back raised, record that too and the action taken; a log that only ever shows perfection is less credible than one that shows a regime responding to real events. If sampling ever does detect a problem, follow the steps in what to do if legionella is detected rather than simply flushing and carrying on.
Free legionella risk assessment template
A structured Word document following the five-step approach in ACOP L8. Covers risk identification, written scheme, monitoring, and records. If it isn't written down, you can't evidence it.
Follows ACoP L8 and HSG274 Part 2. Free. No spam.
Frequently asked questions
Do dental practices need a legionella risk assessment?
Yes. A dental practice is a workplace where water is stored and distributed and where staff and patients are exposed to it, so the same duty applies as for any commercial premises under the Health and Safety at Work Act 1974 and ACOP L8. In practice the assessment has two parts in one document: the building hot and cold water system, assessed against HSG274 Part 2 like any premises, and the dental unit waterlines on each chair, which sit under HTM 01-05 chapter 2 with HTM 04-01 as the healthcare water-safety standard the CQC expects. A small practice can usually assess the building side itself; the waterlines are a different matter and normally need a trained member of staff or specialist input.
How often should dental unit waterlines be flushed?
The working pattern in dental decontamination guidance is a flush at the start and end of each clinical session, with shorter runs between patients, but the exact durations come from the unit manufacturer and should be written into your written scheme of control rather than guessed. On top of the daily flushing, the regime typically includes an approved disinfectant dosing system, a weekly purge, and periodic sampling where the scheme calls for it. Every flush should be recorded with the date, the chair, and who did it, because an unrecorded flush cannot be evidenced.
Is a bottle-fed dental unit safer than a mains-fed one?
Neither is inherently safer; they carry different control burdens. A bottle-fed unit lets you control the source water, but the reservoir warms to surgery temperature and the water stands in it, so bottles need emptying, cleaning and drying each day. A mains-fed unit draws on the practice plumbing, so it inherits the building water quality and needs disciplined flushing and correct backflow protection on the supply. The legal duty and the need to keep records are identical either way, so choose the controls that match the units you actually have.
What does the CQC look for on water safety in a dental practice?
Evidence, not certificates. There is no legionella certificate for a dental practice. What an inspector can ask to see is a written risk assessment covering both the building system and the dental unit waterlines, a written scheme of control that names who does what and how often, a trained and named decontamination lead, and the routine records: daily flush logs, dosing records, bottle maintenance where units are bottle-fed, and any sampling results. The CQC works against HTM 01-05 on decontamination and HTM 04-01 on safe water, sitting on top of the underlying ACOP L8 duty.
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