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Background: Dental procedures often produce aerosols and splatter which have the potential to transmit pathogens such as SARS-CoV-2. The existing literature is limited. Methods: Aerosols and splatter were generated from an ultrasonic scaling procedure on a dental mannequin and characterized by two optical imaging methods – digital inline holography (DIH) and laser sheet imaging (LSI). Capture efficiencies of various aerosol mitigation devices were evaluated and compared. Results: The ultrasonic scaling procedure generates a wide size range of aerosols up to a few hundred micrometers and occasional large splatter which emit at low velocity (mostly below 3 m/s). Use of a saliva ejector (SE) and high-volume evacuator (HVE) resulted in 63% and 88% of overall reduction respectively while an extraoral local extractor (ELE) resulted in a reduction of 96% at the nominal design flow setting. Conclusions: The study results showed that the use of ELE or HVE significantly reduced aerosol and splatter emission. The use of HVE generally requires an additional person to assist a hygienist, while an ELE can be operated hands-free when a dental hygienist is performing ultrasonic scaling and other operations. Practical Implications: An extraoral local extractor aids in the reduction of aerosols and splatters during ultrasonic scaling procedures, potentially reducing transmission of oral or respiratory pathogens, like SARS-CoV-2. Position and airflow of the device are important to effective aerosol mitigation.

A primary caretaker is a potential reservoir of bacteria for an infant child and can be evaluated during a child's caries risk assessment. The aim of this study was to investigate an indirect method for assessing Streptococcus mutans and Streptococcus sobrinus (MS) and lactobacillus (LB) levels in a caretaker's saliva. Thirty‐eight primary caretakers participated in the study to determine whether a 2‐step method to assess the intracellular adenosine triphosphate (ATP) levels in saliva (saliva i‐ATP method) predicted higher MS and LB levels. This method was tested against a 1‐step swab‐based total ATP testing of dental plaque (plaque t‐ATP method). Receiver operating characteristic (ROC) curves were used to examine the relationship between specificity and sensitivity of the two diagnostic tests. Although the area under the ROC curves of both the saliva i‐APT (0.823) and the plaque t‐ATP (0.774) methods were shown to be statistically different (p < .05) than the null hypothesis test of a random coin flip, the diagnostic predictability of the ATP tests to assess high levels of MS and LB remained low. The optimal cutoff, which was defined by the Youden index, for the saliva i‐ATP method produced a sensitivity/specificity of 60.7/100.0 for MS and 78.6/88.9 for LB. Applying these results to populations of low or high bacterial level prevalence produced undesirable positive and negative predictive values for future potential patients. A pair‐wise comparison of both area under the ROC curve values of the saliva i‐ATP and plaque t‐ATP did not find a statistically significant difference in using one test over the other (MS, p = .629; LB, p = .737). The findings of this study can educate dental clinicians that diagnostic tests, such as the 2‐step saliva i‐ATP method, can be found to be statistically significant but not ideal for patient use in terms of diagnostic predictability.