Aerosol transmission for SARS‐CoV‐2 in the dental practice. A review by SIdP Covid‐19 task‐force

Clementini, Marco; Raspini, Mario; Barbato, Luigi; Bonfante, Francesco; Braga, Giovanni; Gioia, Claudio Di; Cristiano, None Littarru; Oreglia, Francesco; Brambilla, Eugenio; Iavicoli, Ivo; Pinchi, Vilma; Landi, Luca; Sforza, Nicola; Cavalcanti, Raffaele; Crea, Alessandro; Cairo, Francesco

doi:10.1111/odi.13649

Cited by 23 publications

(15 citation statements)

References 54 publications

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“…Bruna et al [25] argued that the use of rubber dams should be mandatory, and Butera et al [26] minimized the use of aerosol-producing instruments, such as ultrasound and air, to reduce the production of highly polluted aerosols. It has been reported that it is necessary to promote the use of chlorhexidine, hydrogen peroxide, or povidone iodine; the development of new treatments, such as laser and ozone; and the administration of probiotics prior to each dental treatment [26,27].…”

Section: Discussionmentioning

confidence: 99%

Dispersion of Aerosols Generated during Dental Therapy

Takanabe

Maruoka

Junko

et al. 2021

IJERPH

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The novel coronavirus pandemic has resulted in an urgent need to study the risk of infection from aerosols generated during dental care and to conduct a review of infection controls. However, existing studies on aerosol particles related to dental treatment have mainly evaluated only the scattering range. Few studies have been conducted on the specifics of the generation of aerosol particles in clinical settings, their mechanisms and patterns of distribution throughout open or enclosed spaces, the duration that they remain suspended in air, and the amount and size of particles present. To minimize the influence of background particles, laser lights, a high-sensitivity camera, and particle counters were used in a large super clean laboratory to investigate the dynamics of aerosols generated during the operation of dental micromotors. The results indicate that aerosols tend to scatter upward immediately after generation and then gradually disperse into the surroundings. Most of the particles are less than 5 µm in size (only a few are larger), and all particles are widely distributed over the long term. Our research clearly elucidates that aerosols produced in dental care are distributed over a wide area and remain suspended for a considerable time in dental clinics before settling.

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Section: Discussionmentioning

confidence: 99%

Dispersion of Aerosols Generated during Dental Therapy

Takanabe

Maruoka

Junko

et al. 2021

IJERPH

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“…It is known that the health environments that generate droplets and aerosols have received special attention in sanitary measures, due to the risk of cross-contamination, especially in the pandemic moment of Covid-19 [ 22 ]. With that in mind, in this present study, we simulated a situation of droplets and highly contaminated aerosols dispersion in a dental environment.…”

Section: Discussionmentioning

confidence: 99%

Biosafety devices to control the spread of potentially contaminated dispersion particles. New associated strategies for health environments

et al. 2021

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Dental procedures produce a large amount of spatter and aerosols that create concern for the transmission of airborne diseases, such as Covid-19. This study established a methodology with the objective of evaluating new associated strategies to reduce the risk of cross-transmission in a health environment by simulating spread of potentially contaminated dispersion particles (PCDP) in the environment. This crossover study, was conducted in a school clinic environment (4 clinics containing 12 dental chairs each). As a positive control group (without barriers), 12 professionals activated at the same time the turbine of dental drill, for one minute, with a bacterial solution (Lactobacillus casei Shirota, 1.5x108 CFU/mL), which had been added in the cooling reservoir of the dental equipment. In the experimental groups, the professionals made use of; a) an individual biosafety barrier in dentistry (IBBD) which consists of a metal support covered by a disposable PVC film barrier; b) a Mobile Unit of Disinfection by Ultraviolet-C, consisting of 8 UV lamps-C of 95W, of 304μW/cm2 of irradiance each, connected for 15 minutes (UV-C) and; c) the association between the two methods (IBBD + UV-C). In each clinic, 56 Petri dishes containing MRS agar were positioned on the lamps, benches and on the floor. In addition, plates were placed prior to each test (negative control group) and plates were also placed in the corridor that connects the four clinics. In the groups without barrier and IBBD + UV-C the passive air microorganisms in Petri dishes was also evaluated at times of 30, 60, 90 and 120 minutes after the end of the dental’s drill activation. The mean (standard deviation) of CFU of L. casei Shirota for the positive control group was 3905 (1521), while in the experimental groups the mean using the IBBD was 940 (466) CFU, establishing a reduction on average, of 75% (p<0.0001). For the UV-C group, the mean was 260 (309) CFU and the association of the use of IBBD + UV-C promoted an overall average count of 152 (257) CFU, establishing a reduction on average of 93% and 96%, respectively (p<0.0001). Considering these results and the study model used, the individual biosafety barrier associated with UV-C technology showed to be efficient strategies to reduce the dispersion of bioaerosols generated in an environment with high rate of PCDP generation and may be an alternative for the improvement of biosafety in different healthy environment.

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“…The reduction of bio-aerosol generation can be accomplished by using many protocols ( 26 , 29 ). In our experience, we followed two different approaches to control bio-aerosol generation: (1) the use of pre-operative mouthwash; and (2) the regulation of daily dental procedures ( 30 , 31 ). The use of pre-operative mouthwash (1% hydrogen peroxide, 0.2% povidone iodine, or alcohol free options such as 0.2% chlorhexidine rinse) has been shown to control the bacterial burden ( 23 ).…”

Section: Practice-based Clinical Challengesmentioning

confidence: 99%

Dental Education in the Time of COVID-19 Pandemic: Challenges and Recommendations

Hassan

Amer

2021

Front. Med.

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Moving within the second wave of the coronavirus (COVID-19) pandemic, dental education delivery has been profoundly affected by this crisis, so has the structure, evaluation, and future of dental education. Both pre-clinical and clinical dental education have experienced challenges ranging from fully online educational content to limited dental training for senior dental students. This crisis appears to be a tipping point that produced confusion in dental teaching especially clinical sciences. Although medical institutions immediately started to adapt to the unexpected COVID-19 crisis, dental and oral health educational services are profoundly impaired due to the dental team's propinquity to the patient and the aerosols generated during routine dental therapeutic procedures. Dental students unlike other medical students are considered to be at the highest risk due to the nature of their clinical training that includes working in the oral cavity of patients using aerosol-generating equipment. Some dental schools have taken the leadership and documented their modifications during this pandemic; however, there is a serious need for further investigation and wide range screening of the situation in the dental schools during the COVID-19 crisis. The aim of this mini-review is to present these challenges and how academic dental institutions have implemented strategies to overcome them.

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Aerosol transmission for SARS‐CoV‐2 in the dental practice. A review by SIdP Covid‐19 task‐force

Cited by 23 publications

References 54 publications

Dispersion of Aerosols Generated during Dental Therapy

Dispersion of Aerosols Generated during Dental Therapy

Biosafety devices to control the spread of potentially contaminated dispersion particles. New associated strategies for health environments

Dental Education in the Time of COVID-19 Pandemic: Challenges and Recommendations

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