Assessment of Infectious Diseases Risks From Dental Aerosols in Real-World Settings

Abstract

Background Infectious diseases physicians are leaders in assessing the health risks in a variety of community settings. An understudied area with substantial controversy is the safety of dental aerosols. Previous studies have used in vitro experimental designs and/or indirect measures to evaluate bacteria and viruses from dental surfaces. However, these findings may overestimate the occupational risks of dental aerosols. The purpose of this study was to directly measure dental aerosol composition to assess the health risks for dental healthcare personnel and patients. Methods We used a variety of aerosol instruments to capture and measure the bacterial, viral, and inorganic composition of aerosols during a variety of common dental procedures and in a variety of dental office layouts. Equipment was placed in close proximity to dentists during each procedure to best approximate the health risk hazards from the perspective of the DHCP. Devices used to capture aerosols were set at physiologic respiration rates. Oral suction devices were per the discretion of the dentist. Results We detected very few bacteria and no viruses in dental aerosols – regardless of office layout. The bacteria identified were most consistent with either environmental or oral microbiota, suggesting a low risk of transmission of viable pathogens from patients to DHCPs. When analyzing restorative procedures involving amalgam removal, we detected inorganic elements consistent with amalgam fillings. Conclusions Aerosols generating from dental procedures pose a low health risk for bacterial and likely viral pathogens when common aerosol mitigation interventions, such as suction devices, are employed.

Effectiveness of interventions to reduce aerosol generation in dental environments: A systematic review

“… The addition of PAC equipment to the already existing safety measures was found to be significantly effective in further microbiological risk reduction. Choudhary et al, 2022a , Choudhary et al, 2022b The bacteria identified were most consistent with either environmental or oral microbiota. Aerosols generating from dental procedures pose a low health risk for bacterial and likely viral pathogens when common aerosol mitigation interventions.…”

“… Aerosols generating from dental procedures pose a low health risk for bacterial and likely viral pathogens when common aerosol mitigation interventions. Choudhary et al, 2022a , Choudhary et al, 2022b The number of particles: tip HVE > Conical HVE tip HVE > ISOVAC HVE Dentists should consider using HVE rather than standard-tip evacuators to reduce aerosols generated during routine clinical practice. Das et al 2022 The number of bacteria: no rinse group (control) > water (test) > 0.2% Chlorhexidine gluconate (test) > herbal mouthwash (test) 0.2% Chlorhexidine gluconate is superior in reducing the microbial load in aerosols produced during ultrasonic scaling.…”