Efficacy of Preprocedural Boric Acid Mouthrinse in Reducing Viable Bacteria in Dental Aerosols Produced during Ultrasonic Scaling

Abstract

Introduction: Aerosols and droplets contaminated with bacteria and blood are produced during ultrasonic scaling. Measures to control aerosol contamination in dental clinics are recommended by the Centers for Disease Control and Prevention. This study aimed to evaluate the efficacy of preprocedural boric acid (BA) mouthrinse in reducing bacterial contamination in dental aerosols generated during ultrasonic scaling. Materials and Methods: This was a randomised clinical trial in 90 systemically healthy subjects (25-55 yrs) diagnosed with chronic periodontitis who were allocated into three groups of 30 subjects each to receive, Group A - 0.12% chlorhexidine (CHX), Group B - 0.75% BA and Group C-water, as a preprocedural rinse for 1 min. The aerosol generated while performing ultrasonic scaling for 30 min was collected at three locations on blood agar plates. Incubation of the blood agar plates at 37°C for next 48 h for aerobic culture was performed and subsequently colony-forming units (CFUs) were counted. Results: CFUs in Group A were significantly reduced compared with Group B ( P < 0.001). When we compare CFUs in all the three groups, CFUs in Groups A and B were statistically significantly reduced compared with Group C ( P < 0.001). Furthermore, it was also observed that the assistant's chest area had lowest CFUs whereas patient's chest area had highest. Conclusion: This study recommends routine use of preprocedural mouthrinse as a measure to reduce bacterial aerosols generated during ultrasonic scaling and that 0.12% CHX gluconate is more effective than 0.75% BA mouthwash in reducing CFUs count.

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

“… Nayak et al 2020 The number of bacteria: water > Befresh™ (Sagar Pharmaceuticals) mouthwash > the CHX group This study proves that a regular preprocedural mouth rinse could significantly reduce the majority bacteria present in aerosols generated by the use of an ultrasonic unit, and Befresh™ mouth rinse was found to be equally effective in reducing the aerosol contamination to 0.2% CHX gluconate. Nisha et al 2021 The number of bacteria: group A > group B > group C Routine use of preprocedural mouthrinse could be a measure to reduce bacterial aerosols generated during ultrasonic scaling and 0.12% CHX gluconate is more effective than 0.75% BA mouthwash in reducing CFUs count. Nisha et al 2022 The number of bacteria: distilled water (control) > 1.5% hydrogen peroxide (test) > 0.12% chlorhexidine (test) Preprocedural rinse using HP can effectively be used as a method to reduce dental aerosols generated during ultrasonic scaling.…”