Evaluation of the spatter-reduction effectiveness of two dry-field isolation techniques

Dahlke, William O.; Cottam, Michael R.; Herring, Matthew C.; Leavitt, Joshua M.; Ditmyer, Marcia; Walker, Richard S.

doi:10.14219/jada.archive.2012.0064

Cited by 43 publications

(40 citation statements)

References 11 publications

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“…The National Dental Practice-Based Research Network Collaborative Group in the USA reported on the use of a rubber dam during root canal treatment and suggested that improved infection control, patient protection and treatment efficacy were some of the advantages offered by the rubber dam 61 . A significant reduction of spatter during treatments with the application of a combination rubber dam and high-volume evacuation was reported 62 .…”

Section: Focus Area Four: Environmental Barriersmentioning

confidence: 99%

Compliance with infection prevention and control in oral health-care facilities: a global perspective

Oosthuysen

Potgieter

Fossey

2014

International Dental Journal

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Many publications are available on the topic of compliance with infection prevention and control in oral health-care facilities all over the world. The approaches of developing and developed countries show wide variation, but the principles of infection prevention and control are the same globally. This study is a systematic review and global perspective of the available literature on infection prevention and control in oral health-care facilities. Nine focus areas on compliance with infection-control measures were investigated: knowledge of infectious occupational hazards; personal hygiene and care of hands; correct application of personal protective equipment; use of environmental barriers and disposable items; sterilisation (recirculation) of instruments and handpieces; disinfection (surfaces) and housekeeping; management of waste disposal; quality control of dental unit waterlines, biofilms and water; and some special considerations. Various international studies from developed countries have reported highly scientific evidence-based information. In developed countries, the resources for infection prevention and control are freely available, which is not the case in developing countries. The studies in developing countries also indicate serious shortcomings with regard to infection prevention and control knowledge and education in oral health-care facilities. This review highlights the fact that availability of resources will always be a challenge, but more so in developing countries. This presents unique challenges and the opportunity for innovative thinking to promote infection prevention and control.

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Section: Focus Area Four: Environmental Barriersmentioning

confidence: 99%

Compliance with infection prevention and control in oral health-care facilities: a global perspective

Oosthuysen

Potgieter

Fossey

2014

International Dental Journal

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“…In addition to cotton rolls and/or gauze, some authors and GDPs claimed that other isolation techniques such as Isolite (Benbrook Dental, USA) are able to enhance visibility, reduce the risk of damage of porcelain surfaces, minimize the risk of perforation and can be useful in young patients with incompletely erupted teeth. 5,30,31 Despite these claims, it is strongly believed that all the above-mentioned clinical situations can be managed with RD application (Table 2). More importantly, such devices will not protect the supporting gingivae from toxic irrigants (e.g.…”

Section: Factors Affecting Rubber Dam Use After Graduationmentioning

confidence: 99%

Rubber dam application in endodontic practice: an update on critical educational and ethical dilemmas

et al. 2014

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Proper isolation is an essential prerequisite for successful endodontic treatment. This article aims to provide an update on the prevalence of rubber dam (RD) use, and the role of education along with attitudes of general dental practitioners (GDPs) and patients towards the application of RD in endodontics. Critical ethical issues are also highlighted. Using certain keywords, an electronic search was conducted spanning the period from January 1983 to April 2013 to identify the available related investigations, and the pooled data were then analysed. The results show that although RD is the Standard of Care in endodontic practice, there is a clear discrepancy in what GDPs are taught in dental school and what they practice after graduation. There is little scientific evidence to support the application of RD; however, patient safety and clinical practice guidelines indicate that it is unnecessary and unethical to consider a cohort study to prove what is already universally agreed upon. A few clinical situations may require special management which should be highlighted in the current guidelines. This would pave the way for clear and straightforward universal guidelines.

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“…45 In one study uorescent dye was isolated behind a single ply facemask and within the nose of the operator and their assistant. 23 The effect of HVA on dental bio-aerosol is equivocal. An in-vivo study using collection plates noted no statistically signi cant difference in bio-aerosol and spatter reduction between high volume aspiration and saliva ejector.…”

Section: Discussionmentioning

confidence: 99%

“…Contaminated dental bio-aerosol properties have been quantitatively and qualitatively evaluated,17, 18, 19, 20 and dental bioaerosol distribution around the operating eld has been appraised. 18,21,22,23,24,25 However whilst these studies have provided invaluable insight into contaminated dental bio-aerosol, they have been unable to ascertain at what point the aerosol has been su ciently dispersed to reduce the health risk to an acceptable level -the 'fallow time'.…”

mentioning

confidence: 99%

Quantitative evaluation of dental bio-aerosols using particle count values. Part 1: the effect of High Volume Aspiration and natural ventilation.

Haigh¹,

Vasant²,

O'Hooley³

2020

Preprint

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AimRoutine dental treatments are frequently associated with aerosol generating procedures (AGP). Recently dental AGP have attracted significant attention as a possible vector for the transmission of SARS-CoV-2 and attempts have been made to establish when a surgery may be safely decontaminated following a dental AGP — the ‘fallow time’. There is a paucity of research in the dental literature regarding the near real time generation and dispersion of dental aerosol following a dental AGP. Study aims are to: (1) monitor dental aerosol generation and dispersal through semi-continuous particle count values (PCV), and (2) use this information to delineate a range of suitable fallow times.MethodFollowing baseline measurements, five identical dental AGP were conducted on a dental manikin for each of three groups: (SEO) saliva ejector only, (HVA) high volume aspiration, (WO) high volume aspiration with windows open. For each procedure PCV were recorded every 2.2 minutes with a Light Scattering Airborne Particle Counter (LSAPC) for 3.3 hours. Eleven dependent variables were analysed, including baseline PCV, total PCV, peak PCV, time taken to return to one sample standard deviation of baseline PCV, and a time series extending from 15 minutes to 3 hours after cessation of AGP. Due to heterogeneity, the data was analysed with Krushkall-Wallis test and Dunn-Bonferroni post hoc.ResultsBetween group mean baseline PCV were not statistically significant. Compared with SEO, WO had a statistically significant impact on peak PCV (p=.009) and HVA had a statistically significant impact on total PCV (p=.006). With the exception at 2 and 3 hours, PCV throughout the time series were statistically significantly lower for WO and HVA in comparison with SEO. WO PCV were influenced by outdoor aerosol levels.Four of the five SEO procedures failed to return to baseline PCV within 3.3 hours. Following AGP, the mean time for the HVA procedures to return to baseline PCV was 17.12 minutes, 95% CI [4.96 to 29.28]. The effect of HVA on the time taken to return to baseline PCV was very large (Glass’s Δ= -4.943, CLES=1.00).ConclusionThere is a significant benefit in opening windows during AGP. The effect of HVA on reducing fallow time is very large. Under the conditions of this study, PCV suggest that it might be safe to consider a fallow time of 29.28 minutes.

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Evaluation of the spatter-reduction effectiveness of two dry-field isolation techniques

Abstract: Isolation with a dental dam and HVE or with the Isolite system appears to aid in the reduction of spatter during operative dental procedures, potentially reducing exposure to oral pathogens.

Cited by 43 publications

References 11 publications

Compliance with infection prevention and control in oral health-care facilities: a global perspective

Compliance with infection prevention and control in oral health-care facilities: a global perspective

Rubber dam application in endodontic practice: an update on critical educational and ethical dilemmas

Quantitative evaluation of dental bio-aerosols using particle count values. Part 1: the effect of High Volume Aspiration and natural ventilation.

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