In Vivo Study of Aerosol, Droplets and Splatter Reduction in Dentistry

Abstract

Oral health care workers (OHCW) are exposed to pathogenic microorganisms during dental aerosol-generating procedures. Technologies aimed at the reduction of aerosol, droplets and splatter are essential. This in vivo study assessed aerosol, droplet and splatter contamination in a simulated clinical scenario. The coolant of the high-speed air turbine was colored with red concentrate. The red aerosol, droplets and splatter contamination on the wrists of the OHCW and chests of the OHCW/volunteer protective gowns, were assessed and quantified in cm2. The efficacy of various evacuation strategies was assessed: low-volume saliva ejector (LV) alone, high-volume evacuator (HV) plus LV and an extra-oral dental aerosol suction device (DASD) plus LV. The Kruskal–Wallis rank-sum test for multiple independent samples with a post-hoc test was used. No significant difference between the LV alone compared to the HV plus LV was demonstrated (p = 0.372059). The DASD combined with LV resulted in a 62% reduction of contamination of the OHCW. The HV plus LV reduced contamination by 53% compared to LV alone (p = 0.019945). The DASD demonstrated a 50% reduction in the contamination of the OHCWs wrists and a 30% reduction in chest contamination compared to HV plus LV. The DASD in conjunction with LV was more effective in reducing aerosol, droplets and splatter than HV plus LV.

Efficiancy of HEPA-filtered extra oral suction unit on aerosols during prosthetic dental preparation

“…Many studies have been conducted on aerosols, droplets and splatter contamination during dental treatments [9][10][11][12][13][14][15][16][17][18][19]. In some studies, dental manikin, phantom teeth or extracted teeth were used [12,14,16,17].…”

“…Therefore, in the present study all measurements were made while performing routine dental preparation in a speci c dental room with live patient. The majority of studies used open culture plates which is measured droplets and aerosols fallen onto surface [9,12,13,14,15,16]. However, small particles can remain suspended in air for many hours.…”

Reducing Aerosol, Reducing Infection: A Perspective Analysis of the Pandemic Legacy for Oral Medicine

“…During dental practice, both patients and dentists are exposed to an infective risk, which derives especially from microorganisms in aerosols generated by rotatory devices as a result of water irrigation for cooling of the dental or surgical site (Zemouri et al, 2020). In this context and, considering the presence of body fluids and aerosol production in dental procedures, these particles may contain the novel coronavirus and disperse rapidly through the environment causing a risk of cross-contamination (Noordien et al, 2021). Clinically, aerosol production has been a source of debate in dentistry for decades, however, with COVID-19, this question became more prominent.…”

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

“…However, studies that evaluate the impact of aerosol mitigation devices, such as intraoral suction, suggest that current aerosol mitigation interventions are helpful but may not provide complete protection. (4)(5)(6)(7)(8)(9)(10) These studies have generally been limited to the use of water sources that have been experimentally contaminated with bacteria or dyes to evaluate the effectiveness of mitigation strategies. However, this approach does not reflect the clinical practice setting, and limits generalizability and accurate interpretation of health risks for DHCPs.…”

“…However, this approach does not reflect the clinical practice setting, and limits generalizability and accurate interpretation of health risks for DHCPs. (9) Other analyses are limited to indirect studies of dental aerosols with adenosine triphosphate (ATP), surface swabs, (11) and settle plates. (12) The purpose of this manuscript was to evaluate the occupational health risk of dental aerosols by directly capturing aerosols in a clinical setting with live patients and an experimental design that closely approximates the distance of dentists to aerosols, taking into account DHCP respiratory rate.…”