Measuring Harmful Levels of Bacteria in Dental Aerosols

Earnest, Ronald; Loesohe, Walter

doi:10.14219/jada.archive.1991.0187

Cited by 17 publications

(15 citation statements)

References 14 publications

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“…Therefore, it may not be surprising that no MRSA colonies were cultured from face shields and countertops when rubber dams were used during this investigation. A previous study 45 This apparent variation in colony growth may also have been due to sampling errors combined with the inherent difficulty of selectively isolating and culturing MRSA that were present in much smaller concentrations compared with the more than 300 other microorganisms normally cultured from human saliva and skin. Other limitations of this study include the use of nonselective primary 5% SBA; heteroresistance of MRSA isolates; overlooking factors such as room size, ventilation, patient diet, patient oral hygiene, potential presence o f residual chlorhexidine, and possible persistent aerosolized microorganism carry ~v e r .~~~~) ,~~,~~~~~~~~ In this study chlorhexidine was used as a positive control, and no saline rinse controls were used as in other similar s t~d i e s . "…”

Section: Discussionmentioning

confidence: 93%

“…Therefore, it may not be surprising that no MRSA colonies were cultured from face shields and countertops when rubber dams were used during this investigation. A previous study 45 has suggested that an additional advantage of using a rubber dam could be the prevention o f as p i ration p n e 11 m o n i a. A s p i ratio n pneumonia is dangerous f o r older patients especially if MRSA organisms are involved.…”

Section: Discussionmentioning

confidence: 99%

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Methicillin‐resistant Staphylococcus aureus and infection control for restorative dental treatment in nursing homes

Hall¹

2003

Special Care in Dentistry

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The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in nursing home residents now averages 20-35%. This includes both numerous asymptomatic mostly unidentified carriers, and the occasional patient with an active infection. Among the most common sites for positive MRSA colonization are the nares and mouth (saliva). Ohio State University (OSU) dental students perform routine restorative dental care onsite in local nursing homes using portable equipment including handpieces that can generate aerosols. Using a series of cultured test swabs and plates, this pilot study suggests that protection for both dental health care personnel and patients are provided by the following: 1. universal barrier precautions (for example, gloves, gowns, masks, hats, facial shields, glasses), 2. surface disinfectants, 3. pre-op 0.12% chlorhexidene mouth rinses, 4. high volume evacuation, 5. perioral skin scrubs. Additional infection control methods, techniques and equipment were evaluated and compared including rubber dam isolation, hand excavation and bond technique, high-speed air turbine and electric "high" speed handpiece. There was no indication of a special tendency or heightened ability of MRSA to aerosolize.

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Section: Discussionmentioning

confidence: 93%

“…Therefore, it may not be surprising that no MRSA colonies were cultured from face shields and countertops when rubber dams were used during this investigation. A previous study 45 has suggested that an additional advantage of using a rubber dam could be the prevention o f as p i ration p n e 11 m o n i a. A s p i ratio n pneumonia is dangerous f o r older patients especially if MRSA organisms are involved.…”

Section: Discussionmentioning

confidence: 99%

Methicillin‐resistant Staphylococcus aureus and infection control for restorative dental treatment in nursing homes

Hall¹

2003

Special Care in Dentistry

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“…and NTM, in dental unit water combined with aerosolization could be a significant health hazard. Several studies have examined pathogen content of DUWL (Barbeau et al, 1998;Dutil et al, 2006) while others have shown bacterial aerosolization during dental treatment (Miller, 1976;Earnest and Loesche, 1991;Leggat and Kedjarune, 2001). Few studies have examined whether waterborne pathogens are found in the air of dental work environment.…”

Section: Discussionmentioning

confidence: 99%

Aerosolization of mycobacteria and legionellae during dental treatment: low exposure despite dental unit contamination

Dutil

Veillette

Mériaux

et al. 2007

Environmental Microbiology

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Dental unit waterlines (DUWL) support growth of a dense microbial population that includes pathogens and hypersensitivity-inducing bacteria, such as Legionella spp. and non-tuberculous mycobacteria (NTM). Dynamic dental instruments connected to DUWL generate aerosols in the work environment, which could allow waterborne pathogens to be aerosolized. The use of the real-time quantitative polymerase chain reaction (qPCR) provides a more accurate estimation of exposure levels compared with the traditional culture approach. Bioaerosol sampling was performed 13 times in an isolated dental treatment room according to a standardized protocol that included four dental prophylaxis treatments. Inhalable dust samples were taken at the breathing zone of both the hygienist and patient and outside the treatment room (control). Total bacteria as well as Legionella spp. and NTM were quantified by qPCR in bioaerosol and DUWL water samples. Dental staff and patients are exposed to bacteria generated during dental treatments (up to 4.3 E + 05 bacteria per m(3) of air). Because DUWL water studied was weakly contaminated by Legionella spp. and NTM, their aerosolization during dental treatment was not significant. As a result, infectious and sensitization risks associated with legionellae and NTM should be minimal.

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“…Antiseptic mouthwashing prior to dental surgery has been recommended by various authors to reduce the formation of microbially contaminated aerosols [52,53]. It is also contained in the US "Clinical Guidelines for Infection Control in Dental Education Institutions" [54].…”

Section: Reduction In the Development Of Infectious Aerosols In Dentamentioning

confidence: 99%

Efficacy of Cetylpyridinium Chloride Used as Oropharyngeal Antiseptic

Pitten

Krämer

2011

Arzneimittelforschung

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Cetylpyridinium chloride, (CPC, CAS 123-03-5) as active ingredient of antiseptic oral mouthrinses has a broad antimicrobial spectrum with a rapid bactericidal effect on gram-positive pathogens and a fungicide effect on yeasts in particular. There are gaps in its effectiveness against gram-negative pathogens and mycobacteria. Application of CPC at a concentration of 0.05% as a mouthrinse results in an immediate reduction in bacterial counts of 2.0 to 2.5 log steps (which is adequate to > 99%). This reverts to about 1 log step (= 90%) 1 h after application. The ability of CPC to inhibit plaque and thereby reduce gingivitis is assured. In comparison to chlorhexidine, CPC has a lower residual effect, and as a result a lesser effect against plaque and gingivitis. The efficacy of CPC against oropharyngeal candidiasis is assured. CPC mouthrinses can significantly reduce infectious aerosols in dental practice, thereby protecting both staff and the patient. The balance of intra-oral bacterial flora is not disturbed even in the case of relatively long-term use of CPC (up to six weeks). Taking these properties into consideration, CPC may be considered as an alternative active ingredient in the case of chlorhexidine intolerance in the treatment and prevention of bacterial or fungal disorders of the oropharyngeal cavity. It is also of interest as an element for combination in the development of new types of oropharyngeal antiseptics.

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Measuring Harmful Levels of Bacteria in Dental Aerosols

Cited by 17 publications

References 14 publications

Methicillin‐resistant Staphylococcus aureus and infection control for restorative dental treatment in nursing homes

Methicillin‐resistant Staphylococcus aureus and infection control for restorative dental treatment in nursing homes

Aerosolization of mycobacteria and legionellae during dental treatment: low exposure despite dental unit contamination

Efficacy of Cetylpyridinium Chloride Used as Oropharyngeal Antiseptic

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