Quantitative measurements of aerosols from air-polishing and ultrasonic devices: (How) can we protect ourselves?

Abstract

Aim To assess the distribution and deposition of aerosols during simulated periodontal therapy. Methods A manikin with simulated fluorescein salivation was treated by four experienced dentists applying two different periodontal treatment options, i.e. air-polishing with an airflow device or ultrasonic scaling in the upper and lower anterior front for 5 minutes, respectively. Aerosol deposition was quantitatively measured on 21 pre-defined locations with varying distances to the manikins mouth in triplicates using absorbent filter papers. Results The selected periodontal interventions resulted in different contamination levels around the patient’s mouth. The highest contamination could be measured on probes on the patient’s chest and forehead but also on the practitioner’s glove. With increasing distance to the working site contamination of the probes decreased with both devices. Air-polishing led to greater contamination than ultrasonic. Conclusion Both devices showed contamination of the nearby structures, less contamination was detected when using the ultrasonic. Affirming the value of wearing protective equipment we support the need for universal barrier precautions and effective routine infection control in dental practice.

The efficacy of an extraoral scavenging device on reducing aerosol particles ≤ 5 µm during dental aerosol-generating procedures: an exploratory pilot study in a university setting

“…Moreover, we assumed that larger droplets and particles would be immediately reduced near the mouth opening or may be eliminated by the high-flow suction system with a 16-mm intraoral cannula. 10 , 12 A recent meta-analysis with four RCTs found similar effects for high-volume evacuators, which reduced contamination in aerosols near the patient’s mouth (~0.3 m) but not at longer distances. 13 Surprisingly, one split-mouth RCT found no significant difference in the efficacy of reducing aerosols by the use of a high-volume evacuator compared to a conventional dental suction with a saliva ejector or a low-volume evacuator at 0.4 or 1.5 m with ultrasonic scaling as the AGP.…”

Characterization and mitigation of aerosols and splatters from ultrasonic scalers

“…There is a serious deficiency in the literature regarding the risks posed by aerosols and splatter from aerosol-generating procedures (AGPs) in dental settings and the efficacy of various aerosol mitigation techniques. A number of studies have collected aerosols and splatters directly onto a collecting surface for subsequent analysis, which include fluorescent [13][14][15][16][17] or non-fluorescent [18][19][20] based chromatic indicators and microbiological methods using culture media [21][22][23][24] . These studies are limited by their inefficient collection of small size aerosols (<~50 µm) which do not provide a comprehensive characterization over the entire size spectrum.…”

Effect of spray air settings of speed-increasing contra-angle handpieces on intrapulpal temperatures, drilling times, and coolant spray pattern

“…The current COVID-19 pandemic caused by the coronavirus (SARS-CoV-2) has demonstrated the importance of and concerns regarding existing infection control measures for dental healthcare professionals, as they have an extremely high risk of becoming infected with SARS-CoV-2 [ 6 , 12 ]. Current preventative protocols recommend patient triage, preoperative mouth rinses, hand hygiene, personal protective equipment, rubber dam isolation, cleaning of contaminated surfaces, and limitation of aerosol-producing procedures [ 3 , 5 , 11 – 13 ]. Since dental aerosols and droplets can be primary causes of disease transmission, there are some specific recommendations for reducing aerosol spray [ 16 – 18 ].…”

“…Furthermore, the saliva of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contains this virus, regardless of the presence of symptoms [ 7 – 10 ]. Infected patients may have 9.9 × 10 2 –1.2 × 10 8 viral copies per mL of saliva [ 7 , 11 ]. Furthermore, salivary viral load can be detected up to 25 days after the onset of symptoms [ 7 , 11 ].…”

“…Infected patients may have 9.9 × 10 2 –1.2 × 10 8 viral copies per mL of saliva [ 7 , 11 ]. Furthermore, salivary viral load can be detected up to 25 days after the onset of symptoms [ 7 , 11 ].…”