Risks of Aerosol Contamination in Dental Procedures during the Second Wave of COVID-19—Experience and Proposals of Innovative IPC in Dental Practice

Gandolfi, Maria Giovanna; Zamparini, Fausto; Spinelli, Andrea; Sambri, Vittorio; Prati, Carlo

doi:10.3390/ijerph17238954

Cited by 33 publications

(28 citation statements)

References 35 publications

(56 reference statements)

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“…Interestingly, in this paper, the WMSD prevalence is high in dental specialists (41.9%) and general practitioners (29.2%) and lower for dental hygienists (24.2%). Dentists specialists, general practitioners use highspeed and micromotor handpieces very frequently for removal of caries, root canal treatments, restorations and various other procedures [ 3 ]. Moreover, recurrent movements of the hand and fingers during use of hand files and broaches for root canal procedures lead to a repetitive stress.…”

Section: Discussionmentioning

confidence: 99%

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Musculoskeletal Disorders among Italian Dentists and Dental Hygienists

Gandolfi

Zamparini

Spinelli

et al. 2021

IJERPH

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Dental professionals often perform physically and mentally demanding therapeutical procedures. They work maintaining muscular imbalance and asymmetrical positions for a long time. The aim of the study was to describe the prevalence and the factors associated to work-related musculoskeletal disorders (WMSD) among Italian dental professionals and the most affected body regions. A cross-sectional observational study was conducted between March 2019 and February 2020. The Nordic Musculoskeletal questionnaire (NMQ) was implemented with questions related to working habits (dental occupation, working hours per week and per days, years of work) and lifestyle (practiced physical activity, including frequency and duration, mobilization activities, and knowledge of ergonomic guidelines) was used. The-chi square test was carried out to detect any statistically significant difference (p < 0.05). Logistic regression was carried out to detect the most significant factors associated to WMSD occurrence. A total of 284 questionnaires have been used for the analysis. A high proportion of dental professionals (84.6%) were affected by WMSD in the last 12 months. A higher prevalence was found in females (87%) when compared to males (80%). The prevalence of WMSD was correlated to the working hours/day and hour/week, with a higher risk for operators working >5 h/day and >30 h/week. In addition, a high prevalence was found in operators working for 2–5 years after graduation. Most of the surveyed dental professionals practiced physical activity (70.1%) but only a few had satisfactorily knowledge of ergonomic guidelines (12.7%). Interestingly, participants who practiced yoga or stretching as physical activities demonstrated lower WMSD (77%) when compared to other physical activities (84%). We can highlight that generic physical activities have no functional effect on WMSD for dental professionals. The most affected body areas were neck (59.9%), shoulders (43.3%), lumbar region (52.1%), dorsal region (37.7%) and wrists (30.6%). Considering the magnitude of the problem, there is an urgent need to implement the education in ergonomics among dental professionals, that may be achieved by teaching biomechanics, posturology and integrative functional therapies (such as yoga) during the university education and by promoting holistic health of dental operators.

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Section: Discussionmentioning

confidence: 99%

“…Moreover, with the onset of the Sars-Cov2 pandemic, the use of additional protective devices increases the mental stress, the risks of imbalanced postures and further reduces the freedom of movements [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Musculoskeletal Disorders among Italian Dentists and Dental Hygienists

Gandolfi

Zamparini

Spinelli

et al. 2021

IJERPH

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“…• Continuous vigilance to early detect and properly manage a COVID-19 case in the school • Implementation of dental AGPs with the appropriate procedures to reduce the production of aerosol • Strict compliance with infection prevention and control measures focusing on hand hygiene, appropriate use of PPE and cleaning/disinfection • Training of students and personnel in infection control practices • The Heating Ventilation and Air Conditioning (HVAC) system should fulfill at least the minimum requirements for SARS -CoV-2 in dental settings. It should be noted that new operative and clinical dental procedures and risk-scoring systems of safety protocols are being currently developed by university dental clinics and hospitals in an attempt to reduce risk for dentists, dental personnel and patients [33,34]. Similarly, there is an increasing number of publications about the benefit of specific interventions on aerosol contamination, however further studies are needed on focusing on respiratory agents such as SARS-CoV-2 [35].…”

Section: Principals For Preparing Dental Schools During the Covid-19mentioning

confidence: 99%

Preparing dental schools to refunction safely during the COVID-19 pandemic: an infection prevention and control perspective

Maltezou

Tseroni

Vorou

et al. 2021

J Infect Dev Ctries

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In late 2019 a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China and spread throughout the world over a short period of time causing a pandemic of a respiratory disease named coronavirus disease 2019 (COVID-19). SARS-CoV-2 is easily transmitted from person to person through respiratory droplets and direct contact. The scarce available data indicate that dental healthcare personnel are at increased risk for acquisition of infection. Following the lockdown lifting, dental schools should be prepared to refunction safely and provide essential educational and healthcare services while protecting their students, patients, and personnel. The generation of aerosols in dental practice, in association with the high-transmissibility of SARS-CoV-2 through aerosol-generation procedures, the simultaneous provision of dental services to patients in the same areas, and the fact that asymptomatic and pre-symptomatic infected persons may transmit the virus, render the implementation of specific infection prevention and control measures imperative for dental schools. Herein we review the few evidence-based data available to guide infection prevention and control measures for COVID-19 in dental schools.

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“…This finding conforms to our study in which the amount of aerosol was found mostly at a distance of 12-inches after 30 min and almost no aerosol at farther distances, although a significant reduction was noticed after 30 min compared to the time of immediate cavity preparation. Therefore, to reduce the risk of contamination from airborne pathogens, especially in this era of the COVID-19 pandemic, it is recommended that practitioners keep wearing their personal protective barriers after the completion of the procedure for a certain period [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Dissemination of Aerosol and Splatter in Clinical Environment during Cavity Preparation: An In Vitro Study

Ahmed¹,

Jouhar²

2021

IJERPH

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Dental health care workers around the world are in a constant state of fear and anxiety because they work in a constrained space of the dental practice. During routine dental procedures, they are exposed to aerosol and splatter. These airborne particles pose a great risk of transmitting contagious infections to health care workers and patients, especially in an era of social distancing due to COVID-19. The current study was conducted to evaluate contamination amount, duration, the distance of aerosol, and splatter produced after cavity preparation using a two-hole and four-hole handpiece. The study was performed on a dental manikin in a dental simulation laboratory at the College of Dentistry, King Faisal University Al Ahsa. The dental manikin was set to a reclined position to simulate the clinical operatory position of the patient for dental restorative procedures. Aerosol and splatter were collected on Grade 1 qualitative cotton cellulose filter paper. These were placed on adhesive tape extending from the headrest of the dental manikin in six different directions (2, 4, 6, 8, 10, and 12 o’clock) for up to 60 inches and on certain positions of the operator and assistant such as the chest, head, forearms, upper leg, and inside facemask. Class V cavity preparation was done by the principal investigator at a specific time of 3 min on tooth #11 using a two-hole high-speed handpiece, then on the next day, Class V cavity preparation was performed on tooth #21 by a four-hole handpiece. High volume suction was used throughout the cavity preparation. Immediately after cavity preparation, the first filter paper disc was replaced with new ones in all positions. The second set of filter papers was removed after 30 min. Transparent grids were used to count the contamination area on the filter paper disc. No statistically significant difference was found in the mean amount of aerosol and splatter produced by both handpieces, however, a statistically significant difference was found in an amount of aerosol and splatter produced at a 12, 24, and 36 inches distance immediately after cavity preparation and 30 min after cavity preparation, regardless of the type of handpiece used. It is advisable to refrain from removing the personal protective barriers immediately after the procedure within the vicinity of the dental practice. The use of other adjuncts such as high volume suction to reduce the spread of aerosol and splatter is also recommended.

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Risks of Aerosol Contamination in Dental Procedures during the Second Wave of COVID-19—Experience and Proposals of Innovative IPC in Dental Practice

Cited by 33 publications

References 35 publications

Musculoskeletal Disorders among Italian Dentists and Dental Hygienists

Musculoskeletal Disorders among Italian Dentists and Dental Hygienists

Preparing dental schools to refunction safely during the COVID-19 pandemic: an infection prevention and control perspective

Dissemination of Aerosol and Splatter in Clinical Environment during Cavity Preparation: An In Vitro Study

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