Role of preprocedural rinse and high volume evacuator in reducing bacterial contamination in bioaerosols

Narayana, T. V.; Mohanty, Leeky; Sreenath, G; Vidhyadhari, Pavani

doi:10.4103/0973-029x.180931

Cited by 45 publications

(29 citation statements)

References 15 publications

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“…Of the periodontal papers, the majority only looked at one type of periodontal procedure. At total of 44 papers examined ultrasonic scaling, 20 , 32 – 50 , 52 , 53 , 55 – 58 , 60 – 67 , 69 – 72 , 74 – 79 a further four considered air polishing, 51 , 54 , 59 , 68 two looked at prophylaxis, 16 , 53 and three studies involved hand scaling. 16 , 62 , 73 No papers were identified for surgical periodontal procedures.…”

Section: Resultsmentioning

confidence: 99%

Dental periodontal procedures: a systematic review of contamination (splatter, droplets and aerosol) in relation to COVID-19

et al. 2021

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Introduction The emergence of the SARS-CoV-2 virus and subsequent COVID-19 pandemic has had a significant effect on the delivery of routine dentistry; and in particular, periodontal care across the world. This systematic review examines the literature relating to splatter, droplet settle and aerosol for periodontal procedures and forms part of a wider body of research to understand the risk of contamination in relation to periodontal care procedures relevant to COVID-19. Methods A search of the literature was carried out using key terms and MeSH words relating to the review questions. Sources included Medline (OVID), Embase (OVID), Cochrane Central Register of Controlled Trials, Scopus, Web of Science and LILACS, ClinicalTrials.Gov. Studies meeting inclusion criteria were screened in duplicate and data extraction was carried out using a template. All studies were assessed for methodological quality and sensitivity. Narrative synthesis was undertaken. Results Fifty studies were included in the review with procedures including ultrasonic scaling (n = 44), air polishing (n = 4), prophylaxis (n = 2) and hand scaling (n = 3). Outcomes included bacterial (colony-forming units e.g. on settle plates) or blood contamination (e.g. visible splatter) and non bacterial, non blood (e.g. chemiluminescence or coloured dyes) contamination. All studies found contamination at all sites although the contamination associated with hand scaling was very low. Contamination was identified in all of the studies even where suction was used at baseline. Higher power settings created greater contamination. Distribution of contamination varied in relation to operator position and was found on the operator, patient and assistant with higher levels around the head of the operator and the mouth and chest of the patient. Settle was identified 30 min after treatments had finished but returned to background levels when measured at or after an hour. The evidence was generally low to medium quality and likely to underestimate contamination. Conclusion Ultrasonic scaling, air polishing and prophylaxis procedures produce contamination (splatter, droplets and aerosol) in the presence of suction, with a small amount of evidence showing droplets taking between 30 min and 1 h to settle. Consideration should be given to infection control, areas of cleaning particularly around the patient and appropriate personal protective equipment, with particular attention to respiratory, facial and body protection for these procedures. In addition, the use of lower power settings should be considered to reduce the amount and spread of contamination.

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Section: Resultsmentioning

confidence: 99%

Dental periodontal procedures: a systematic review of contamination (splatter, droplets and aerosol) in relation to COVID-19

et al. 2021

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“…High-volume evacuators (HVEs) are also very effective in minimizing bioaerosol contamination. Additionally, experts highlight that individual methods such as HVE and CHX mouth rinse are very effective at decreasing dental bioaerosols; however, a combination of both methods is even more effective [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Do exposures to aerosols pose a risk to dental professionals?

Kobza

Brągoszewska

2018

Occupational Medicine

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BackgroundDental care professionals are exposed to aerosols from the oral cavity of patients containing several pathogenic microorganisms. Bioaerosols generated during dental treatment are a potential hazard to dental staff, and there have been growing concerns about their role in transmission of various airborne infections and about reducing the risk of contamination.AimsTo investigate qualitatively and quantitatively the bacterial and fungal aerosols before and during clinical sessions in two dental offices compared with controls.MethodsAn extra-oral evacuator system was used to measure bacterial and fungal aerosols. Macroscopic and microscopic analysis of bacterial species and fungal strains was performed and strains of bacteria and fungi were identified based on their metabolic properties using biochemical tests.ResultsThirty-three bioaerosol samples were obtained. Quantitative and qualitative evaluation showed that during treatment, there is a significant increase in airborne concentration of bacteria and fungi. The microflora included mainly gram-positive organisms (Staphylococcus epidermidis and Micrococcus spp.), gram-positive rod-shaped bacteria and those creating endospores as well as non-porous bacteria and mould fungi (Cladosporium and Penicillium).ConclusionsExposure to the microorganisms identified is not a significant occupational hazard for dental care professionals; however, evidence-based prevention measures are recommended.

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“…• Aerosol dispersion should be minimised by adjusting dental treatment procedures, for example by using hand instruments instead of water-cooled instruments or ultrasonic cleaning devices (Harrel, Barnes, & Rivera-Hidalgo, 1998). In addition, adequate saliva as well as aerosol extraction using high volume evacuation is important to minimise aerosol production (Devker et al, 2012;Narayana, Mohanty, Sreenath, & Vidhyadhari, 2016). Procedures that provoke gag reflexes or coughing should be avoided if possible (Meng et al, 2020a).…”

Section: Administrative Controls: Changing the Way Dhcws Organise Tmentioning

confidence: 99%

Infection control in dental health care during and after the SARS‐CoV‐2 outbreak

et al. 2020

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COVID‐19 is an emerging infectious disease caused by the widespread transmission of the coronavirus SARS‐CoV‐2. Some of those infected become seriously ill. Others do not show any symptoms, but can still contribute to transmission of the virus. SARS‐CoV‐2 is excreted in the oral cavity and can be spread via aerosols. Aerosol generating procedures in dental health care can increase the risk of transmission of the virus. Due to the risk of infection of both dental healthcare workers and patients, additional infection control measures for all patients are strongly recommended when providing dental health care. Consideration should be given to which infection control measures are necessary when providing care in both the current situation and in the future.

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Role of preprocedural rinse and high volume evacuator in reducing bacterial contamination in bioaerosols

Cited by 45 publications

References 15 publications

Dental periodontal procedures: a systematic review of contamination (splatter, droplets and aerosol) in relation to COVID-19

Dental periodontal procedures: a systematic review of contamination (splatter, droplets and aerosol) in relation to COVID-19

Do exposures to aerosols pose a risk to dental professionals?

Infection control in dental health care during and after the SARS‐CoV‐2 outbreak

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