Aerosol exposure of staff during dental treatments: a model study

Abstract

Background Due to exposure to potentially infectious aerosols during treatments, the dental personnel is considered being at high risk for aerosol transmitted diseases like COVID-19. The aim of this study was to evaluate aerosol exposure during different dental treatments as well as the efficacy of dental suction to reduce aerosol spreading. Methods Dental powder-jet (PJ; Air-Flow®), a water-cooled dental handpiece with a diamond bur (HP) and water-cooled ultrasonic scaling (US) were used in a simulation head, mounted on a dental unit in various treatment settings. The influence of the use of a small saliva ejector (SE) and high-volume suction (HVS) was evaluated. As a proxy of aerosols, air-born particles (PM10) were detected using a Laser Spectrometer in 30 cm distance from the mouth. As control, background particle counts (BC) were measured before and after experiments. Results With only SE, integrated aerosol levels [median (Q25/Q75) µg/m3 s] for PJ [91,246 (58,213/118,386) µg/m3 s, p < 0.001, ANOVA] were significantly increased compared to BC [7243 (6501/8407) µg/m3 s], whilst HP [11,119 (7190/17,234) µg/m3 s, p > 0.05] and US [6558 (6002/7066) µg/m3 s; p > 0.05] did not increase aerosol levels significantly. The use of HVS significantly decreased aerosol exposure for PJ [37,170 (29,634/51,719) µg/m3 s; p < 0.01] and HP [5476 (5066/5638) µg/m3 s; p < 0.001] compared to SE only, even reaching lower particle counts than BC levels for HP usage (p < 0.001). Conclusions To reduce the exposure to potentially infectious aerosols, HVS should be used during aerosol-forming dental treatments.

Visualization of droplets and aerosols in simulated dental treatments to clarify the effectiveness of oral suction devices

“…Our results are concordant with those of previous reports in that the combination of IOS and EOS reduces aerosols more than that of IOS alone [37,38]. IOS spreads aerosols faster during high-speed handpiece preparation and powder jet cleaning than in saliva drainage tubes [39]. EOS is particularly effective in reducing the number of smaller-sized particles (0.1-0.3 µm) [40].…”

“…No consensus has been attained regarding the optimal EOS location. In previous reports, the EOS suction hood was set primarily 10-40 cm from the patient's mouth [37][38][39][40][41][42][43]. In this study, the EOS was set 10 cm above the patient's mouth, which might have resulted in a significant effect.…”

Comparative Dissemination of Aerosol and Splatter Using Suction Device during Ultrasonic Scaling: A Pilot Study

“…The generation of aerosol and splatter creates a significant risk for airborne contamination within the dental clinic [ 1 , 2 , 3 , 4 ]. Most routine dental treatments are aerosol-generating procedures that produce a mixture of splatter and aerosols that contain saliva, blood, and viable microorganisms (including bacteria and viruses) [ 1 , 5 ].…”

“…Furthermore, the faculty of dentistry does not provide each dental student with a dental assistant. Moreover, dental work is a difficult process that necessitates a good view of the operation field, and the procedures are frequently associated with patient saliva, dispersed aerosol, and splatter [ 1 , 2 , 3 ]. Moreover, aerosol and splatter are carriers of infection from the blood and saliva [ 4 ].…”

Aerosol Reduction of 2 Dental Extraoral Scavenger Devices In Vitro

“…This study compared two commercially available EOSs in terms of their efficacy in aerosol control. Such devices are getting widespread, and while some studies suggested that their use is not absolutely necessary for good aerosol control 20 , there is an agreement in the literature that they are efficient and increase the safety of the dental operatory 21 , 22 , 23 , 24 . The results of a previous study of our own group corroborate this 16 .…”