Effectiveness of a pre-procedural mouthwash in reducing bacteria in dental aerosols: randomized clinical trial

Retamal‐Valdes, Belén; Soares, Geisla Mary Silva; Stewart, Bernal; Figueiredo, Luciene Cristina; Faveri, Marcelo; Miller, S; Zhang, Yun Po; Feres, Magda

doi:10.1590/1807-3107bor-2017.vol31.0021

Cited by 50 publications

(80 citation statements)

References 34 publications

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“…Variations in the components of aerosol occur with the operative site and patient and can include blood, plaque/calculus, saliva, nasopharyngeal secretions, tooth components and any dental material, such as abrasives for air polishing, used during the procedure [13]. Ultrasonic scalers, Dental hand pieces, air polishers and air abrasion units are the greatest aerosols producing devices [14].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Two Mouth Rinses in Reducing Aerosol Bacterial Load during Ultrasonic Scaling

Anjum

Hosein

Butt

et al. 2019

JAMMR

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Aims:The aim of this study was to compare the efficacy of two mouth washes namely Chlorhexidine 0.2% and 5% green tea mouth rinse when used as pre-procedural rinses in reducing the number of CFU in aerosol generated during ultrasonic scaling. Methodology: 70 subjects were recruited in this study (43 males, 27 females: age range 18-65 years with presence of minimum 20 permanent functional teeth, less than 5 mm mean probing depth and plaque and gingival score between 1-3. Subjects were randomly divided into two groups, group 1 and group 2. Each group comprised of 35 patients. A split mouth design technique was used for collecting the aerosol samples on blood agar Anjum et al.; JAMMR, 31 (7): 1-9, 2019; Article no.JAMMR.53094 2 plates. For every patient, there was a control side and test side of mouth. Ultrasonic scaling was done on control side without pre procedural rinsing and vice versa. Group 1 used 0.2% Chlorhexidine while group 2 rinsed with 5% green tea mouthwash. The blood agar plates were then transported to Microbiology lab and incubated for counting the colony forming units (CFU). Results: Significant reduction of CFU occurred with pre procedural rinsing with both mouthwashes as compared to non-rinsing before ultrasonic scaling and 0.2% Chlorhexidine found to be superior to 5% green tea in reducing bacterial load in aerosol samples Conclusion: Pre procedural mouth rinsing with effective mouthwashes significantly reduces aerosol contamination and should be used before all dental procedures that results in formation of aerosols and splatters along with some other infection control protocol to minimize the risks of cross infection in clinical settings. Original Research Article

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Section: Introductionmentioning

confidence: 99%

Efficacy of Two Mouth Rinses in Reducing Aerosol Bacterial Load during Ultrasonic Scaling

Anjum

Hosein

Butt

et al. 2019

JAMMR

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“…15 Fusobacterium family pathogens have been identified in aerosols produced after ultrasonic scaling in practice through checkerboard DNA-DNA hybridization techniques. 16,17 Of the family, Fusobacterium nucleatum has been identified as a bacterium related to pathologic, ophthalmic, and respiratory implications, while also inductive of cellular apoptosis in vivo. 18,19 In addition, it has been reported as related to the launch and progression of periodontitis, or as attenuating attribute of gingival fibroblast mesenchymal cell proliferation.…”

Section: Microbiologic Considerations and Bio-aerosolsmentioning

confidence: 99%

“…Nonetheless, studies assessing mostly periodontal pathogens have identified an increased prevalence of species belonging to the so-called orange complex in aerosols generated during usage of ultrasonic scaler. 16 , 17 These mostly pertained to Campylobacter rectus , Prevotella intermedia, and others, including F. periodonticum in addition to F. nucleatum . Apart from directly exposed aerosolized bacteria, another potential contamination source within dental offices or in hospital based dental units has been identified and special attention has been placed to the presence of Legionella pneumophilla as well as Pseudomonas spp in DUWLs.…”

Section: Microbiologic Considerations and Bio-aerosolsmentioning

confidence: 99%

“…The vast majority have studied in-service utilization of ultrasonic scaling, whereas some have reported on orthodontic related strategies of debonding procedures, or other dental prophylaxis or restorative procedures. 17 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 Largescale efforts have been lately endorsed to collectively appraise all available evidence and provide justifiable ranking of the efficiency of these methods. 35 , 36 The most prevalent recorded approaches were preprocedural mouth rinse using a wide variety of potentially antimicrobial agents, such as, chlorhexidine (CHX) 0.12%, CHX 0.2% or tempered CHX 0.2%, cetylpiridinium chloride 0.05%, povidone iodine (PI) 1%, chlorine dioxide, herbal-based agents, or others pertaining to ozone irrigation, use of high volume evacuators and/or dental isolation systems, or agents added to DUWLs to reduce the load.…”

Section: Microbiologic Considerations and Bio-aerosolsmentioning

confidence: 99%

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Minimizing the aerosol-generating procedures in orthodontics in the era of a pandemic: Current evidence on the reduction of hazardous effects for the treatment team and patients

Eliades

Koletsi

2020

American Journal of Orthodontics and Dentofacial Orthopedics

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The purpose of this critical review is to list the sources of aerosol production during orthodontic standard procedure, analyze the constituent components of aerosol and their dependency on modes of grinding, the presence of water and type of bur, and suggest a method to minimize the quantity and detrimental characteristics of the particles comprising the solid matter of aerosol. Minimization of water-spray syringe utilization for rinsing is suggested on bonding related procedures, while temporal conditions as represented by seasonal epidemics should be considered for the decision of intervention scheme provided as a preprocedural mouth rinse, in an attempt to reduce the load of aerosolized pathogens. In normal conditions, chlorhexidine 0.2%, preferably under elevated temperature state should be prioritized for reducing bacterial counts. In the presence of oxidation vulnerable viruses within the community, substitute strategies might be represented by the use of povidone iodine 0.2%-1%, or hydrogen peroxide 1%. After debonding, extensive material grinding, as well as aligner related attachment clean-up, should involve the use of carbide tungsten burs under water cooling conditions for cutting efficiency enhancement, duration restriction of the procedure, as well as reduction of aerosolized nanoparticles. In this respect, selection strategies of malocclusions eligible for aligner treatment should be reconsidered and future perspectives may entail careful and more restricted utilization of attachment grips. For more limited clean-up procedures, such as grinding of minimal amounts of adhesive remnants, or individualized bracket debonding in the course of treatment, handinstruments for remnant removal might well represent an effective strategy. Efforts to minimize the use of rotary instrumentation in orthodontic settings might also lead the way for future solutions. Measures of self-protection for the treatment team should never be neglected. Dressing gowns and facemasks with filter protection layers, appropriate ventilation and fresh air flow within the operating room comprise significant links to the overall picture of practice management. Risk management considerations should be constant, but also updated as new material applications come into play, while being grounded on the best available evidence.

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“…[69101112] Extensive research conducted with respect to the use of preprocedural antibacterial mouthrinses has shown positive results. [12131415]…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of the chlorhexidine and cinnamon extract as ultrasonic coolant for reduction of bacterial load in dental aerosols

Sethi

Mamajiwala

Mahale

et al. 2019

J Indian Soc Periodontol

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Background: Ultrasonic instruments generate aerosols with significantly greater number of bacteria. Preprocedural mouthrinses or chemotherapeutic coolants are used for the reduction of bacterial load in dental aerosols. The use of chlorhexidine as an ultrasonic coolant has been well established. However, this application has not yet been investigated for cinnamon extract which is known to have antibacterial and anti-inflammatory properties in vivo . Aim: The aim of this study is to compare and evaluate the efficacy of chlorhexidine and cinnamon extract as an ultrasonic coolant in reduction of aerosol contamination and biofilm formation during ultrasonic scaling in comparison with the distilled water (DW). Materials and Methods: Sixty patients diagnosed with moderate-to-severe gingivitis were randomly divided into three groups of twenty patients each undergoing ultrasonic scaling. For Group I, chlorhexidine was used as an ultrasonic coolant; for Group II, cinnamon extract was used; and Group III was served as control where DW was used. The aerosols from ultrasonic units were collected on two blood agar plates at three different positions. Both the plates from each position were incubated aerobically for 48 h. The total number of colony-forming units were counted as mean ± standard deviation and statistically analyzed. In addition, biofilm sampling of dental unit waterlines (DUWLs) was also done to evaluate the effect of these antimicrobials. Apart from microbial examination, clinical parameters such as plaque index and gingival index were also evaluated at baseline and 1-month follow-up. Results: Chlorhexidine and cinnamon both were equally effective ( P > 0.05) in reducing the bacterial count in aerosols and biofilm in DUWL as compared to DW when used as ultrasonic cooling agent. Conclusion: Both cinnamon and chlorhexidine used as an ultrasonic device coolant through DUWLs effectively helped in the reduction of bacterial count in dental aerosols.

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Effectiveness of a pre-procedural mouthwash in reducing bacteria in dental aerosols: randomized clinical trial

Cited by 50 publications

References 34 publications

Efficacy of Two Mouth Rinses in Reducing Aerosol Bacterial Load during Ultrasonic Scaling

Efficacy of Two Mouth Rinses in Reducing Aerosol Bacterial Load during Ultrasonic Scaling

Minimizing the aerosol-generating procedures in orthodontics in the era of a pandemic: Current evidence on the reduction of hazardous effects for the treatment team and patients

Comparative evaluation of the chlorhexidine and cinnamon extract as ultrasonic coolant for reduction of bacterial load in dental aerosols

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