Perioral Aerosol Sequestration Suction Device Effectively Reduces Biological Cross-Contamination in Dental Procedures

Abstract

Objective The infection risk during dental procedures is a common concern for dental professionals which has increased due to coronavirus (severe acute respiratory syndrome coronavirus 2) pandemic. The development of devices to specifically mitigate cross-contamination by droplet/splatter is crucial to stop infection transmission. The objective of this study is to assess the effectiveness of a perioral suction device (Oral BioFilter, OBF) to reduce biological contamination spread during dental procedures. Materials and Methods Forty patients were randomized 1:1 to a standard professional dental hygiene treatment with OBF and without. Adenosine triphosphate (ATP) bioluminescence assay was used to evaluate the spread of potential contaminants. The total number of relative light units (RLU) from key dental operatory locations: operator’s face-shield, back of the surgical operator’s-gloves, patient’s safety-goggles, and instrumental table were measured. Percentage contamination reductions between control and OBF were compared. Statistical Analysis Primary outcome, total RLU, was analyzed by comparing the means of logged data, using a two-sided two-sample t-test. Secondary outcomes as RLU of logged data for the different locations were analyzed in the same way. Proportion of patients from whom different locations reported events (clean, acceptable, and failure) were analyzed by using Fisher’s exact test. Results For the whole dental environment, RLUs reduction (<150 units) achieved with OBF was 98.4% (97.4–99%). By dental operatory location the reduction in RLUs was from 99.6%, on the operator face-shield, to 83% on instrumental table. The control group reported a very high percentage of failures, (>300) being 100% on the surfaces closer to the patient’s mouth and decreasing to 70% on instrumental table. In contrast, the higher failure percentage in the OBF group was found on the patient’s goggles (40%), while the operator face-shield showed an absence of contamination. Conclusion OBF device has shown efficient reduction of biological aerosol cross-contamination during dental procedures as proved by ATP-bioluminescence assay. Nevertheless, for maximum safety, its use must be combined with standard protective gear such as goggles, face shield, and surgical gloves.

Novel use of riboflavin as a fluorescent tracer in the dissemination of aerosol and splatter in an open operatory dental clinic

“…In this study, we observed similar contamination patterns across all suction groups. This is consistent with other reported findings where the use of a saliva ejector (low‐volume suction), high‐volume suction, and extraoral suction results in a reduction of ≤96% of particles generated (Lloro et al, 2021 ; Ou et al, 2021 ; Puljich et al, 2022 ). When comparing saliva ejector to high‐volume suction contamination, the difference was found to be minimal between these groups (D'Antonio et al, 2022 ; Holloman et al, 2015 ; Melzow et al, 2022 ; Yang et al, 2021 ).…”

“…In the present study, we focused on the dissemination of droplets and aerosol from an ultrasonic scaler, which has been reported to be the main sources of aerosol and splatter generation in a dental practice (Haffner et al, 2021 ). While other studies commonly used fluorescein, adenosine triphosphate, citric acid, or bacteria as tracers for measuring dispersal, our study is novel in that we are the first to use riboflavin in live patient volunteers (Holliday et al, 2021 ; Lloro et al, 2021 ; Puljich et al, 2022 ; Shahdad et al, 2020 ; Watanabe et al, 2018 ).…”

The Efficacy of High-Volume Evacuators and Extraoral Vacuum Aspirators in Reducing Aerosol and Droplet in Ultrasonic Scaling Procedures during the COVID-19 Pandemic

“…7,8 Dental procedures that generate aerosols ("aerosolgenerating procedures") are considered as high-risk mode of SARS-CoV-2 airborne transmission. 4,9 Several reports indicate that ultrasonic scaling procedures are one of the largest major sources of aerosols and droplets 10 that are mainly contaminated with bacteria and viruses. 11 Therefore, safety and infection control procedures are very important to minimize the risk of transmission, one of which is by reducing the number of aerosols and droplets.…”

Bacterial contamination potential of personal protective equipment itself in dental aerosol-producing treatments

“…However, it should be noted that the selected protective device is unhandy for everyday use and also not patient compatible. With a suction device (perioral suction device, Oral BioFilter) for perioral aerosol deposition during dental hygiene treatment, contamination of face shields can be prevented as one study showed [ 67 ].…”