The effect of rubber dam on atmospheric bacterial aerosols during restorative dentistry

Abstract

Rotatory dental instruments generate atmospheric aerosols that settle on various surfaces, including the dentist's head. The aim of this study was to quantitatively assess bacterial contamination of the dentist's head and to evaluate whether it is affected by using a rubber dam. Senior dental students (n=52) were asked to wear autoclaved headscarves as collection media while performing restorative dental treatment with and without a rubber dam. Four points from each headscarf were swabbed for bacterial culture after 30min of operative work. Bacterial contamination was quantified by counting the colony-forming units. Regardless of the collection point, using a rubber dam was associated with more bacterial colony-forming units than not using a rubber dam (P=0.009). Despite its clinical value, the rubber dam seems to result in significantly higher aerosol levels on various areas of the dentist's head, requiring that dentists cover their heads with suitable protective wear.

Evaluating aerosol and splatter following dental procedures: addressing new challenges for oral healthcare and rehabilitation

“…Reassuringly, in our study splatter was greatly reduced using of suction. We demonstrated significant contamination of the operator, assistant and mannequin for all procedures, which is consistent with the findings of other investigators 33,37,40,43 . This is unsurprising and underscores the need for adequate personal protective equipment (PPE), for the operator and assistant.…”

“…The current literature regarding the risks posed by aerosols and splatter in dental settings is particularly limited. A number of authors have used microbiological methods to study bacterial contamination from aerosol and splatter following dental procedures, either by air sampling 20, 31,32 , swabbing of contaminated surfaces 33,34 , or most commonly, by collection directly onto culture media [35][36][37][38] . These studies are limited in that they only detect culturable bacteria as a marker of aerosol and splatter distribution.…”

Covid-19 outbreak and Oral Health Concerns – A Systematic Review

“…Peng et al recommends use of Carisolv, a minimally invasive chemo-mechanical removal of carious dentine and hand scaler for periodontal procedures where rubber dam is not feasible 25 . Finally, the effectiveness of rubber dam as an isolation barrier is merely dependent on the placement skills of the provider and its' technique sensitivity 45 . Peng et al emphasized use of dental hand piece with anti-retraction/anti-re ux valve to prevent aspiration of contaminated bodily uids into the tubes of hand-piece or dental unit and subsequent cross-infection 25 .…”

“…Some authors suggest wearing FFP1/standard surgical mask for non-aerosol generating procedures and FFP2/N95 or higher for aerosol generating procedures 25,27 while others suggest FFP2/N95 for all procedures for both clinical and non-clinical staff 31, 34, and 35 . A systematic review of clinical trials assessing effectiveness of N95 respirators in comparison to standard surgical mask found no additional protection in preventing in uenza 45 . The evidence from SARS-CoV research suggests that small infectious particles of up to 3 μm remain airborne inde nitely in an isolated room 48 .…”

High total volatile organic compounds pollution in a hospital dental department

“…Studies have shown that the central location of a dentist’s face (including the eyes and nasal region) are at high-risk for infection (Nejatidanesh et al 2013 ). Dental rubber barriers used in mouth during patient treatment can effectively reduce aerosol concentrations (Pina-Vaz et al 2008 ; Al-Amad et al 2016 ; Tag and El-Hady 1997 ), while patients using antibacterial mouthwash before dental treatment also proved to decrease aerosolized bacterial production effectively (Fine et al 1992 ; Molinari and Molinari 1992 ; Fine et al 1993 ).…”