Up in the Air? Future Research Strategies to Assess Aerosols in Dentistry

Geisinger, Maria L.; Iaonnidou, E

doi:10.1177/2380084420982506

Cited by 5 publications

(4 citation statements)

References 25 publications

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“…The risk assessment of pathogenic transmission through dental aerosols has been repeatedly discussed over the years due to the relevant aerosol production during the majority of dental procedures [1,2]. The current diffusion of the SARS-CoV-2 pandemic has highlighted the need for a better understanding of the dynamics and potential infectivity of dental aerosols [3].…”

Section: Introductionmentioning

confidence: 99%

Experimental Evaluation of Aerosol Production after Dental Ultrasonic Instrumentation: An Analysis on Fine Particulate Matter Perturbation

Graziani

Izzetti

Lardani

et al. 2021

IJERPH

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Aerosol production represents a major concern during the majority of dental procedures. The aim of the present study is to investigate the dynamics of aerosol particles after 15 min of continuous supragingival ultrasonic instrumentation with no attempt of containment through particle count analysis. Eight volunteers were treated with supragingival ultrasonic instrumentation of the anterior buccal region. A gravimetric impactor was positioned 1 m away and at the same height of the head of the patient. Particles of different sizes (0.3–10 µm) were measured at the beginning of instrumentation, at the end of instrumentation (EI), and then every 15 min up to 105 min. The 0.3-µm particles showed non-significant increases at 15/30 min. The 0.5–1-µm particles increased at EI (p < 0.05), and 0.5 µm remained high for another 15 min. Overall, all submicron aerosol particles showed a slow decrease to normal values. Particles measuring 3–5 µm showed non-significant increases at EI. Particles measuring 10 µm did not show any increases but a continuous reduction (p < 0.001 versus 0.3 µm, p < 0.01 versus 0.5 µm, and p < 0.05 versus 1–3 µm). Aerosol particles behaved differently according to their dimensions. Submicron aerosols peaked after instrumentation and slowly decreased after the end of instrumentation, whilst larger particles did not show any significant increases. This experimental study produces a benchmark for the measurement of aerosol particles during dental procedures and raises some relevant concerns about indoor air quality after instrumentation.

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Section: Introductionmentioning

confidence: 99%

Experimental Evaluation of Aerosol Production after Dental Ultrasonic Instrumentation: An Analysis on Fine Particulate Matter Perturbation

Graziani

Izzetti

Lardani

et al. 2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…no cases of transmission by aerosols have been identified in these environments [16,31]. This suggests that considering the use of individual protection equipment such as filtering facepiece respirators and face shields, the airborne infection may not be a significant concern in dental practice.…”

Section: Discussionmentioning

confidence: 99%

“…Droplet and aerosol generation in dental practice has long been a traditional research agenda [14,15]. Droplet and aerosol size are significant in assessing the risk of droplet and airborne infections, and more studies on how and to what extent aerosols are produced from aerosol-generating dental procedures (AGDPs) are required to verify infectivity in confined areas [16]. Previous studies on droplet and aerosol size distinguish "aerosols" from "droplets" at a threshold of 5 µm; "droplets" larger than 5 µm can cause droplet infections but fall quickly under gravity to within 1 meter of the source.…”

Section: Introductionmentioning

confidence: 99%

Particle Size Analysis in Aerosol-Generating Dental Procedures Using Laser Diffraction Technique

Onoyama

Matsui

Kikuchi

et al. 2022

Front. Oral. Health

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The global outbreak of coronavirus disease 2019 (COVID-19) has raised concerns about the risk of airborne infection during dental treatment. Aerosol-generating dental procedures (AGDP) produce droplets and aerosols, but the details of the risks of COVID-19 transmission in AGDP are not well-understood. By discriminating between droplets and aerosols, we devised a method to measure particle size using laser diffraction analysis and evaluated aerosols generated from dental devices for providing a basis for proper infection control procedures. The droplets and aerosols generated from dental devices were characterized by multimodal properties and a wide range of droplet sizes, with the majority of droplets larger than 50 μm. AGDP emitted few aerosols smaller than 5 μm, which are of concern for pulmonary infections due to airborne transmission. In addition, the use of extraoral suction was found to prevent the spread of aerosols from high-speed dental engines. This study suggests that the risk of aerosol infections is considerably limited in regular dental practice and that current standard precautions, such as mainly focusing on protection against droplet and contact infections, are sufficient. While several cases of airborne transmission of COVID-19 in general clinics and emergency hospitals have been reported, cluster outbreaks in dental clinics have not yet been reported, which may indicate that AGDP does not pose a significant threat in contributing to the spread of SARS-CoV-2.

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“…In particular, the current diffusion of the SARS-CoV-2 pandemic has highlighted the risk of potential infectivity of dental aerosols [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a Water Disinfection Method Based on Osmosis and Chlorine Dioxide for the Prevention of Microbial Contamination in Dental Practices

Totaro

Badalucco

Papini

et al. 2022

IJERPH

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In dental clinics, the infections may be acquired through contaminated devices, air, and water. Aerosolized water may contain bacteria, grown into the biofilm of dental unit waterlines (DUWLs). We evaluated a disinfection method based on water osmosis and chlorination with chlorine dioxide (O-CD), applied to DUWL of five dental clinics. Municipal water was chlorinated with O-CD device before feeding all DUWLs. Samplings were performed on water/air samples in order to research total microbial counts at 22–37 °C, Pseudomonas aeruginosa, Legionella spp., and chlorine values. Water was collected from the taps, spittoons, and air/water syringes. Air was sampled before, during, and after 15 min of aerosolizing procedure. Legionella and P. aeruginosa resulted as absent in all water samples, which presented total microbial counts almost always at 0 CFU/mL. Mean values of total chlorine ranged from 0.18–0.23 mg/L. Air samples resulted as free from Legionella spp. and Pseudomonas aeruginosa. Total microbial counts decreased from the pre-aerosolizing (mean 2.1 × 102 CFU/m3) to the post-aerosolizing samples (mean 1.5 × 10 CFU/m3), while chlorine values increased from 0 to 0.06 mg/L. O-CD resulted as effective against the biofilm formation in DUWLs. The presence of residual activity of chlorine dioxide also allowed the bacteria reduction from air, at least at one meter from the aerosolizing source.

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Up in the Air? Future Research Strategies to Assess Aerosols in Dentistry

Cited by 5 publications

References 25 publications

Experimental Evaluation of Aerosol Production after Dental Ultrasonic Instrumentation: An Analysis on Fine Particulate Matter Perturbation

Experimental Evaluation of Aerosol Production after Dental Ultrasonic Instrumentation: An Analysis on Fine Particulate Matter Perturbation

Particle Size Analysis in Aerosol-Generating Dental Procedures Using Laser Diffraction Technique

Effectiveness of a Water Disinfection Method Based on Osmosis and Chlorine Dioxide for the Prevention of Microbial Contamination in Dental Practices

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