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Comparison of aerosol mitigation strategies and aerosol persistence in dental environments

Published online by Cambridge University Press:  20 April 2022

Shruti Choudhary
Affiliation:
Aerosol and Air Quality Research Laboratory, Department of Chemical, Environmental and Material Engineering, University of Miami, Miami, Florida, United States
Michael J. Durkin
Affiliation:
Division of Infectious Disease, Washington University School of Medicine, St. Louis, Missouri, United States
Daniel C. Stoeckel
Affiliation:
St. Louis University Center for Advanced Dental Education, St. Louis University, St. Louis, Missouri, United States
Heidi M. Steinkamp
Affiliation:
St. Louis University Center for Advanced Dental Education, St. Louis University, St. Louis, Missouri, United States
Martin H. Thornhill
Affiliation:
The School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom Department of Oral Medicine, Carolinas Medical Center, Atrium Health, North Carolina, United States
Peter B. Lockhart
Affiliation:
Department of Oral Medicine, Carolinas Medical Center, Atrium Health, North Carolina, United States
Hilary M. Babcock
Affiliation:
Division of Infectious Disease, Washington University School of Medicine, St. Louis, Missouri, United States
Jennie H. Kwon
Affiliation:
Division of Infectious Disease, Washington University School of Medicine, St. Louis, Missouri, United States
Stephen Y. Liang
Affiliation:
Division of Infectious Disease, Washington University School of Medicine, St. Louis, Missouri, United States Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri, United States
Pratim Biswas*
Affiliation:
Aerosol and Air Quality Research Laboratory, Department of Chemical, Environmental and Material Engineering, University of Miami, Miami, Florida, United States
*
Author for correspondence: Pratim Biswas, Email: pbiswas@miami.edu

Abstract

Objective:

To determine the impact of various aerosol mitigation interventions and to establish duration of aerosol persistence in a variety of dental clinic configurations.

Methods:

We performed aerosol measurement studies in endodontic, orthodontic, periodontic, pediatric, and general dentistry clinics. We used an optical aerosol spectrometer and wearable particulate matter sensors to measure real-time aerosol concentration from the vantage point of the dentist during routine care in a variety of clinic configurations (eg, open bay, single room, partitioned operatories). We compared the impact of aerosol mitigation strategies (eg, ventilation and high-volume evacuation (HVE), and prevalence of particulate matter) in the dental clinic environment before, during, and after high-speed drilling, slow–speed drilling, and ultrasonic scaling procedures.

Results:

Conical and ISOVAC HVE were superior to standard-tip evacuation for aerosol-generating procedures. When aerosols were detected in the environment, they were rapidly dispersed within minutes of completing the aerosol-generating procedure. Few aerosols were detected in dental clinics, regardless of configuration, when conical and ISOVAC HVE were used.

Conclusions:

Dentists should consider using conical or ISOVAC HVE rather than standard-tip evacuators to reduce aerosols generated during routine clinical practice. Furthermore, when such effective aerosol mitigation strategies are employed, dentists need not leave dental chairs fallow between patients because aerosols are rapidly dispersed.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

PREVIOUS PRESENTATION. The preliminary data from this study were presented in the National Dental Practiced-Based Research Network webinar on Friday May 21, 2021.

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