Transmission of infection or disease during aerosol generating processes (AGP) such as high speed drilling has been an increasing concern to the dental profession. The reason is the risk of direct contact with saliva or blood, contact with contaminated instruments or surfaces that have been improperly sterilized, or respiratory fluids that may become aerosols during operative dentistry.
Dental clinics might pose risks for both patients and dental healthcare workers. The aerosols and splatter produced during dental procedures have the potential to spread infection to both dental personnel and patients. Transmission of microorganisms may occur by direct contact with contaminated tissues or instruments. Also direct contact with saliva, blood or aerosol particles from saliva and respiratory fluids might transmit infection.
In infection control as well as in occupational health aerosols are important considerations. Aerosols may carry potentially hazardous microbes, viruses, allergens and other toxic substances that may harm the dental operator, patient, and the dental assistant by causing infections. The propelling force of a high-speed dental drill, for example, being used in combination with a water spray, generate airborne particles which can be derived from blood, tooth debris, dental plaque, saliva, restorative materials and more.
Reducing the risk of contamination
Several options can be considered in the control of dental aerosols in the clinics. Equipment producing less aerosols might be used but hard to obtain, and additional barriers such as respirator masks or face shields could be used. Another example of ways of to reduce the contamination risk is extraction of the aerosols at or close to the source since most of the aerosols have been found to radiate toward the patient's chest and the operator, as well the dental assistant's face.
- Face masks - A well-fitting surgical facemask is preferable to the paper type which rapidly can becomes permeable and inefficient.
- Eye protection - Protect eyes against splatter and aerosols which may arise during operative dentistry.
- Protective clothing - Wear protective clothing which covers areas that can be contaminated.
- Surface cleaning and decontamination - The area around the dental unit becomes contaminated for example by direct splatter and by touching surfaces with gloved hands. Cleaning the surface prevents transmission of infection by direct contact with hands and equipment.
- Extraction and ventilation - Good ventilation and source extraction which exhaust the aerosol reduce the risk of cross-infection and cross-contamination.
It is difficult to completely eliminate the risk posed by dental aerosols, but it is possible to minimize the risk with relatively simple precautions. Routine use of standard barriers such as masks and gloves, the universal use of pre-procedural rinses, high-volume evacuation and source extraction are potential solutions for reducing the risks.
