AEROSOLS
IN DENTISTRY
Veronika Chuchmová
394229@mail.muni.cz
Department of Public Health, Faculty of Medicine, Masaryk University
̶ Basic information
̶ Infectious aerosols in dental office
̶ Current information about aerosols and COVID-19
2
Content
Picture reference: https://www.todaysrdh.com/3
DEFINITION
̶ Aerosols = liquid or solid particles
suspended in the air by humans,
animals, instruments, or machines.
̶ Bio-aerosols = aerosols consisting
of particles of any kind of
organism.
̶ Aerosol - particles less than 5 μm in diameter
̶ Splatter - particles larger than 5 μm in diameter
Picture reference: Collection, particle sizing and detection of airborne viruses (2019)4
DEFINITION
Aerosol particles: < 5 μm
Mycobacterium tuberculosis: 2 µm
Staphylococcus epidermidis: 1,5 µm
Coronaviridae: 100-150 nm
Influenza viruses: 80-120 nm
Picture reference: https://www.news-medical.net/health/The-Size-of-SARS-CoV-2-Compared-to-Other-Things.aspx5
SIZE COMPARISON
Reference: Aerosols and splatter in dentistry (2004) https://jada.ada.org/article/S0002-8177(14)61227-7/fulltext#cesec60
Particle sizes of infectious aerosols: implications for infection control (2020)
6
DISEASES KNOWN TO BE SPREAD BY
DROPLETS OR AEROSOLS
Tuberculosis, Influenza, Legionnaires' Disease, Severe Acute Respiratory
Syndrome, Measles, Pneumonic Plague,
diseases caused by herpetic viruses (Varicella Zoster Virus) and rhinovirus.
Reference: A scoping review on bio-aerosols in healthcare and the dental environment (2017)7
INFECTIOUS AEROSOLS IN DENTAL OFFICE
To minimise the likelihood of airborne disease transmission via droplets or aerosols,
the dental team adopts the following (SARS, 2004):
1.Reduction of droplet/aerosol generation
2.Use of rubber dam isolation
3.Use of pre-procedure mouthwash ( 0.12% chlorhexidine mouth rinse or povidone iodine)
4.Dilution and efficient removal of contaminated ambient air (High volume evacuation, ventilation)
5.Disinfect air/aerosol generated (Ultraviolet germicidal irradiation etc.)
6.Adoption of contact precautions (Thorough hand washing, Personal protective equipment )
Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7091810/8
INFECTIOUS AEROSOLS IN DENTAL OFFICE
Reference: https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html9
CDC: Summary of Recent Changes
COVID-19: Guidance for Dental Settings
WHO
https://www.who.int
CDC
https://www.cdc.gov/coronavirus/2019-ncov/index.html
Science
https://www.sciencemag.org/collections/coronavirus?intcmp=sci_cov
Actual information from Ministry of Health of the Czech Republic
https://onemocneni-aktualne.mzcr.cz/covid-19?utm_source=general&utm_medium=widget&utm_campaign=covid-19
10
COVID-19: RELEVANT INFORMATION
̶ To date (October 28) there are no relevant studies in COVID-19 and aerosol
̶ The current guidelines are extrapolated from influenza and previous
outbreaks of SARS-1 and on expert opinion
̶ At this moment there are few researching groups around the world which
focused on aerosol in dental offices (one in Czech Republic)
11
Aerosols in dental offices
Conclusion