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Gund MP, Naim J, Rupf S, Gärtner B, Hannig M. Bacterial contamination potential of personal protective equipment itself in dental aerosol-producing treatments. Odontology 2024; 112:309-316. [PMID: 37702832 PMCID: PMC10925564 DOI: 10.1007/s10266-023-00848-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/18/2023] [Indexed: 09/14/2023]
Abstract
Personal protective equipment (PPE) has long been a high priority in dental aerosol-producing treatments. Since COVID-19 pandemic, its importance has increased yet again. While importance of PPE in preventing transmission and thus possible infection of pathogens is well known, contamination potential of PPE after treatment itself is less investigated. This review aims to give an overview of the current literature and contamination potential (viral, blood, bacterial) of components of protective equipment itself. The literature search was performed using the Medline database; furthermore, a hand search was conducted. Last search took place on 23 November 2022. Two categories of hygiene-related keywords were formed (category A: mask, face shield, goggles, eyewear, personal protective equipment; category B: contamination, aerosol). Each keyword from one category was combined with all keywords from the other one. In addition, the keyword "dental" was always added. First, a title and abstract screening was performed. Afterward, a full-text analysis was followed for the included studies. A total of 648 search hits were found in the Medline database. 47 were included after title and abstract screening. 22 studies were excluded after full-text analysis, 25 studies were included. The hand search resulted in 4 studies that were included. Bacterial contamination of PPE after treatment has been adequately studied, contamination with blood less. Microorganisms mainly originate from the oral and cutaneous flora; however, a transmission of potential pathogens like Staphylococcus aureus or Escherichia coli was also described. Studies showing transmission pathways starting from PPE and its various components are lacking. No measures have yet been described that fully protect the protective equipment from contamination. There is growing awareness that PPE itself can be a source of pathogen transmission, and thus possible infection. Therefore, not only wearing of protective clothing, but also conscious handling of it is crucial for transmission and possible infection prevention. However, studies showing transmission pathways starting from PPE and its various components are lacking. Several studies have investigated what measures can be taken to protect the protective equipment itself. So far, none of the methods evaluated can prevent contamination of PPE.
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Affiliation(s)
- Madline Priska Gund
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Clinic of Operative Dentistry, Saarland University Hospital, Saarland University, Kirrberger Str. 100, Building 73, 66421, Homburg, Saar, Germany.
| | - Jusef Naim
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Clinic of Operative Dentistry, Saarland University Hospital, Saarland University, Kirrberger Str. 100, Building 73, 66421, Homburg, Saar, Germany
| | - Stefan Rupf
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Clinic of Operative Dentistry, Saarland University Hospital, Saarland University, Kirrberger Str. 100, Building 73, 66421, Homburg, Saar, Germany
- Chair of Synoptic Dentistry, Homburg, Germany
| | - Barbara Gärtner
- Institute of Medical Microbiology and Hygiene, Department of Hospital Hygiene, Saarland University, Homburg, Germany
| | - Matthias Hannig
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Clinic of Operative Dentistry, Saarland University Hospital, Saarland University, Kirrberger Str. 100, Building 73, 66421, Homburg, Saar, Germany
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Gund MP, Naim J, Bayhan HM, Hannig M, Gärtner B, Halfmann A, Boros G, Rupf S. Dental aerosol-producing treatments: Comparison of contamination patterns of face shields and surgical masks. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2024; 21:126-135. [PMID: 38393941 DOI: 10.1080/15459624.2023.2285363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
During the COVID-19 pandemic, dental face shields were recommended to protect the eyes. This study aimed to examine to what extent face shield and mask contamination differ when a pre-procedural mouth rinsing with Chlorhexidine (CHX) is conducted before treatment. In this prospective, randomized study, three groups of subjects were formed (rinsing with 0.1% CHX, water, or no rinsing (control) before aerosol-producing treatments). After each of the 301 treatments, the practitioner's face shield was swabbed with eSwab and the mask was brought into contact with agar plates. Sampling was done from the exterior surface only. Samples were cultured for 48 h at 35 °C under aerobic and anaerobic conditions. Bacteria were classified by phenotypic characteristics, biochemical test methods, and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Colony-forming units were counted and mean values were compared (WSR, H-test, U-test, p < 0.05). Within each subject group, face shields showed significantly more contamination than surgical masks (control group: 350 CFU, 50 CFU; intervention water: 270 CFU, 40 CFU; intervention CHX: 250 CFU, 30 CFU). Comparison of face shields of the different subject groups did not reveal any statistically significant differences. However, CHX resulted in a statistically significant bacterial reduction on surgical masks compared to the water and control group (control: 50 CFU, intervention water: 40 CFU, intervention CHX: 30 CFU). Contamination of face shields and surgical masks was highest in the control group, followed by the water group, and lowest in the intervention group with CHX. Streptococcus spp. and Staphylococcus spp. dominated, representing the oral and cutaneous flora. Contamination of masks worn with or without face shields did not differ. Presumably, face shields intercept first splashes and droplets, while the masks were mainly exposed to bioaerosol mist. Consequently, face shields protect the facial region and surroundings from splashes and droplets, but not the mask itself. A pre-procedural mouth rinse with CHX had no statistically significant reducing effect on contamination of the face shield, but a statistically significant reducing effect was observed on contamination of the mask.
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Affiliation(s)
- Madline P Gund
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
- Oral Surgery Clinic, German Armed Forces Central Hospital, Koblenz, Germany
| | - Jusef Naim
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Halil Muhammed Bayhan
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Matthias Hannig
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Barbara Gärtner
- Institute of Medical Microbiology and Hygiene, Department of Hospital Hygiene, Saarland University, Homburg, Germany
| | - Alexander Halfmann
- Institute of Medical Microbiology and Hygiene, Department of Hospital Hygiene, Saarland University, Homburg, Germany
| | - Gabor Boros
- Oral Surgery Clinic, German Armed Forces Central Hospital, Koblenz, Germany
| | - Stefan Rupf
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
- Synoptic Dentistry, Saarland University, Homburg, Germany
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Gund MP, Naim J, Lang J, Hannig M, Gärtner B, Halfmann A, Boros G, Rupf S. Detection of viable oral bacteria of the patient on the surgical mask of dentists. BDJ Open 2024; 10:4. [PMID: 38228600 DOI: 10.1038/s41405-023-00182-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 01/18/2024] Open
Abstract
INTRODUCTION AND AIM Bioaerosols contaminate the personal protective equipment (PPE), especially masks. The PPE harbors microorganisms from various sources. However, no previous studies have investigated the specific sources of bacteria found on used masks and their correlation with those from the treated patient. SETTING, DESIGN, MATERIAL AND METHODS Intraoral samples from the patient were collected prior to dental aerosol-producing treatments using a nylon flock fiber swab. After treatment, the practitioner's mask was imprinted onto agar plates. MAIN OUTCOME METHODS Following cultivation, colony forming units were counted and identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). After the samples were analyzed, the intraoral samples as well as the mask samples were assessed for the presence of identical species, which were subsequently quantified. RESULTS 126 treatments were included. One species match occurred most frequently (26.2%), followed by two (11.9%%) and three or more (3.97%). In the intraoral samples, Neisseria subflava occurred most often, within mask samples Staphylococcus epidermidis were detected most. Staphylococcus aureus could be cultivated three times more often in intraoral samples than on the mask. DISCUSSION AND CONCLUSION Oral microorganisms originating from the patient's oral cavity can be found on the outside of masks. When using PPE during treatments, it should therefore always be in mind that potentially pathogenic microorganisms may land on the mask becoming a source of for itself.
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Affiliation(s)
- Madline Priska Gund
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany.
- Oral Surgery Clinic, German Armed Forces Central Hospital, Koblenz, Germany.
| | - Jusef Naim
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Janina Lang
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Matthias Hannig
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Barbara Gärtner
- Institute of Medical Microbiology and Hygiene, Department of Hospital Hygiene, Saarland University, Homburg, Germany
| | - Alexander Halfmann
- Institute of Medical Microbiology and Hygiene, Department of Hospital Hygiene, Saarland University, Homburg, Germany
| | - Gabor Boros
- Oral Surgery Clinic, German Armed Forces Central Hospital, Koblenz, Germany
| | - Stefan Rupf
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
- Synoptic Dentistry, Saarland University, Homburg, Germany
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Kumar MS, He R, Feng L, Olin P, Chew HP, Jardine P, Anderson GC, Hong J. Particle generation and dispersion from high-speed dental drilling. Clin Oral Investig 2023; 27:5439-5448. [PMID: 37479870 DOI: 10.1007/s00784-023-05163-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/13/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVE To investigate the characteristics of particle generation and dispersion during dental procedure using digital inline holography (DIH) METHODS: Particles at two locations, near-field and far-field, which represent the field closer to the procedure location and within 0.5 m from the procedure location respectively, are studied using two different DIH systems. The effect of three parameters namely rotational speed, coolant flow rate, and bur angle on particle generation and dispersion are evaluated by using 10 different operating conditions. The particle characteristics at different operating conditions are estimated from the holograms using machine learning-based analysis. RESULTS The particle concentration decreased by at least two orders of magnitude between the near-field and far-field locations across the 10 different operating conditions, indicating significant dispersion of the particles. High rotational speed is found to produce a larger number of smaller particles, while lower rotational speeds generate larger particles. Coolant flow rate is found to have a greater impact on particle transport to the far-field location. Irregular shape dental particles account for 29% of total particles at far-field location, with the majority of these irregular shape particles having diameters ranging from 12 to 18 μm. CONCLUSIONS All three parameters have significant effects on particle generation and dispersion, with rotational speed having a more significant influence on particle generation at near-field and coolant flow rate playing a more important role on particle transport to the far-field. CLINICAL RELEVANCE This study provides valuable insights on particle characteristics during high-speed drilling. It can help dental professionals minimize exposure risks for themselves and patients by optimizing clinical operating conditions.
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Affiliation(s)
- M Shyam Kumar
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Ruichen He
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN, USA
- Saint Anthony Falls Laboratory, University of Minnesota, Minneapolis, MN, USA
| | - Lei Feng
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN, USA
- Saint Anthony Falls Laboratory, University of Minnesota, Minneapolis, MN, USA
| | - Paul Olin
- University of Minnesota School of Dentistry, Minneapolis, MN, USA
| | - Hooi Pin Chew
- University of Minnesota School of Dentistry, Minneapolis, MN, USA
| | - Paul Jardine
- University of Minnesota School of Dentistry, Minneapolis, MN, USA
| | - Gary C Anderson
- University of Minnesota School of Dentistry, Minneapolis, MN, USA
| | - Jiarong Hong
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN, USA.
- Saint Anthony Falls Laboratory, University of Minnesota, Minneapolis, MN, USA.
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Beltrán EO, Castellanos JE, Corredor ZL, Morgado W, Zarta OL, Cortés A, Avila V, Martignon S. Tracing ΦX174 bacteriophage spreading during aerosol-generating procedures in a dental clinic. Clin Oral Investig 2023:10.1007/s00784-023-04937-z. [PMID: 36933045 PMCID: PMC10024015 DOI: 10.1007/s00784-023-04937-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 02/28/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVE The aim of this study was to test the plausibility of using the ΦX174 bacteriophage as a tracer of viral aerosols spreading in a dental aerosol-generating procedure (AGP) model. METHODS ΦX174 bacteriophage (~ 108 plaque-forming units (PFU)/mL) was added into instrument irrigation reservoirs and aerosolized during class-IV cavity preparations followed by composite fillings on natural upper-anterior teeth (n = 3) in a phantom head. Droplets/aerosols were sampled through a passive approach that consisted of Escherichia coli strain C600 cultures immersed in a LB top agar layer in Petri dishes (PDs) in a double-layer technique. In addition, an active approach consisted of E coli C600 on PDs sets mounted in a six-stage cascade Andersen impactor (AI) (simulating human inhalation). The AI was located at 30 cm from the mannequin during AGP and afterwards at 1.5 m. After collection PDs were incubated overnight (18 h at 37 °C) and bacterial lysis was quantified. RESULTS The passive approach disclosed PFUs mainly concentrated over the dental practitioner, on the mannequin's chest and shoulder and up to 90 cm apart, facing the opposite side of the AGP's source (around the spittoon). The maximum aerosol spreading distance was 1.5 m in front of the mannequin's mouth. The active approach disclosed collection of PFUs corresponding to stages (and aerodynamic diameters) 5 (1.1-2.1 µm) and 6 (0.65-1.1 µm), mimicking access to the lower respiratory airways. CONCLUSION The ΦX174 bacteriophage can be used as a traceable viral surrogate in simulated studies contributing to understand dental bioaerosol's behavior, its spreading, and its potential threat for upper and lower respiratory tract. CLINICAL RELEVANCE The probability to find infectious virus during AGPs is high. This suggests the need to continue characterizing the spreading viral agents in different clinical settings through combination of passive and active approaches. In addition, subsequent identification and implementation of virus-related mitigation strategies is relevant to avoid occupational virus infections.
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Affiliation(s)
- Edgar O Beltrán
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra 9 No. 131A-02, 110121, Bogotá, Colombia
| | - Jaime E Castellanos
- Laboratorio de Virología, Vicerrectoría de Investigaciones, Universidad El Bosque, Av. Cra 9 No. 131A-02, 110121, Bogotá, Colombia
- Grupo de Investigaciones Básicas y Aplicadas en Odontología, Universidad Nacional de Colombia, Carrera 30 No. 45-03, Edificio 210, 111321, Bogotá, Colombia
| | - Zayda L Corredor
- Bacterial Molecular Genetics Laboratory, Research Department, Universidad El Bosque, Cra 9 No. 131A-02, 110121, Bogotá, Colombia
| | - Wendy Morgado
- Department of Exact and Natural Sciences, Universidad de la Costa, Calle 58 No. 55-66, 080002, Barranquilla, Colombia
| | - Olga L Zarta
- Dental School, Universidad El Bosque, Cra 9 No. 131A-02, 110121, Bogotá, Colombia
| | - Andrea Cortés
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra 9 No. 131A-02, 110121, Bogotá, Colombia
| | - Viviana Avila
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra 9 No. 131A-02, 110121, Bogotá, Colombia
| | - Stefania Martignon
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra 9 No. 131A-02, 110121, Bogotá, Colombia.
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Checchi V, Montevecchi M, Valeriani L, Checchi L. Bioburden Variation of Filtering Face Piece Respirators over Time: A Preliminary Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:8790. [PMID: 36556594 PMCID: PMC9785761 DOI: 10.3390/ma15248790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/29/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The microbial contamination of a respirator can be evaluated through a count of the number of bacteria living on a non-sterilized surface (bioburden). This preliminary study investigated the external contamination of two different FFP2s over time by studying the bioburden values in increasing exposure times. METHODS FFP2 respirators of two different brands were used during routine clinical settings and examined through the bioburden test; for each brand, three devices were tested at 8, 16, and 30 h. RESULTS No significant differences were observed between mask brands (p = 0.113). There were only significant CFU differences between each mask and its control (p = 0.027 and p = 0.004). CONCLUSIONS Both brands of respirators were found to be contaminated and this contamination increased with the increase in exposure time. Further studies are needed to investigate the exact amount of contamination that could be considered acceptable before discarding each used mask.
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Affiliation(s)
- Vittorio Checchi
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Marco Montevecchi
- Unit of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40100 Bologna, Italy
| | - Leoluca Valeriani
- Unit of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40100 Bologna, Italy
| | - Luigi Checchi
- Unit of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40100 Bologna, Italy
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Li M, Hou Z, Meng R, Hao S, Wang B. Unraveling the potential human health risks from used disposable face mask-derived micro/nanoplastics during the COVID-19 pandemic scenario: A critical review. ENVIRONMENT INTERNATIONAL 2022; 170:107644. [PMID: 36413926 PMCID: PMC9671534 DOI: 10.1016/j.envint.2022.107644] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 06/09/2023]
Abstract
With the global spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), disposable face masks (DFMs) have caused negative environmental impacts. DFMs will release microplastics (MPs) and nanoplastics (NPs) during environmental degradation. However, few studies reveal the release process of MPs/NPs from masks in the natural environment. This review presents the current knowledge on the abiotic and biotic degradation of DFMs. Though MPs and NPs have raised serious concerns about their potentially detrimental effects on human health, little attention was paid to their impacts on human health from DFM-derived MPs and NPs. The potential toxicity of mask-derived MPs/NPs, such as gastrointestinal toxicity, pneumotoxicity, neurotoxicity, hepatotoxicity, reproductive and transgenerational toxicity, and the underlying mechanism will be discussed in the present study. MPs/NPs serve as carriers of toxic chemicals and pathogens, leading to their bioaccumulation and adverse effects of biomagnification by food chains. Given human experiments are facing ethical issues and animal studies cannot completely reveal human characteristics, advanced human organoids will provide promising models for MP/NP risk assessment. Moreover, in-depth investigations are required to identify the release of MPs/NPs from discarded face masks and characterize their transportation through the food chains. More importantly, innovative approaches and eco-friendly strategies are urgently demanded to reduce DFM-derived MP/NP pollution.
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Affiliation(s)
- Minghui Li
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China; Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Zongkun Hou
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China
| | - Run Meng
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China
| | - Shilei Hao
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China.
| | - Bochu Wang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China.
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Benmamoun Z, Wyhopen T, Li Y, Ducker WA. Mechanism and Efficacy of Cu 2O-Treated Fabric. Antibiotics (Basel) 2022; 11:1633. [PMID: 36421277 PMCID: PMC9686972 DOI: 10.3390/antibiotics11111633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/12/2022] [Accepted: 11/15/2022] [Indexed: 09/11/2023] Open
Abstract
Pathogenic bacteria can remain viable on fabrics for several days and therefore are a source of infection. Antimicrobial fabrics are a potential method of reducing such infections, and advances in antimicrobial fabrics can be enhanced by knowledge of how the fabric kills bacteria. Metal oxides have been considered and used as antimicrobial ingredients in self-sanitizing surfaces, including in clinical settings. In this work, we examine how the addition of cuprous oxide (Cu2O) particles to polypropylene fibers kills bacteria. First, we show that the addition of the Cu2O particles reduces the viability of common hospital pathogens, Staphylococcus aureus, Pseudomonas aeruginosa, and Streptococcus pneumoniae, by 99.9% after 30 min of contact with the treated polypropylene. Then, we demonstrate that the main killing effect is due to the drying of the bacteria onto the cuprous oxide particles. There is also a weaker effect due to free Cu+ ions that dissolve into the liquid. Other dissolved species were unimportant. Chelation of these Cu+ ions in soluble form or precipitation removes their antimicrobial activity.
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Affiliation(s)
- Zachary Benmamoun
- Department of Chemical Engineering, Virginia Tech, Blacksburg, VA 24061, USA
- Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, VA 24061, USA
| | - Trent Wyhopen
- Department of Chemical Engineering, Virginia Tech, Blacksburg, VA 24061, USA
- Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, VA 24061, USA
| | - You Li
- Department of Chemical Engineering, Virginia Tech, Blacksburg, VA 24061, USA
- Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, VA 24061, USA
| | - William A. Ducker
- Department of Chemical Engineering, Virginia Tech, Blacksburg, VA 24061, USA
- Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, VA 24061, USA
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Al-Moraissi EA, Kaur A, Günther F, Neff A, Christidis N. Can aerosols-generating dental, oral and maxillofacial, and orthopedic surgical procedures lead to disease transmission? An implication on the current COVID-19 pandemic. FRONTIERS IN ORAL HEALTH 2022; 3:974644. [PMID: 35979536 PMCID: PMC9376374 DOI: 10.3389/froh.2022.974644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/04/2022] [Indexed: 12/01/2022] Open
Abstract
Various dental, maxillofacial, and orthopedic surgical procedures (DMOSP) have been known to produce bioaerosols, that can lead to the transmission of various infectious diseases. Hence, a systematic review (SR) aimed at generating evidence of aerosols generating DMOSP that can result in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), further investigating their infectivity and assessing the role of enhanced personal protective equipment (PPE) an essential to preventing the spreading of SARS-CoV-2 during aerosol-generating procedures (AGPs). This SR was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) guidelines based on a well-designed Population, Intervention, Comparison, Outcomes and Study (PICOS) framework, and various databases were searched to retrieve the studies which assessed potential aerosolization during DMOSP. This SR included 80 studies (59 dental and 21 orthopedic) with 7 SR, 47 humans, 5 cadaveric, 16 experimental, and 5 animal studies that confirmed the generation of small-sized < 5 μm particles in DMOSP. One study confirmed that HIV could be transmitted by aerosolized blood generated by an electric saw and bur. There is sufficient evidence that DMOSP generates an ample amount of bioaerosols, but the infectivity of these bioaerosols to transmit diseases like SARS-CoV-2 generates very weak evidence but still, this should be considered. Confirmation through isolation and culture of viable virus in the clinical environment should be pursued. An evidence provided by the current review was gathered by extrapolation from available experimental and empirical evidence not based on SARS-CoV-2. The results of the present review, therefore, should be interpreted with great caution.
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Affiliation(s)
- Essam Ahmed Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Dhamar, Yemen
- *Correspondence: Essam Ahmed Al-Moraissi ;
| | - Amanjot Kaur
- Oral and Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Frank Günther
- Medical Microbiology and Hygiene, Marburg University Hospital, Marburg, Germany
| | - Andreas Neff
- Department of Oral and Maxillofacial Surgery, University Hospital Marburg Universitätsklinikum Giessen und Marburg GmbH, Marburg, Germany
| | - Nikolaos Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Gund MP, Naim J, Hannig M, Halfmann A, Gärtner B, Boros G, Rupf S. CHX and a Face Shield Cannot Prevent Contamination of Surgical Masks. Front Med (Lausanne) 2022; 9:896308. [PMID: 35677818 PMCID: PMC9167959 DOI: 10.3389/fmed.2022.896308] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Bacterial contamination on surgical masks puts a threat to medical staff and patients. The aim of the study was to investigate its contamination during dental treatments, wearing a face shield and performing a pre-procedural mouth rinsing with chlorhexidine (CHX). Methods In this prospective, randomized study, 306 treatments were included, 141 single-tooth (restorations) and 165 total dentition treatments (preventive or periodontal supportive ultrasonic application). A total of three groups (each: n = 102) were formed: participants rinsed for 60 s with 0.1 % CHX or with water before treatment, and, for control, a non-rinsing group was included. In view of the COVID-19 pandemic, a face shield covering the surgical mask enhanced personal protective equipment. After treatment, masks were imprinted on agar plates and incubated at 35°C for 48 h. Bacteria were classified by phenotypic characteristics, biochemical assay methods, and matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS). Colonies (CFU) were counted and mean values were compared (Kruskal–Wallis-, U test, p < 0.05). Results Chlorhexidine led to a statistically significant reduction of bacterial contamination of the surgical mask (mean: 24 CFU) in comparison with water (mean: 47 CFU) and non-rinsing (mean: 80 CFU). Furthermore, rinsing with water reduced CFU significantly in comparison with the non-rinsing group. There were no significant differences between single or total dentition treatments. Streptococcus spp., Staphylococcus spp., Micrococcus spp., and Bacillus spp. dominated, representing the oral and cutaneous flora. Conclusion A pre-procedural mouth rinse is useful to reduce the bacterial load of the surgical mask. However, contamination cannot be prevented completely, even by applying a face shield. In particular, during pandemic, it is important to consider that these additional protective measures are not able to completely avoid the transmission of pathogens bearing aerosols to the facial region. If antiseptic rinsing solutions are not available, rinsing with water is also useful.
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Affiliation(s)
- Madline P. Gund
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
- Oral Surgery Clinic, German Armed Forces Central Hospital, Koblenz, Germany
- *Correspondence: Madline P. Gund
| | - Jusef Naim
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Matthias Hannig
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Alexander Halfmann
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Barbara Gärtner
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Gabor Boros
- Oral Surgery Clinic, German Armed Forces Central Hospital, Koblenz, Germany
| | - Stefan Rupf
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
- Chair of Synoptic Dentistry, Universität Des Saarlandes, Homburg, Germany
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11
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Application Research of Tooth Arrangement Based on Rotation Matrix Calculation and Resistance Detection in Oral. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:4675181. [PMID: 35634084 PMCID: PMC9142327 DOI: 10.1155/2022/4675181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/18/2022] [Accepted: 04/28/2022] [Indexed: 12/04/2022]
Abstract
The goal of this research was to provide a new approach for analyzing orthodontic teeth arrangement inside oral depending on the rotation matrix computation and resistance detection. The present method includes the following operations within a certain therapy period: first three-dimensional positions of the tooth were evaluated with a pierced laser beam and a three-dimensional system of surface-scanning. Second, the three-dimensional shape data was automatically registered at maxillary 1st molars, and methods of coordinate had been normalized. Third, a translation vector and rotation matrix had been evaluated from automatic registration of two position data of a particular tooth. Fourth, the limited spiral axes of teeth had been measured as the zero rotational dislocation locus; and impressions for a model of the dental cast had been taken at five different points: shortly before and after device was fitted, and ten days, one month, and two months after the treatment started. The results showed that existing analysis approach could more quickly classify a specific tooth's movement by spinning all over and translating along a finite helical axis. It can provide statistical visual three-dimensional data on complex tooth arrangement throughout orthodontic therapy.
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12
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Bergmann N, Lindörfer I, Ommerborn MA. Blood and saliva contamination on protective eyewear during dental treatment. Clin Oral Investig 2022; 26:4147-4159. [PMID: 35165772 PMCID: PMC8853203 DOI: 10.1007/s00784-022-04385-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/13/2022] [Indexed: 11/26/2022]
Abstract
Objectives Dental treatments are inherently associated with the appearance of potentially infective aerosols, blood and saliva splashes. The aim of the present study was to investigate the quantitative contamination of protective eyewear during different dental treatments and the efficacy of the subsequent disinfection. Materials and methods Fifty-three standardized protective eyewear shields worn by students, dentists and dental assistants during different aerosol-producing dental treatment modalities (supragingival cleaning, subgingival periodontal instrumentation, trepanation and root canal treatment and carious cavity preparation; within all treatments, dental evacuation systems were used) were analysed, using common forensic techniques. For detection of blood contamination, luminol solution was applied onto the surface of safety shields. A special forensic test paper was used to visualize saliva contamination. Further analysis was conducted after standardized disinfection using the same techniques. Statistical analysis was performed using SPSS. Results Macroscopically detectable contamination was found on 60.4% of protective eyewear surfaces. A contamination with blood (median 330 pixels, equivalent to 0.3% of the total surface) was detected on all shields after dental treatment. Between various dental treatments, the contamination with blood tend to be statistically significant (p = 0.054). Highest amount of blood was observed after professional tooth cleaning (median 1,087 pixels). Significant differences of saliva contamination were detected between the different measurements (p < 0.001) with contamination only after dental treatment. Due to the low variance and right-skewed distribution for saliva contamination, no statistical analysis between different treatments could be performed. After disinfection, 0.02% blood contamination and no saliva contamination were detected. Conclusions Disinfection is effective against blood and saliva contamination. Macroscopically, clean protective eyewear contains up to 12% surface contamination with blood. Based on the results, it may be concluded that protective eyewear is essential for each dental practitioner. Clinical relevance As standard for infection prevention in the dental practice, disinfection of protective eyewear after each patient is necessary.
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Affiliation(s)
- Nora Bergmann
- Department of Operative Dentistry, Periodontology and Endodontology, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Isabell Lindörfer
- Department of Operative Dentistry, Periodontology and Endodontology, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Michelle Alicia Ommerborn
- Department of Operative Dentistry, Periodontology and Endodontology, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
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13
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Nóbrega MTC, Bastos RTDRM, Mecenas P, de Toledo IP, Richardson-Lozano R, Altabtbaei K, Flores-Mir C. Aerosol generated by dental procedures: A scoping review. J Evid Based Med 2021; 14:303-312. [PMID: 34936216 DOI: 10.1111/jebm.12461] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 09/30/2021] [Accepted: 11/15/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND The current pandemic has raised awareness of aerosol dispersion in dental offices. This scoping review was conducted to assess the amount and spread of aerosol generated by dental procedures. METHODS This scoping review followed the PRISMA-ScR protocol and was conducted by searching multiple databases adopting a core search structure for each database. Detailed eligibility criteria were applied. The authors placed no restrictions on study design, year of publication, and study location. The literature search was updated on September 15, 2021. RESULTS A total of 51 papers were included in this scoping review. The risk of bias assessment was not conducted as per guidelines. The majority of studies found microorganisms, bloodstains, splatters of aerosol, and particles in the air part of the search strategy. Publication dates ranged from 1969 to 2021. Data came from different dental settings locations. Several factors were identified that have an effect on the amount and spread of the aerosol and spatter. CONCLUSION Although it is clear that the microbial contamination occurred mainly during aerosol-generating dental procedures, our understanding of the contamination level, spread, and half-life are limited.
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Affiliation(s)
| | | | - Paulo Mecenas
- Department of Orthodontics, Federal University of Pará, Belém, Pará, Brazil
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14
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Brooks JK, Sultan AS, Jabra-Rizk MA. Prolonged facial mask wear is a concern for the development of dysbiotic microbiome. Respir Med Res 2021; 81:100877. [PMID: 34911024 PMCID: PMC8627006 DOI: 10.1016/j.resmer.2021.100877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 11/19/2021] [Indexed: 12/22/2022]
Affiliation(s)
- John K Brooks
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.
| | - Ahmed S Sultan
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; University of Maryland Greenebaum Cancer Center, Baltimore, MD 21201, USA
| | - Mary Ann Jabra-Rizk
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, USA; Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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15
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Farah RI, Althunayyan AA, Al-Haj Ali SN, Farah AI. Reduction of aerosols and splatter generated during ultrasonic scaling by adding food-grade thickeners to coolants: an in-vitro study. Clin Oral Investig 2021; 26:2863-2872. [PMID: 34783913 PMCID: PMC8593632 DOI: 10.1007/s00784-021-04265-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 10/27/2021] [Indexed: 01/25/2023]
Abstract
Objective The effectiveness of using food-grade coolant thickener solutions on the amount of aerosols generated and splatter contamination spread distance during simulated ultrasonic scaling was examined. Materials and methods The study was performed using a phantom lower jaw placed on a black box. Simulated ultrasonic scaling was performed for 2 min using four coolant solutions: distilled water (control), 2% wt. polyacrylic acid (PAA), 0.4% wt. xanthan gum (XA), and 0.4% wt. carboxymethyl cellulose (CMC). The simulation was repeated 10 times for each coolant group. The generated aerosols and droplets were quantified using a handheld particle counter, and the splatter contamination spread distance was evaluated by adding tracing fluorescent dye to the coolant reservoir supplying the scaler unit. One-way multivariate analysis of variance was performed to determine the difference among coolant groups (a = .05). Results The amount of aerosols and droplets and splatter contamination distance (p < .001) pertaining to the three food-grade coolant thickener solutions were considerably lower than those for the distilled water (control). The PAA group exhibited a significantly lower splatter contamination distance (p < .001) and a number of generated droplets (p = .031) than those of the XA group. The CMC group exhibited a significantly lower splatter contamination distance (p < .001) than that of the XA group. No statistically significant difference was observed between the PAA and CMC in terms of the three dependent variables (p > .05). Conclusion The food-grade coolant thickeners could reduce the amount of generated aerosols and splatter contamination distance but not completely eliminate them. PAA and CMC solutions were more effective in reducing the aerosol/splatter during scaling compared to XA. Clinical relevance Many dental procedures generate aerosols and splatter, which pose a potential risk to the patients and dental personnel, especially during the current COVID-19 pandemic.
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Affiliation(s)
- Ra'fat I Farah
- Department of Prosthetic Dental Sciences, College of Dentistry, Qassim University, Al-Mulaydah, Qassim, Kingdom of Saudi Arabia.
| | | | - Sanaa N Al-Haj Ali
- Department of Orthodontic and Pediatric Dentistry, College of Dentistry, Qassim University, Al-Mulaydah, Qassim, Kingdom of Saudi Arabia
| | - Amani I Farah
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
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16
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Gund MP, Boros G, Hannig M, Thieme-Ruffing S, Gärtner B, Rohrer TR, Simon A, Rupf S. Bacterial contamination of forehead skin and surgical mask in aerosol-producing dental treatment. J Oral Microbiol 2021; 13:1978731. [PMID: 34567438 PMCID: PMC8462870 DOI: 10.1080/20002297.2021.1978731] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Bacterial contamination of dental professionals’ facial skin and protective equipment from treatment-related aerosols and droplets are poorly studied. Methods This prospective study analyzed samples from 67 consecutive aerosol-producing dental treatments. Sterile nylon swabs served to collect samples from dental professionals’ foreheads before and after exposure. Contact samples were obtained from used surgical masks. Samples were incubated on agar under aerobic and anaerobic conditions. Bacteria were classified by MALDI-TOF mass spectrometry. We determined the frequencies of obligate and facultative oral bacteria and scored bacterial growth (0: none; 1: < 100 colonies; 2: >100 colonies; 3: dense). Results Bacteria were detected in 95% of skin-swab and 76% of mask samples. Median bacterial scores were 2 for forehead samples before and after treatment, and 1 for masks. Obligate and facultative oral bacteria were more frequent (6% and 30%) in samples from exposed forehead skin, which also showed increased bacterial scores (28%). 5% of samples contained methicillin-sensitive Staphylococcus aureus; 3% contained obligate anaerobes. Conclusion Exposed forehead skin was significantly less contaminated with obligate oral bacteria than expected based on surgical mask findings. Exposed forehead skin showed increased contamination attributable to aerosol-producing procedures. The forehead’s physiological skin microbiota may offer some protection against bacterial contamination.
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Affiliation(s)
- Madline P Gund
- Clinic Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany.,Oral Surgery Clinic, German Armed Forces Central Hospital; Koblenz, Germany
| | - Gabor Boros
- Oral Surgery Clinic, German Armed Forces Central Hospital; Koblenz, Germany
| | - Matthias Hannig
- Clinic Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Sigrid Thieme-Ruffing
- Institute of Medical Microbiology and Hygiene, Department of Hospital Hygiene, Saarland University, Homburg, Germany
| | - Barbara Gärtner
- Institute of Medical Microbiology and Hygiene, Department of Hospital Hygiene, Saarland University, Homburg, Germany
| | - Tilman R Rohrer
- University Children's Hospital, Saarland University Medical Center, Homburg, Germany
| | - Arne Simon
- University Children's Hospital, Saarland University Medical Center, Homburg, Germany
| | - Stefan Rupf
- Clinic Department of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany.,Chair of Synoptic Dentistry, Saarland University, Homburg, Germany
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17
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Pierre-Bez AC, Agostini-Walesch GM, Bradford Smith P, Hong Q, Hancock DS, Davis M, Marcelli-Munk G, Mitchell JC. Ultrasonic scaling in COVID-era dentistry: A quantitative assessment of aerosol spread during simulated and clinical ultrasonic scaling procedures. Int J Dent Hyg 2021; 19:474-480. [PMID: 34418305 PMCID: PMC8652710 DOI: 10.1111/idh.12548] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/02/2021] [Accepted: 08/19/2021] [Indexed: 12/11/2022]
Abstract
Objective Healthcare agencies recommend limited use of aerosol‐generating procedures to mitigate disease (COVID‐19) transmission. However, total dispersion patterns of aerosols, particularly respirable droplets, via dental ultrasonic units is unclear. The purpose of this study was to characterize and map total spatter, droplet and aerosol dispersion during ultrasonic scaling in simulated and clinical contexts. Methods Ultrasonic scaling was performed on dental simulation units using methylene blue dye‐stained water. All resultant stain profiles were photoanalysed to calculate droplet size and travel distance/direction. Airborne particle concentrations were also documented 0–1.2 m (0–4ft.) and 1.2–2.4 m (4–8ft.) from patients during in vivo ultrasonic scaling with a saliva ejector. Results Stain profiles showed droplets between 25 and 50µm in diameter were most common, with smaller droplets closer to the mouth. In‐vivo particle concentrations were uniformly low. The smallest (<1 µm, PM1) and largest (>10 µm, PM10+) particles were most common, especially within 1.2 m (4ft.) of the patient. Respirable particles (PM2.5) were uncommon. Conclusions Tests showed the highest concentration of small droplets in zones nearest the patient. While uncommon, particles were detected up to 2.4 m (8ft.) away. Furthermore, observed particle sizes were consistent with those that can carry infectious agents. Efforts to mitigate the spread of inhalable aerosols should emphasize proximate regions nearest the procedure, including personal protective equipment and the use of evacuation devices.
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Affiliation(s)
| | | | - P Bradford Smith
- College of Dental Medicine-Arizona, Midwestern University, Glendale, AZ, USA
| | - Qing Hong
- College of Dental Medicine-Arizona, Midwestern University, Glendale, AZ, USA
| | - David S Hancock
- College of Dental Medicine-Arizona, Midwestern University, Glendale, AZ, USA
| | - Megan Davis
- College of Dental Medicine-Arizona, Midwestern University, Glendale, AZ, USA
| | | | - John C Mitchell
- College of Dental Medicine-Arizona, Midwestern University, Glendale, AZ, USA
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18
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Carvalho JC, Declerck D, Jacquet W, Bottenberg P. Dentist Related Factors Associated with Implementation of COVID-19 Protective Measures: A National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168381. [PMID: 34444131 PMCID: PMC8391182 DOI: 10.3390/ijerph18168381] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 12/23/2022]
Abstract
Little is known about the extent to which dentists have implemented COVID-19 infection control guidelines and the factors influencing this process in daily practice. This national online survey assessed the implementation of enhanced infection control guidelines in daily practice, and explored dentist related factors influencing their application, more specifically dentist infection status and their perceived risk of cross-infection in the dental setting. The survey was validated, pretested and carried out in 2020. A total of 1436 dentists participated, of whom 9.1% presumably had COVID-19 infection experience. At least 75% of dentists complied with the core part of the recommended protective measures protocol. For each patient treated during the pandemic, an additional cost of 10–30 EUR (86.7%) and an extra time of 10–30 min (70.7%) was estimated. A stepwise binary logistic regression analysis revealed that dentists assumed to have experienced COVID-19 reported a higher self-perceived risk of virus acquisition (β = 2.090; p = 0.011), lower concern of getting infected (β = 0.576; p = 0.027), and lower confidence in being able to prevent disease transmission in the dental setting (β = 0.535; p = 0.022). Some parts of the protective measures were more difficult to apply than others; however, there was no indication of increased disease acquisition in the dental setting.
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Affiliation(s)
- Joana Christina Carvalho
- Faculty of Medicine and Dentistry, UCLouvain, 1200 Brussels, Belgium
- Correspondence: ; Tel.: +32-475-626-927
| | - Dominique Declerck
- Department of Oral Health Sciences, Population Studies in Oral Health, KU Leuven, 3000 Leuven, Belgium;
| | - Wolfgang Jacquet
- Oral Health Research Cluster, Faculty of Medicine and Pharmacy, VUB, 1090 Brussels, Belgium; (W.J.); (P.B.)
| | - Peter Bottenberg
- Oral Health Research Cluster, Faculty of Medicine and Pharmacy, VUB, 1090 Brussels, Belgium; (W.J.); (P.B.)
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19
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The COVID-19 pandemic and its global effects on dental practice. An international survey. J Dent 2021; 114:103749. [PMID: 34280498 PMCID: PMC8285212 DOI: 10.1016/j.jdent.2021.103749] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 12/17/2022] Open
Abstract
Objectives A multicentre survey was designed to evaluate the impact of COVID-19 outbreak on dental practice worldwide, estimate the COVID-19 related symptoms/signs, work attitudes and behaviour and the routine use of protective measures and Personal Protective Equipment (PPE). Methods A global survey using a standardized questionnaire with research groups from 36 countries was designed. The questionnaire was developed and pretested during April 2020 and contained three domains: 1) Personal data; 2) COVID-19 positive rate and symptoms/signs presumably related to the coronavirus; 3) Working conditions and PPE adopted after the outbreak. Countries’ data were grouped by the Country Positive Rate (CPR) during the survey period and by Gross-National-Income per capita. An ordinal multinomial logistic regression model was carried out with COVID-19 self-reported rate referred by dental professionals as dependent variable to assess the association with questionnaire items. Results A total of 52,491 questionnaires were returned with a male/female ratio of 0.63. Out of the total respondents, 7,859 dental professionals (15%) reported symptoms/signs compatible with COVID-19. More than half of the sample (n = 27,818; 53%) stated to use FFP2/N95 masks, while 21,558 (41.07%) used eye protection. In the bivariate analysis, CPR and N95/FFP2 were significantly associated (OR = 1.80 95%CI = 1.60/2.82 and OR = 5.20 95%CI = 1.44/18.80, respectively), while Gross-National-Income was not statistically associated with CPR (OR = 1.09 95%CI = 0.97/1.60). The same significant associations were observed in the multivariate analysis. Conclusions Oral health service provision has not been significantly affected by COVID-19, although access to routine dental care was reduced due to country-specific temporary lockdown periods. While the dental profession has been identified at high-risk, the reported rates of COVID-19 for dental professionals were not significantly different to those reported for the general population in each country. These findings may help to better plan oral health care for future pandemic events.
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20
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Splatters and Aerosols Contamination in Dental Aerosol Generating Procedures. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041914] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Dental aerosol-generating procedures produce a large amount of splatters and aerosols that create a major concern for airborne disease transmission, such as COVID-19. This study established a method to visualise splatter and aerosol contamination by common dental instrumentation, namely ultrasonic scaling, air-water spray, high-speed and low-speed handpieces. Mock dental procedures were performed on a mannequin model, containing teeth in a typodont and a phantom head, using irrigation water containing fluorescein dye as a tracer. Filter papers were placed in 10 different locations to collect splatters and aerosols, at distances ranging from 20 to 120 cm from the source. All four types of dental equipment produced contamination from splatters and aerosols. At 120 cm away from the source, the high-speed handpiece generated the greatest amount and size (656 ± 551 μm) of splatter particles, while the triplex syringe generated the largest amount of aerosols (particle size: 1.73 ± 2.23 μm). Of note, the low-speed handpiece produced the least amount and size (260 ± 142 μm) of splatter particles and the least amount of aerosols (particle size: 4.47 ± 5.92 μm) at 120 cm. All four dental AGPs produce contamination from droplets and aerosols, with different patterns of distribution. This simple model provides a method to test various preventive strategies to reduce risks from splatter and aerosols.
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