Evaluation of Aerosol and Water Contamination and Control of Cross Infection in Dental Clinics

Effectiveness of interventions to reduce aerosol generation in dental environments: A systematic review

Certain dental procedures produce high levels of aerosols containing pathogenic microorganisms, posing a risk for the transmission of infections in dental settings. This study aimed to assess the effectiveness of various aerosol mitigation interventions during clinical dental procedures in real-world environments. A systematic literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, and Embase for English studies up to March 2023 according to the PRISMA guidelines. Only peer-reviewed controlled clinical trials (CCT) or randomized controlled trials (RCT) studies involving human subjects were included. The risk of bias of selected researches were evaluated by two independent authors using the Cochrane Collaboration tool. The literature search yielded 3491 articles, of which 42 studies met the inclusion criteria and were included in this study. Most studies evaluated bacterial contamination in bio-aerosols, while the viral and fungal contamination was assessed in only three studies. Overall, various approaches have been applied in reducing aerosol contamination in clinical scenarios, including high-volume evacuators (HVE), mouse rinses and rubber dams, air cleaning systems, and high-efficiency particulate air (HEPA) filters. The available evidence suggests that various aerosol mitigation strategies could be implemented to decrease the risk of cross-infection during clinical dental procedures in real-world environments. However, further clinical trials are necessary to establish statistical validity in measuring aerosol contamination and mitigation, as well as to evaluate the risk of infection transmission for viral and fungal contamination.

Nursing strategies for COVID-19 prevention and control in a selected dental clinic

Aim

To comprehensively introduce the prevention and control measures that we can take in dental clinics during the pandemic period of coronavirus disease 2019 (COVID‐19) and provide some practical experience for the development of nursing and health policies applicable to COVID‐19.

Background

The outbreak of COVID‐19 has placed the global health system under threat, which seriously influences the normal operations of human society. Safe and effective nursing measures should be taken to ensure the normal operation of dental clinics.

Sources of evidence

We searched and referenced many references on the PubMed database. Through the combination of related literatures and our experience, we describe various strategies, including personnel management, personal protection, disinfection and isolation, adopted in the dental clinic of our Chinese hospital during the pandemic of COVID‐19.

Discussion/Conclusions

We introduced strategies for the nursing staff in dental clinics to assist them with the prevention and control of COVID‐19. The successful implementation of the protective measures could ensure the safety of medical staff and patients, and contributed to the normal operation of dental clinics during the pandemic period.

Conclusions for nursing and health policy

During the pandemic, frontline nurses are under physical and mental pressure facing the threat of infection while at work. In addition to pandemic prevention, we should also pay attention to the needs of nursing staff. More reasonable and effective nursing and health policies should be formulated to ensure their safety and protect their rights and interests. This is the only way that the prevention and control of COVID‐19 can be achieved, and we can prepare for future public health events.

Aerosols how dangerous they are in clinical practice

BACKGROUND AND OBJECTIVES

The purpose of the present study was to determine the microbial atmospheric contamination during initial periodontal treatment using a modern piezoelectric scaler and to evaluate the efficacy of two commercially available mouth rinses (0.2% Chlorhexidine mouth rinse and Listerine) in reducing bacterial contamination when used as a pre-procedural rinse, with and without high volume evacuation (Aerosol reduction device).

MATERIALS AND METHODS

Subjects for the study were selected from the outpatient Department of Periodontics, Sri Siddhartha Dental College and Hospital, Tumkur, India. Total 60 patients were taken for the study and on the basis of inclusion and exclusion criteria's they were divided into three groups. The sampling was carried out in two stages before and after implementing a set protocol. Total duration of study was four months.

MICROBIOLOGICAL EVALUATION

The samples (blood agar plates) were transported immediately to the Department of Microbiology, Sri Siddhartha Medical College, Tumkur for: Identification of microorganisms as per standard procedures (Gram stain, Biochemical Test, Species Identification).Counting the number of colonies formed on blood agar plates using colony counter unit.

RESULTS

Out of all the three pre-procedural rinses 0.2% w/v Chlorhexidine is the best in reducing aerobic bacteria (CFU) followed by Listerine and then Water.

CONCLUSION

The following conclusion was drawn that the use of pre-procedural rinses along with the use of high volume suction apparatus significantly reduced the aerosol contamination and hence chances of cross-infection in the dental units.