Vernon, JJ orcid.org/0000-0002-0072-9294, Black, EVI orcid.org/0000-0003-1600-1094, Dennis, T et al. (4 more authors) (2021) Dental Mitigation Strategies to Reduce Aerosolization of SARS-CoV-2. Journal of Dental Research, 100 (13). pp. 1461-1467. ISSN 0022-0345
Abstract
Limiting infection transmission is central to the safety of all in dentistry, particularly during the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Aerosol-generating procedures (AGPs) are crucial to the practice of dentistry; it is imperative to understand the inherent risks of viral dispersion associated with AGPs and the efficacy of available mitigation strategies. In a dental surgery setting, crown preparation and root canal access procedures were performed with an air turbine or high-speed contra-angle handpiece (HSCAH), with mitigation via rubber dam or high-volume aspiration and a no-mitigation control. A phantom head was used with a 1.5-mL min−1 flow of artificial saliva infected with Φ6-bacteriophage (a surrogate virus for SARS-CoV-2) at ~108 plaque-forming units mL−1, reflecting the upper limits of reported salivary SARS-CoV-2 levels. Bioaerosol dispersal was measured using agar settle plates lawned with the Φ6-bacteriophage host, Pseudomonas syringae. Viral air concentrations were assessed using MicroBio MB2 air sampling and particle quantities using Kanomax 3889 GEOα counters. Compared to an air turbine, the HSCAH reduced settled bioaerosols by 99.72%, 100.00%, and 100.00% for no mitigation, aspiration, and rubber dam, respectively. Bacteriophage concentrations in the air were reduced by 99.98%, 100.00%, and 100.00% with the same mitigations. Use of the HSCAH with high-volume aspiration resulted in no detectable bacteriophage, both on nonsplatter settle plates and in air samples taken 6 to 10 min postprocedure. To our knowledge, this study is the first to report the aerosolization in a dental clinic of active virus as a marker for risk determination. While this model represents a worst-case scenario for possible SARS-CoV-2 dispersal, these data showed that the use of HSCAHs can vastly reduce the risk of viral aerosolization and therefore remove the need for clinic fallow time. Furthermore, our findings indicate that the use of particle analysis alone cannot provide sufficient insight to understand bioaerosol infection risk.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © International Association for Dental Research and American Association for Dental, Oral, and Craniofacial Research 2021. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (CC-BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/) |
Keywords: | aerosol-generating procedure, bacteriophage, bioaerosol, high-speed contra-angle handpiece, fallow time, dentistry |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Engineering & Physical Sciences (Leeds) > School of Civil Engineering (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Dentistry (Leeds) > Oral Biology (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Dentistry (Leeds) > Restorative Dentistry (Leeds) |
Funding Information: | Funder Grant number British Endodontic Society only project title rqd |
Depositing User: | Symplectic Publications |
Date Deposited: | 18 Aug 2021 09:39 |
Last Modified: | 25 Jun 2023 22:44 |
Status: | Published |
Publisher: | SAGE Publications |
Identification Number: | 10.1177/00220345211032885 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:177191 |