Aerosols and splatter in dentistry: a brief review of the literature and infection control implications

Abstract

Background: Aerosols and droplets are produced during many dental procedures. With the advent of the droplet-spread disease severe acute respiratory syndrome, or SARS, a review of the infection control procedures for aerosols is warranted.

Types of studies reviewed: The authors reviewed representative medical and dental literature for studies and reports that documented the spread of disease through an airborne route. They also reviewed the dental literature for representative studies of contamination from various dental procedures and methods of reducing airborne contamination from those procedures.

Results: The airborne spread of measles, tuberculosis and SARS is well-documented in the medical literature. The dental literature shows that many dental procedures produce aerosols and droplets that are contaminated with bacteria and blood. These aerosols represent a potential route for disease transmission. The literature also documents that airborne contamination can be minimized easily and inexpensively by layering several infection control steps into the routine precautions used during all dental procedures.

Clinical implications: In addition to the routine use of standard barriers such as masks and gloves, the universal use of preprocedural rinses and high-volume evacuation is recommended.

Figure 1

The visible aerosol cloud produced by an ultrasonic scaler using a flow of 17 milliliters per minute of coolant water.

Figure 2

The visible aerosol cloud, made up of water and abrasive at the levels recommended by the manufacturer, produced by an air polisher.

Figure 3

The two sources of aerosols produced during dental treatment: coolant water and the patient.