Spatter contamination in dental practices--how can it be prevented?

Abstract

Infectious diseases endanger all dental personnel during treatment, especially when spatter and aerosols are produced. Therefore, there is a strong need for better infection control principles during all treatments. The purpose of this in-vitro pilot study was to measure the environmental spatter contamination through a fluorescence technique. Scaling was performed using different power-driven devices and high-volume evacuation combined with a newly developed cannula (PS), standard suction cannulas (STS) and saliva ejectors (CDS).

Material and methods: One sonic (AIR) and two ultrasonic devices (TIG, VEC) were utilized to remove biofilm from 168 artificial teeth in a manikin head. Teeth were scaled for 120s supra- or subgingivally. The spatter contamination of an area of 1.5m2 around the manikin head was assessed.

Results and conclusions: The contaminated area (%) was significantly different for the AIR (median [25th; 75th percentiles]: 2.5 [1.16; 6.05]) versus TIG (0.25 [0.18; 0.88]) and VEC (0.08 [0.06; 0.1]) (p<0.001). Irrespective of the instrument, subgingival scaling led to a less contaminated area (0.18 [0.07; 1.05]) than supragingival scaling (0.34 [0.1; 2.24]) (p < 0.001). High-volume evacuation combined with STS (0.17 [0.07; 1.04]) and PS (0.18 [0.07; 1.14]) reduced the contamination similarly (p=0.302) and was more effective compared to CDS (1.01 [0.12-5.78]) (p<0.001; p=0.002). Beside the limitation of an in-vitro investigation, it can be conclude that only high-volume evacuation with an adequately calibrated cannula is capable of significantly reducing the amount of spatter contamination produced during power-driven scaling.