Experimental evaluation of aerosol mitigation strategies in large open-plan dental clinics

Abstract

Background: Aerosols are generated routinely during patient care in dentistry. Managing exposure risk requires understanding characteristics of aerosols created during procedures such as those performed using high-speed drills that operate at 200,000 revolutions per minute.

Methods: A trained dentist performed drilling procedures on a manikin's incisors (teeth nos. 8 and 9) using a high-speed drill and high-volume evacuator. The authors used high-speed imaging to visualize the formation and transport of aerosol clouds and particle sampling to measure aerosol concentration and size distribution at several locations. The authors studied several aerosol mitigation strategies.

Results: Aerosols produced during high-speed drilling were erratic and yielded high concentrations that were at least an order of magnitude above baseline. High-speed imaging showed aerosols initially travelled at 1 m per second. Owing to erratic behavior of aerosols, supplemental suction was not effective at collecting all aerosols; however, barriers were effective.

Conclusions: Barriers are the most effective mitigation strategy. Other methods studied have limitations and risks. To the authors' knowledge, this article presents the first characterization of aerosols generated during high-speed drilling by a dentist.

Practical implications: With thorough preoperative planning and the use of this investigation's findings about effectiveness of mitigation strategies as a guide, dental offices may be able to return to prepandemic productivity.

Keywords: Aerosols; dental high-speed equipment; dental office; interior design and furnishings; safety management.