Respiratory infectious disease transmission of dental healthcare workers

Abstract

Respiratory pathogens significantly impact public health, with transmission primarily occurring during close contact. Dental healthcare workers (HCWs) are particularly at high risk due to long-term mouth opening of patients, and frequent close proximity between HCWs and patients. This study systematically analyzed close contact patterns in 200 dental procedures in mainland China's specialized dental settings, developing a mechanistic model to quantify exposure doses and infection risks for HCWs treating patients with respiratory infections. Findings revealed that the infection risks among dentists are 5.0-fold that among assistants, underscoring the need for enhanced protective measures. Infection risks for assistants were significantly impacted by patient age, especially in cases involving patients under 14 years, while disease type influenced risks for both dentists and assistants, with higher risks in prosthodontics and orthodontics. The assessments of protective measures for HCWs showed that combining N95 respirators with face shields provided over 95 % protection, while N95 respirators alone conferred over 89 % protection, suitable for high-risk settings. Face shields with surgical masks offered over 75 % protection, providing a cost-effective alternative in resource-limited environments. These results emphasize the importance of tailoring protective strategies to specific risk factors, offering valuable guidance for infection control practices in specialist-based dental healthcare systems. ENVIRONMENTAL IMPLICATION: This study addresses the environmental challenge of respiratory pathogen transmission in specialist-based dental healthcare systems. Through mechanistic modeling based on real close-contact behaviors from 200 dental procedures, dentists face 5.0-fold higher infection risks than assistants, with prosthodontics and orthodontics presenting high risks. The findings emphasize the necessity of targeted protective measures, recommending N95 respirators with face shields for optimal protection and surgical masks with face shields as cost-effective alternatives. By tailoring infection control strategies to specific risks, this study offers practical insights to enhance occupational safety and mitigate pathogen transmission in specialist-based dental environments.

Keywords: Close contact; Dental practice; Facial protective equipment; Healthcare worker; Respiratory infection.