Optimum Travel Distance of Dental Aerosols in the Dental Hygiene Practice
Author: Milejczak, Catherine Bowden
Source: Journal of Dental Hygiene, Number 4, Fall 1st October 2005 , pp. 20-20(1)
Publisher: American Dental Hygienists' Association
Abstract:Purpose: Dental hygienists have a legal and ethical responsibility to prevent disease transmission. Dental aerosols are produced from mechanized instruments used in dental hygiene treatment protocols. These aerosols can contain blood, saliva, and bacteria combinations that can produce potentially harmful air contaminants (bioaerosols). Current health issues such as the continuous changes in HIV/AIDS rates, the increase in number of people infected with the hepatitis C virus, the reemergence of tuberculosis, the increase in number of people with respiratory infections, the recent outbreak of Severe Acute Respiratory Syndrome, and the number of immunocompromised individuals seeking dental care has triggered a re-evaluation of infection control procedures. The American Dental Association, the Centers for Disease Control and Prevention, and the Organization for Safety and Asepsis Procedures have issued recommendations for the reduction of dental aerosols. Though invisible to the human eye, aerosols can potentially cause severe diseases to both oral health care workers and their clients. The purpose of this study is to determine how far bioaerosols travel and if the aerosols linger beyond the client appointment time (usually one hour or less). Knowledge of the distance that these bioaerosols travel and the amount of time they remain airborne will enable the clinician to employ better aseptic techniques, employ personal protective equipment, and create a safe environment for both the dental clinician and the dental client.
Methods and Materials: The operator conducted five timed mock trials of 20 minutes for each instrument type (sonic scaler, ultrasonic scaler, and air abrasive). A DataRAM Real-Time aerosol monitor designed to measure airborne particulate concentrations was used to measure the aerosols. The measurements were recorded during three phases (pre-procedure, procedure, and post-procedure) at eight specified distances (30 cm increments). The data were organized into an analysis of variance table (block design) and a factorial balanced design method (8 x 4 x 3) of analysis of variance using repeated measures (means of the means) as conducted. A repeated measures design was used to control the extraneous variation of the study (location, air/heating, air currents). The analysis was computed using the Minitab statistic analysis program. A two-way analysis of variance of the data was used to determine if there were any significant differences in the means for the distance the aerosols traveled, the length of time the aerosols remained airborne, and the concentration amounts of aerosols produced from each machine.
Results: The results of the study demonstrated that particulate concentrations were present for 240 cm (nearly eight feet) and, while the greatest concentration of particles were present at the end of the procedure, a mean aerosol amount of 0.022 units was still present two hours past the procedure. The greatest amounts of aerosols were found during all time trials in the 30 to 90 cm range (1-3 ft), which is in the operators' work zone.
Conclusion: The study demonstrated that the ultrasonic scaler produced more aerosols than the sonic scaler and the air abrasive instrument at each measured time. Conclusions from this study support the necessity of the dental hygiene health care provider using measures to reduce aerosols in the dental hygiene operatory. This includes the use of high volume suctioning devices (large-bore suction tips, funnel shape attachments), pre-procedural rinsing, properly wearing personal protective equipment, good ventilation air recirculation in the operatory, and properly disinfecting areas where splash, splatter, and aerosols may contaminate.
Document Type: Abstract
Affiliations: laboratory manager at Midlands Technical College
Publication date: Fall 2005
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