A Comparison of Aerosol Mitigation Strategies and Aerosol Persistence in Dental Environments

Objectives To determine the impact of various aerosol mitigation interventions and establish duration of aerosol persistence in a variety of dental clinic configurations. Methods We performed aerosol measurement studies in endodontic, orthodontic, periodontic, pediatric, and general dentistry clinics. We used an optical aerosol spectrometer and wearable particulate matter sensors to measure real-time aerosol concentration from the vantage point of the dentist during routine care in a variety of clinic configurations (e.g, open bay, single room, partitioned operatories). We compared the impact of aerosol mitigation strategies [ventilation and high-volume evacuation (HVE)] and prevalence of particulate matter in the dental clinic environment before, during and after high-speed drilling, slow speed drilling and ultrasonic scaling procedures. Results Conical and ISOVAC® HVE were superior to standard tip evacuation for aerosol-generating procedures. When aerosols were detected in the environment, they were rapidly dispersed within minutes of completing the aerosol-generating procedure. Few aerosols were detected in dental clinics – regardless of configuration – when conical and ISOVAC® HVE were used. Conclusions Dentists should consider using conical or ISOVAC® HVE rather than standard tip evacuators to reduce aerosols generated during routine clinical practice. Furthermore, when such effective aerosol mitigation strategies are employed, dentists need not leave dental chairs fallow between patients as aerosols are rapidly dispersed. Clinical Significance ISOVAC® HVE is highly effective in reducing aerosol emissions, with adequate ventilation and HVE use, dental fallow time can be reduced to 5 minutes.