Rubber dam isolation and high-volume suction reduce ultrafine dental aerosol particles: An experiment in a simulated patient

Abstract

The ongoing Coronavirus Disease 2019 (COVID-19) pandemic has triggered the paralysis of dental services ascribed to the potential spread of severe acute respiratory syndrome (SARS)-CoV-2. Aerosol-generating procedures (AGPs) are common in dentistry, which in turn increase the risk of infection of the dental personnel due to the salivary presence of SARS-CoV-2 in COVID-19 patients. The use of rubber dam isolation (RDI) and high-volume evacuators (HVE) during AGPs is recommended to control dental aerosols, but the evidence about their effectiveness is scarce. This first study aimed to compare, in a simulated patient, the effectiveness of the following strategies: standard suction (SS), RDI and RDI + HVE. Using the laser diffraction technique, the effect of each condition on the volume distribution, average size and concentration of coarse (PM10), fine (PM2.5) and ultrafine (PM0.1) particles were evaluated. During the teeth drilling, the highest volume fraction of dental aerosol particles with SS was below 1 μm of aerodynamic diameter. Additionally, the RDI + HVE significantly reduced both the ultrafine dental aerosol particles and the concentration of total particulate matter. AGPs represent a potential risk for airborne infections in dentistry. Taken together, these preliminary results suggest that isolation and high-volume suction are effective to reduce ultrafine dental aerosol particles.