Aerosols in the Dental Office: Best Practices for Patient and Practitioner Safety

As dental procedures and technologies have evolved, the incidence of aerosol-creating procedures has increased. Inhalation of airborne particles and aerosols produced during dental procedures may cause adverse respiratory health effects and bidirectional disease transmission. Oral healthcare professionals should be aware of these “invisible” risks within their operatories and follow recommended infection prevention protocols before, during and after patient care.

With the rapid pandemic of COVID-19 and the spread of its underlying viral agent, SARS-CoV-2, there has been a renewed interest in aerosol-generating dental procedures in the dental office. Airborne disease transmission for SARS-CoV-2 has been established as a method of community spread. What is less well-defined is the role of aerosols generated during dental care in disease transmission. While previous research has demonstrated that microorganisms originating in the oral cavity and/or present in dental unit water lines (DUWL) are capable of causing respiratory infections, the current pandemic has highlighted the potential risks of dental aerosols and potential mitigation strategies. In addition to the close contact that routinely occurs during the delivery of dental care, the use of dental handpieces, powered scalers, air/water syringes, and other dental instruments are known to create aerosols and spatter. As dental procedures and technologies have evolved, the incidence of aerosol-generating dental procedures has increased and a focus on methodologies to reduce aerosol bioload, to mitigate aerosol spread throughout the dental office, and to decrease aerosol generation is warranted.