Dental researchers have found that the combined use of a large volume evacuator (HVE) with an intraoral suction device significantly reduces the amount of microbial aerosols generated during a dental cleaning procedure, according to a new report. research.

The study, conducted by a team of professors and researchers from Loma Linda University School (LLU) of Dentistry, reported that the combination of the two devices improves the safety of patients and dental professionals against potentially harmful airborne microbes.

Researchers found a three-fold reduction in microbial aerosols with simultaneous use of an HVE and an additional suction device placed in a patient’s mouth compared to using only HVE.

Published in the Journal of the American Dental Association this month, “A Clinical Investigation of Dental Evacuation Systems to Reduce Aerosols,” gives proven and real steps dental professionals can take to keep their dental care safe. team and their patients.

These types of surveys and research are essential to assess how dentistry works today and how it may evolve in the future to improve the safety of our patients and dental professionals.Dr Montry Suprono

The dangerous spread of the COVID-19 virus and the growing understanding of its routes of transmission, including via airborne respiratory droplets, has sparked researchers’ determination to investigate aerosol dispersion during dental procedures, explains Montry S. Suprono, DDS, MSD, director of LLU Dental Research Center and principal investigator of the study.

“Once organizations like the WHO and the CDC released reports describing the modes of transmission of the virus, we quickly understood how dentistry would be affected because a number of dental procedures generate aerosols,” he says. “So we wanted to find ways to minimize the risks by decreasing the amount of aerosols generated during dental procedures. “

The investigation began with a clinical trial involving over 90 participating dental students who would play roles as operator or patient at the LLU dental clinic. The researchers collected aerosol samples by placing blood agar plates – dishes intended to collect the aerosols – in various areas of the clinic, such as shelves or patient chests, for time intervals before, during and after dental cleaning procedures.

The procedures themselves were conducted using a split-mouth design – meaning that operators used both the HVE instrument and the intraoral suction device on one side of the mouth. patient’s mouth during one cycle of the cleaning procedure and only used the HVE on the other side of the patient’s mouth. for the other round of the procedure.

After collecting the aerosols in the different agar plates that were incubated for two days, Suprono and his team measured the microbial levels of each sample.

Some of the significant results included:

• The highest microbial counts were from plates placed on patients in the operating area as opposed to plates placed on movable trays and shelves further away;
• Microbial levels during procedures were highest compared to levels in the period before or after treatment;
• Compared to using HVE alone, the combination of HVE and an intraoral aspirator significantly reduced the amount of microbial aerosols generated.

Suprono also notes another critical finding: microbial levels before procedures were similar to microbial levels after procedures, meaning that a 30-minute interval for air change and for aerosols to settle on surfaces afterwards. the procedure seems to be adequate. “We now know that dental professionals should allow aerosols to settle for a period of time before disinfecting the treatment area and that the risk between patients is minimal if given time,” he says.

Suprono says he hopes the research will inform and guide best clinical practices for improving safety and hygiene during dental cleanings. There are also many opportunities to consider other types of dental procedures or equipment in assessing aerosol generation. Understanding aerosol dynamics through computer simulations and modeling is also another rapidly developing area of ​​research, he says.

The team of researchers will continue to study personal protective equipment, aerosols and air quality as it relates to dental practice, Suprono said.

“These types of surveys and research are essential to assess how dentistry works today and how it might evolve in the future to improve the safety of our patients and dental professionals,” he says.

To learn more about the School of Dentistry’s research efforts, visit dentalclinics.llu.edu/center-dental-research or call 909-558-8069.