Laser and photocatalysis in the control of aerosols in the dental office post-COVID-19.

Abstract

Sonia Regina Aykroyd

Introduction: Since the establishment of the current COVID-19 pandemic by the new SARS-CoV-2 virus, dental health care providers have been on the spotlight, as one of the professional team workers at highest risk for the contraction and dissemination of the disease, due to the unavoidable formation of aerosol and splatter during dental procedures.

Aim: There is a need to understand the influence of the particle sizes in virus dissemination in the dental office and to discuss modern solutions for the reduction of the production of aerosol during dental procedures and the possible inactivation of viruses.

Method: We revised the literature and gave an overview of the importance of particle sizes as an essential foundation for selecting an effective method of reducing aerosols in dentistry.

Introduction: Dental procedures with high and low-speed handpieces, lasers, electrosurgery units, ultrasonic scalers, air polishers, prophy angles, hand instruments or air/water syringes can create bioaerosols and spatter, with ultrasonic scalers and high-speed handpieces considered to produce more airborne contamination than any other instrument in dentistry, followed by air polishing, air/water syringe, and high-speed handpiece aerosolization. Dental aerosols can travel 4 ft from the emission zone and remain airborne for up to 30 minutes. Ultrasonic instrumentation can transmit 100,000 microbes per cubic foot with aerosolization of up to six feet, and, if improper air current is present, microbes can last anywhere from 35 minutes to 17 hours. The ultrasonic scaler causes the greatest source of aerosol contamination, due to the composition of particles of varying size, ranging from 0.001 to 100 µm, including both aerosol and spatter. Approximately 90-95 % of dental aerosols produced by dental procedures are < 5.0 µm, whilst in laser dentistry, only 5% of the emitted plume contains potentially hazardous bioaerosols, including cellular debris, blood fragments, and bacteria, however, the particle sizes are much smaller.