The impact of high and low volume suction devices on aerosol mitigation in a dental setting

ABSTRACT

Background & Aim: The COVID-19 pandemic changed the approach to aerosol mitigation in dentistry, although there is limited evidence and notable inconsistency among measures implemented in different countries. The aim of this study was to investigate aerosol mitigation by different high and low volume suction devices (HVE/LVE) during two distinct aerosol generating procedures (AGPs) a full mouth ultrasonic scaling (USS) and an anterior crown preparation with a high speed handpiece. Methods: Two different sensor set ups were optimized;a single sensor in a funnel positioned above the mouth and a two-sensor set up with sensors positioned at the patient's nose and chin. The particulate sensors (Plantower PMS5003) quantified aerosol concentration, expressed as the number of >0.3 μm particles/0.1 L of air. Defined dental procedures were carried out on a dental phantom head. Aerosol generation was measured throughout the procedures. Efficacy of different suction devices was assessed. Statistical analysis was performed using the mean normalized area under the curve of five independent experiments. Results: The high speed handpiece generated 3.4 times more aerosol/ min than ultrasonics when measured with the single sensor funnel device, and comparable amount of aerosol when measured with the two-sensor set up. HVE devices, that are moved around the mouth, provided consistent reduction of aerosol - to background levels - when carrying out ultrasonic scaling or crown preparation. We evaluated both HVE and LVE 'static' devices that are placed in the patient's mouth in a predetermined position for the duration of the procedure. These 'static' devices offered reduction of aerosol but with consistent 'spikes' recorded during procedures when aerosol escaped. Conclusions: In this simulated test system, either HVE or LVE 'static' devices provide inconsistent reduction of aerosols when conducting ultrasonic instrumentation. By contrast, an appropriately used HVE could reduce detectable aerosol to background levels during ultrasonic instrumentation in this test system.