Is it safe to visit the dentist during COVID-19?

At the beginning of the pandemic, doctors decided to cut back on health services such as dentistry due to the unknown risk of the spread and transmission of COVID-19. However, over the past year research has significantly expanded knowledge in the field, and clinical teams now feel better positioned to make informed healthcare decisions, including whether it is safe to go to the dentist during COVID-19 .

A team of clinicians, dentists, scientists and microbiologists from the School of Dental Sciences at Newcastle University, UK, conducted a study to understand the spread of airborne particles during dental procedures. The aim of the study was to determine the aerosol distribution from dental interventions in a large-scale clinic. In addition, the scientists examined the aerosol settling time after dental surgery.

The study comprised a total of nine experiments. Six experiments were carried out in a large-scale hospital to investigate the aerosol and splash distribution in this environment. Another three experiments were carried out in a clinical training laboratory to investigate the persistence of dental aerosols. The researchers performed the same clinical procedure in all experiments – a ten-minute crown preparation of the upper right central incisor in the upper jaw. Each of the nine experiments was repeated three times. Elements such as suction, spraying, ventilation and clinic layout were analyzed.

The study reported that most of the contamination was confined to the first 1.5 m before the procedure. If a 1.5 m high side partition with open fronts is used, at least 99.99% of the splashes after an aerosol generation process are contained in the pen. The researchers discovered minimal splashes outside of the aerosol generating process bay. It has been found that any removed contamination from deposited aerosol is very little.

Interestingly, the water spray from dental instruments caused a significant dilution effect. The study also reported that dental suction had a significantly positive impact, especially on contamination further away.

Most contaminated aerosol splashes that were supposed to settle on surfaces did so within ten minutes of completing the procedure. This means that at this point it is suitable for cleaning the environment.

Research has led to a better understanding of the spread of infected aerosol particles during a dental procedure, and therefore has provided information on how dentists can safely perform procedures during the pandemic.

The study results, published in the Journal of Dentistry, have shaped national clinical guidelines for dental procedures across the UK and form the top COVID-19 guidelines for the profession.

It has also resulted in students from Newcastle University's School of Dental Sciences starting teaching aerosol generation techniques again. One of the first universities in the UK to have safely returned to face-to-face teaching of procedures during this period. The university has taken its lead from the study to reconfigure clinics and enable the safe return of student-led treatments to patients.

This study has led to a better understanding of how aerosol generating dental treatments can be made safer for both the clinician and the patient. However, more research is ongoing and will look in more depth into aerosols and droplets from dental instruments, where they move and how far they go. Methods to control aerosols in the air are also being investigated.

References:

EurekAlert !. 2021. Research shapes safe dentistry during Covid-19. (online) Available at: (Accessed January 18, 2021).

Holliday, R., Allison, J., Currie, C., Edwards, D., Bowes, C., Pickering, K., Reay, S., Durham, J., Lumb, J., Rostami, N., Coulter, J., Nile, C., and Jakubovics, N., 2021. Evaluation of Contaminated Dental Aerosol and Splatter in an Open Clinical Environment: Impacts on the COVID-19 Pandemic. Journal of Dentistry, 105, p. 103565.

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