Purpose: Aerosols are defined as airborne particles that range in size from 0.5 to 10 microns (micron). They are produced during ultrasonic instrumentation, but they can be reduced. Irrigant solutions, which produce the therapeutic effects of lavage, also combine with blood, saliva, and bacteria to produce potentially harmful airborne particulates. The American Dental Association (ADA) and the Centers for Disease Control and Prevention (CDC) recommend utilization of high volume evacuation, rubber dam, and patient positioning for aerosol control. But for the non-assisted dental hygienist, these recommendations are difficult to implement. This study was designed to compare the concentration of airborne particulates from ultrasonic scaling, utilizing three different methods of evacuation.
Methods: In a laboratory setting, ultrasonic airborne particulates were generated utilizing a 25,000 cps magnetostrictive ultrasonic scaling instrument. Three evacuation devises were compared for effectiveness: a standard saliva ejector intraorally positioned; and two extraorally positioned, hands-free high-volume evacuation (HFHVE) techniques. One of these devices had a standard attachment, and, the other had a funnel-shaped attachment. Measurement of airborne particles was performed with a DataRAM Real-Time Aerosol Monitor.
Results: This study (N = 21) found a significant reduction in the number of airborne particulates with either form of extraoral HFHVE attachment in place. Standard attachments and funnel-shaped attachments to HFHVE resulted in reduction of particulates by 90.8% and 89.7%, respectively, when compared to the intraorally positioned standard saliva ejector.
Conclusions: Utilizing either form of HFHVE during ultrasonic instrumentation significantly reduced the number of aerosolized particulates that reached the breathing space of the client and clinician. This lends support for the ADA and CDC recommendation that HVE be used during aerosol producing procedures. Currently, no preventive measure is 100% effective; therefore, clinicians are encouraged to use additional methods to minimize the number of airborne particulates produced during intraoral instrumentation.