The effect of location and method of tooth preparation on aerosol and splatter mitigation

Abstract Objectives : This study investigated the influence of tooth position within the quadrant and method of tooth preparation on aerosol and splatter reduction by suction techniques. Materials and methods : Using four suction techniques, tooth preparation was done using fast handpiece and combined air and water spray on tooth #28, #29 and #30. Splatter, aerosol and total sound generated were recorded. Two-way analysis of variance and posthoc pairwise comparisons compared amount of aerosol, spatter and total sound among suction techniques, tooth location and method of preparation. Results : There were statistically significant more splatter (P < 0.000) for tooth preparation with air and water spray compared with high-speed handpiece for all suction techniques, but no significant difference in aerosol and total sound (P > 0.05) was recorded. A significant reduction in environmental splatter during tooth preparation of the distal tooth #30 by all suction methods was observed compared with tooth #28. However, there was no significant difference in the amount of face shield, chest, right arm and left arm splatter, aerosol and total sound based on tooth location. Overall, the prototype suction device had statistically significant less environmental splatter (P < 0.001) and aerosol (P = 0.004) than the conventional HVE device. Conclusions : The method of tooth preparation affected splatter mitigation by suction techniques but had no influence on aerosol mitigation. Mitigation of environmental splatter by suction techniques was affected by tooth position within the arch. The prototype suction device reduced environmental spatter and aerosol more than the conventional HVE device. Clinical Significance: The variations observed in aerosol and splatter mitigation based on tooth preparation methods and tooth location provides evidence for adjunctive means of reducing risk of direct transmission of infection in the dental practice such as combining strategies of protective equipment, improved room ventilation and use of air filtration system.