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Research Article

Quantifying strategies to minimize aerosol dispersion in dental clinics

Shamudra Dey1, Maryam Tunio2, Louis C. Boryc2, Brian D. Hodgson2, Guilherme J. M. Garcia1( )
Joint Department of Biomedical Engineering, Marquette University, Medical College of Wisconsin, Milwaukee 53226, USA
School of Dentistry, Marquette University, Milwaukee 53233, USA
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Graphical Abstract

Abstract

Many dental procedures are aerosol-generating and pose a risk for the spread of airborne diseases, including COVID-19. Several aerosol mitigation strategies are available to reduce aerosol dispersion in dental clinics, such as increasing room ventilation and using extra-oral suction devices and high-efficiency particulate air (HEPA) filtration units. However, many questions remain unanswered, including what the optimal device flow rate is and how long after a patient exits the room it is safe to start treatment of the next patient. This study used computational fluid dynamics (CFD) to quantify the effectiveness of room ventilation, an HEPA filtration unit, and two extra-oral suction devices to reduce aerosols in a dental clinic. Aerosol concentration was quantified as the particulate matter under 10 μm (PM10) using the particle size distribution generated during dental drilling. The simulations considered a 15 min procedure followed by a 30 min resting period. The efficiency of aerosol mitigation strategies was quantified by the scrubbing time, defined as the amount of time required to remove 95% of the aerosol released during the dental procedure. When no aerosol mitigation strategy was applied, PM10 reached 30 µg/m3 after 15 min of dental drilling, and then declined gradually to 0.2 µg/m3 at the end of the resting period. The scrubbing time decreased from 20 to 5 min when the room ventilation increased from 6.3 to 18 air changes per hour (ACH), and decreased from 10 to 1 min when the flow rate of the HEPA filtration unit increased from 8 to 20 ACH. The CFD simulations also predicted that the extra-oral suction devices would capture 100% of the particles emanating from the patient’s mouth for device flow rates above 400 L/min. In summary, this study demonstrates that aerosol mitigation strategies can effectively reduce aerosol concentrations in dental clinics, which is expected to reduce the risk of spreading COVID-19 and other airborne diseases.

Keywords

COVID-19computational fluid dynamics (CFD) simulationdental aerosolsextra-oral suction devicehigh-efficiency particulate air (HEPA) filtration unitfallow time

References

 
Allison, J. R., Dowson, C., Pickering, K., Červinskytė, G., Durham, J., Jakubovics, N. S., Holliday, R. 2022. Local exhaust ventilation to control dental aerosols and droplets. Journal of Dental Research, 101: 384–391
Crossref Google Scholar
 
Allison, J. R., Edwards, D. C., Bowes, C., Pickering, K., Dowson, C., Stone, S. J., Lumb, J., Durham, J., Jakubovics, N., Holliday, R. 2021. The effect of high-speed dental handpiece coolant delivery and design on aerosol and droplet production. Journal of Dentistry, 112: 103746.
Crossref Google Scholar
 
Bhattacharyya, S., Dey, K., Paul, A. R., Biswas, R. 2020. A novel CFD analysis to minimize the spread of COVID-19 virus in hospital isolation room. Chaos, Solitons & Fractals, 139: 110294.
Crossref Google Scholar
 
Chen, C., Zhao, B., Cui, W., Dong, L., An, N., Ouyang, X. 2010. The effectiveness of an air cleaner in controlling droplet/aerosol particle dispersion emitted from a patient’s mouth in the indoor environment of dental clinics. Journal of the Royal Society Interface, 7: 1105–1118.
Crossref Google Scholar
 
Chuang, C. Y., Cheng, H. C., Yang, S., Fang, W., Hung, P. C., Chuang, S. Y. 2014. Investigation of the spreading characteristics of bacterial aerosol contamination during dental scaling treatment. Journal of Dental Sciences, 9: 294–296.
Crossref Google Scholar
 
Dudding, T., Sheikh, S., Gregson, F., Haworth, J., Haworth, S., Main, B. G., Shrimpton, A. J., Hamilton, F. W., Group, A., Ireland, A. J., et al. 2022. A clinical observational analysis of aerosol emissions from dental procedures. PLoS One, 17: e0265076.
Crossref Google Scholar
 
Eames, I., D'Aiuto, F., Shahreza, S., Javanmardi, Y., Balachandran, R., Hyde, M., Ng, Y. L., Gulabivala, K., Watson, S., Davies, H., et al. 2021. Removal and dispersal of biofluid films by powered medical devices: Modeling infectious agent spreading in dentistry. iScience, 24: 103344.
Crossref Google Scholar
 
Fennelly, M., Gallagher, C., Harding, M., Hellebust, S., Wenger, J., O'Sullivan, N., O’Connor, D., Prentice, M. 2022. Real-time monitoring of aerosol generating dental procedures. Journal of Dentistry, 120: 104092.
Crossref Google Scholar
 
Grenier, D. 1995. Quantitative analysis of bacterial aerosols in two different dental clinic environments. Applied and Environmental Microbiology, 61: 3165–3168.
Crossref Google Scholar
 
Haffner, E. A., Bagheri, M., Higham, J. E., Cooper, L., Rowan, S., Stanford, C., Mashayek, F., Mirbod, P. 2021. An experimental approach to analyze aerosol and splatter formations due to a dental procedure. Experiments in Fluids, 62: 202.
Crossref Google Scholar
 
Harrel, S. K., Molinari, J. 2004. Aerosols and splatter in dentistry: A brief review of the literature and infection control implications. Journal of the American Dental Association, 135: 429–437.
Crossref Google Scholar
 
Holliday, R., Allison, J. R., Currie, C. C., Edwards, D. C., Bowes, C., Pickering, K., Reay, S., Durham, J., Lumb, J., Rostami, N., et al. 2021. Evaluating contaminated dental aerosol and splatter in an open plan clinic environment: Implications for the COVID-19 pandemic. Journal of Dentistry, 105: 103565.
Crossref Google Scholar
 
Jungo, S., Moreau, N., Mazevet, M. E., Ejeil, A. L., Biosse Duplan, M., Salmon, B., Smail-Faugeron, V. 2021. Prevalence and risk indicators of first-wave COVID-19 among oral health-care workers: A French epidemiological survey. PLoS One, 16: e0246586.
Crossref Google Scholar
 
Klompas, M., Baker, M. A., Rhee, C. 2020. Airborne transmission of SARS-CoV-2: Theoretical considerations and available evidence. JAMA, 324: 441–442.
Crossref Google Scholar
 
Komperda, J., Peyvan, A., Li, D., Kashir, B., Yarin, A. L., Megaridis, C. M., Mirbod, P., Paprotny, I., Cooper, L. F., Rowan, S., et al. 2021. Computer simulation of the SARS-CoV-2 contamination risk in a large dental clinic. Physics of Fluids, 33: 033328.
Crossref Google Scholar
 
Kumar, P. S., Subramanian, K. 2020. Demystifying the mist: Sources of microbial bioload in dental aerosols. Journal of Periodontology, 91: 1113–1122.
Crossref Google Scholar
 
Leggat, P. A., Kedjarune, U. 2001. Bacterial aerosols in the dental clinic: A review. International Dental Journal, 51: 39–44.
Crossref Google Scholar
 
Li, X., Mak, C. M., Ma, K. W., Wong, H. M. 2021. Evaluating flow-field and expelled droplets in the mockup dental clinic during the COVID-19 pandemic. Physics of Fluids, 33: 047111.
Crossref Google Scholar
 
Liu, P. 2022 Computational Fluid Dynamics Optimization of an Extraoral Vacuum Aerosol Cup for Airborne Disease Control in Dental Offices. Aerosol Science and Engineering, 6: 21–29. Available at .
Crossref Google Scholar
 
Meethil, A. P., Saraswat, S., Chaudhary, P. P., Dabdoub, S. M., Kumar, P. S. 2021. Sources of SARS-CoV-2 and other microorganisms in dental aerosols. Journal of Dental Research, 100: 817–823.
Crossref Google Scholar
 
Memarzadeh, F., Xu, W. 2012. Role of air changes per hour (ACH) in possible transmission of airborne infections. Building Simulation, 5: 15–28.
Crossref Google Scholar
 
Méndez, C., San José, J. F., Villafruela, J. M., Castro, F. 2008. Optimization of a hospital room by means of CFD for more efficient ventilation. Energy and Building, 40: 849–854.
Crossref Google Scholar
 
Natapov, L., Schwartz, D., Domb Herman, H., Dekel Markovich, D., Yellon, D., Jarallah, M., Liphshiz, I., Carmeli, Y., Karakis, I. 2021. Risk of SARS-CoV-2 transmission following exposure during dental treatment—A national cohort study. Journal of Dentistry, 113: 103791.
Crossref Google Scholar
 
Ohya, T., Nakagawa, K., Arai, Y., Kato, H. 2022. Visualization of droplets produced by dental air turbines that require infection control measured during coronavirus 2019 outbreaks. Journal of Hospital Infection, 119: 196–198.
Crossref Google Scholar
 
Ou, Q., Placucci, R. G., Danielson, J., Anderson, G., Olin, P., Jardine, P., Madden, J., Yuan, Q., Grafe, T. H., Shao, S., et al. 2021. Characterization and mitigation of aerosols and spatters from ultrasonic scalers. Journal of the American Dental Association, 152: 981–990.
Crossref Google Scholar
 
Pasquarella, C., Veronesi, L., Napoli, C., Castiglia, P., Liguori, G., Rizzetto, R., Torre, I., Righi, E., Farruggia, P., Tesauro, M., et al. 2012. Microbial environmental contamination in Italian dental clinics: A multicenter study yielding recommendations for standardized sampling methods and threshold values. Science of the Total Environment, 420: 289–299.
Crossref Google Scholar
 
Petti, S. 2016. Tuberculosis: Occupational risk among dental healthcare workers and risk for infection among dental patients. A meta-narrative review. Journal of Dentistry, 49: 1–8.
Crossref Google Scholar
 
Polednik, B. 2021. Exposure of staff to aerosols and bioaerosols in a dental office. Building and Environment, 187: 107388.
Crossref Google Scholar
 
Pourfattah, F., Wang, L. P., Deng, W., Ma, Y. F., Hu, L., Yang, B. 2021. Challenges in simulating and modeling the airborne virus transmission: A state-of-the-art review. Physics of Fluids, 33: 101302.
Crossref Google Scholar
 
Remington, D. W., Ott, B. C., Hartka, T. R. 2022. Effectiveness of barrier devices, high-volume evacuators, and extraoral suction devices on reducing dental aerosols for the dental operator: A pilot study. Journal of the American Dental Association, 153: 309–318.
Crossref Google Scholar
 
Sergis, A., Wade, W. G., Gallagher, J. E., Morrell, A. P., Patel, S., Dickinson, C. M., Nizarali, N., Whaites, E., Johnson, J., Addison, O., et al. 2021. Mechanisms of atomization from rotary dental instruments and its mitigation. Journal of Dental Research, 100: 261–267.
Crossref Google Scholar
 
Sotiriou, M., Ferguson, S. F., Davey, M., Wolfson, J. M., Demokritou, P., Lawrence, J., Sax, S. N., Koutrakis, P. 2008. Measurement of particle concentrations in a dental office. Environmental Monitoring and Assessment, 137: 351–361.
Crossref Google Scholar
 
Timmerman, M. F., Menso, L., Steinfort, J., van Winkelhoff, A. J., van der Weijden, G. A. 2004. Atmospheric contamination during ultrasonic scaling. Journal of Clinical Periodontology, 31: 458–462.
Crossref Google Scholar
 
To, K. K. W., Tsang, O. T. Y., Yip, C. C. Y., Chan, K. H., Wu, T. C., Chan, J. M. C., Leung, W. S., Chik, T. S. H., Choi, C. Y. C., Kandamby, D. H., et al. 2020. Consistent detection of 2019 novel coronavirus in saliva. Clinical Infectious Diseases, 71: 841–843.
Crossref Google Scholar
 
Vernon, J. J., Black, E. V. I., Dennis, T., Devine, D. A., Fletcher, L., Wood, D. J., Nattress, B. R. 2021. Dental mitigation strategies to reduce aerosolization of SARS-CoV-2. Journal of Dental Research, 100: 1461–1467.
Crossref Google Scholar
 
Ye, M. J., Sharma, D., Campiti, V. J., Rubel, K. E., Burgin, S. J., Illing, E. A., Ting, J. Y., Park, J. H., Johnson, J. D., Vernon, D. J., et al. 2021. Aerosol and droplet generation from mandible and midface fixation: Surgical risk in the pandemic era. American Journal of Otolaryngology, 42: 102829.
Crossref Google Scholar
 
Zhang, M. 2021. Estimation of differential occupational risk of COVID-19 by comparing risk factors with case data by occupational group. American Journal of Industrial Medicine, 64: 39–47.
Crossref Google Scholar
Experimental and Computational Multiphase Flow
Volume 5 Issue 3,
September 2023
Pages 290-303
DOI: 10.1007/s42757-022-0157-3
Cite this article:
Dey S, Tunio M, Boryc LC, et al. Quantifying strategies to minimize aerosol dispersion in dental clinics. Experimental and Computational Multiphase Flow, 2023, 5(3): 290-303. https://doi.org/10.1007/s42757-022-0157-3

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Received: 23 August 2022
Revised: 12 November 2022
Accepted: 25 December 2022
Published: 28 March 2023
© Tsinghua University Press 2022
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