Dental nurses helping research that shapes safe dentistry during COVID-19
Dental nurses have contributed to new research at Newcastle University that is being used to shape how dentistry can be carried out safely during the pandemic by mitigating the risks of dental aerosols.
The research, published in the Journal of Dentistry, has led the way in helping shape national clinical guidance for the profession to work effectively under extremely challenging circumstances.
The findings have been used by the Dental Schools' Council, Association of Dental Hospitals and the Scottish Dental Clinical Effectiveness Programme to guide key Covid-19 policies for the profession.
Research revealed that aerosol-generated procedures can spray aerosol and saliva particles large distances, with contamination varying widely depending on the processes used.
In the open clinic settings, dental suction substantially decreased contamination at sites further away from the patient, such as bays five meters away. Often these distant sites had no contamination present or if contamination was detected it was at very low levels, diluted by 60,000-70,000 times.
It was also found that, after 10 minutes, very little additional contaminated aerosol settled onto surfaces and, therefore, is a suitable time to clean a surgery after an aerosol-generating procedure.
Dr Richard Holliday, NIHR Clinical Lecturer in Restorative Dentistry at Newcastle University, UK, said: 'Our research has improved our understanding of dental aerosol generated procedures and identified how cross-contamination could be a risk for spreading COVID-19.
'When the pandemic began, dental services were significantly reduced and there was an urgent need by the profession to focus on how dental clinics could work in a safe environment for patients and staff.
'We now have a much greater understanding of where the splatter of aerosols go and how far they travel during different procedures and settings, allowing clinical teams to make informed decisions to protect people.
'I am pleased that our research here at Newcastle has been used nationally by leading dental bodies to inform their policies on how the profession should carry out procedures during the pandemic.'
A research team from the School of Dental Sciences, including clinicians, dental nurses, microbiologists and scientists carried out the study.
The team used the tracer dye, fluorescein, while carrying out aerosol-generating procedures on a dental mannequin to analyse how far and where aerosol particles and saliva travelled from the patient's mouth.
A range of procedures were done and the effect of suction and ventilation analysed. Experts looked at contamination close by and also in an open plan clinic.
Kimberley Pickering, a research dental nurse involved in the study, said: 'For the safe re-opening of dental services, it was essential to understand the behaviour of the aerosols that come out of a patient's mouth during dental work.
'We now better understand where the aerosols go and how far they travel during different procedures and settings.
'We also understand how dental aerosols settle over time, which has helped inform cross-infection control procedures.'
Further research will continue to focus on where aerosol and droplets from dental instruments travel and how far they go. Experts will also look at how long aerosols hang around in the air and examine a number of common dental procedures and methods of controlling aerosols.
A key part of the research will investigate if viruses can be carried in dental aerosols, and if viruses remain infective at a distance from the procedure. This will help experts to understand how to reduce the risk of microbes, like COVID-19, being spread by aerosols during dental treatment.
Author: Julie Bissett