Impact of COVID-19 on Dental Services
Initial Response to the Pandemic
At the onset of the COVID-19 pandemic, health professionals, including dentists, opted to limit healthcare services due to uncertainties surrounding the virus’s spread and transmission. This decision was primarily aimed at safeguarding both patients and healthcare providers.
Advancements in Research
Over the past year, research has significantly enhanced understanding of COVID-19 transmission in healthcare settings. Clinical teams are now better equipped to make informed decisions regarding healthcare, including the safety of visiting dental practices during the pandemic.
Study on Aerosol Spread in Dental Procedures
Research Team and Objectives
A collaborative study conducted by a team of clinicians, dental nurses, scientists, and microbiologists from the School of Dental Sciences at Newcastle University in the United Kingdom aimed to investigate the spread of airborne particles during dental procedures. The primary goals were to identify aerosol distribution in an open-plan clinic and to assess the settling time of aerosols post-procedure.
Methodology
The study comprised nine experiments. Six were performed in an open-plan clinic to analyze aerosol and splatter distribution, while three were conducted in a clinical teaching laboratory to evaluate the persistence of dental aerosols. All experiments involved a standardized clinical procedure: a ten-minute crown preparation of the right maxillary central incisor tooth. Each experiment was conducted three times, taking into account factors such as suction, water spray, ventilation, and clinic layout.
Key Findings
The findings indicated that most contamination remained within 1.5 meters of the procedure. The introduction of a 1.5-meter high lateral bay partition with open fronts effectively contained over 99.99% of splatter from aerosol-generating procedures. Researchers noted minimal splatter beyond the designated area, with distant contamination from settled aerosols found to be at very low levels. Notably, the water spray from dental instruments significantly diluted aerosols, while dental suction proved to be particularly effective in reducing contamination at greater distances.
Timing analyses revealed that most aerosol splatter settled onto surfaces within ten minutes following the procedure, indicating an optimal timeframe for cleaning the environment.
Implications for Dental Practice
Guidance and Policy Formation
The research has enhanced understanding of aerosol particle movement during dental procedures, informing safe practices for dentists amid the pandemic. Published in the Journal of Dentistry, the study’s results have influenced national clinical guidelines for dental procedures across the United Kingdom, contributing to the development of key COVID-19 policies in the profession.
Return to In-Person Teaching
This research has also facilitated the resumption of teaching aerosol-generating techniques to students at Newcastle University’s School of Dental Sciences, making it one of the first institutions in the UK to safely reintroduce in-person procedural training during this period. The university utilized insights from the study to reconfigure clinic layouts, promoting safe student-led treatments on patients.
Future Research Directions
The study has significantly advanced knowledge on enhancing safety during aerosol-generating dental procedures for both clinicians and patients. Ongoing research aims to delve deeper into the behavior of aerosols and droplets produced by dental instruments, examining their travel patterns and distances. Additionally, methods for controlling aerosols in the air are currently being explored.
References
EurekAlert!. 2021. Research Shapes Safe Dentistry During Covid-19. [online] Available at: [Accessed 18 January 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. Evaluating contaminated dental aerosol and splatter in an open plan clinic environment: Implications for the COVID-19 pandemic. Journal of Dentistry, 105, p.103565.
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