Dental professionals in dental clinics are more likely to be infected by dental aerosols and splatters (splatter: >50 µm in diameter). An extraoral suction (EOS) device has long been developed but has not been widely used to remove dental aerosols in dentistry because its performance varies widely. An innovative new design with an annular air curtain (EOS-AAC) was proposed in this work. The performance of both the commercial EOS and the new EOS-AAC design in removing dental aerosols and splatters was evaluated by numerical simulations. The new design can confine and guide the released dental aerosols and splatters towards the suction head. The new design for dental surgeries can create a large separation distance of 30 cm from the patient's mouth. The aerosol and splatter removal ratios were up to 98% by the innovative EOS-AAC design at a low central suction velocity of 6–9 m/s (flow rate: 1.5–2.25 m3/min). It is a significant improvement over currently available EOS devices with an aerosol removal ratio of 10% and splatter removal ratio of less than 1% at a distance of 30 cm. The new design can also be promoted to different indoor scenarios to remove contaminants.
MillerRLMicikREAbelCRygeG. Studies on dental aerobiology: II. Microbial splatter discharged from the oral cavity of dental patients. J Dent Res1971; 50: 621–625.
2.
MicikREMillerRLMazzarellaMARygeG. Studies on dental aerobiology: I. Bacterial aerosols generated during dental procedures. J Dent Res1969; 48: 49–56.
3.
EklundKMarianosD. Providing a safe environment for dental care in an era of infectious diseases. J Am Dent Assoc2013; 144: 1330–1332.
4.
HarrelSKMolinariJ. Aerosols and splatter in dentistry: a brief review of the literature and infection control implications. J Am Dent Assoc2004; 135: 429–437.
5.
IliadiAKoletsiDEliadesTEliadesG. Particulate production and composite dust during routine dental procedures. A systematic review with meta-analyses. Materials2020; 13: 2513.
6.
LeggatPAKedjaruneU. Bacterial aerosols in the dental clinic: a review. Int Dent J2001; 51: 39–44.
7.
ZhuNZhangDWangWLiXYangBSongJZhaoXHuangBShiWLuR. A novel coronavirus from patients with pneumonia in China, 2019. New Engl J Med2020; 382: 727–733.
8.
WangCHorbyPWHaydenFGGaoGF. A novel coronavirus outbreak of global health concern. Lancet2020; 395: 470–473.
9.
AllisonJRCurrieCCEdwardsDCBowesCCoulterJPickeringKKozhevnikovaEDurhamJNileCJJakubovicsN. Evaluating aerosol and splatter following dental procedures: addressing new challenges for oral health care and rehabilitation. J Oral Rehabil2021; 48: 61–72.
10.
WangCMiaoLWangZXiongYJiaoYLiuH. Emergency management in a dental clinic during the coronavirus disease 2019 (COVID-19) epidemic in Beijing. Int Dent J2021; 71: 32–39.
11.
KayahanEWuMVan GervenTBraekenLStijvenLPolitisCLeblebiciME. Droplet size distribution, atomization mechanism and dynamics of dental aerosols. J Aerosol Sci2022; 166: 106049.
12.
InnesNJohnsonIAl-YaseenWHarrisRJonesRKcSMcGregorSRobertsonMWadeWGallagherJE. A systematic review of droplet and aerosol generation in dentistry. J Dent2021; 105: 103556.
13.
AdhikariAKurellaSBanerjeePMitraA. Aerosolized bacteria and microbial activity in dental clinics during cleaning procedures. J Aerosol Sci2017; 114: 209–218.
14.
KobzaJPastuszkaJBrgoszewskaE. Do exposures to aerosols pose a risk to dental professionals?Occup Med2018; 68: 454–458.
15.
BennettAFulfordMWalkerJBradshawDMartinMMarshP. Microbial aerosols in general dental practice. Br Dent J2000; 189: 664–667.
16.
GrenierD. Quantitative analysis of bacterial aerosols in two different dental clinic environments. Appl Environ Microbiol1995; 61: 3165–3168.
17.
RautemaaRNordbergAWuolijoki-SaaristoKMeurmanJH. Bacterial aerosols in dental practice – a potential hospital infection problem?J Hosp Infect2006; 64: 76–81.
18.
WyllieALFournierJCasanovas-MassanaACampbellMTokuyamaMVijayakumarPGengBMuenkerMCMooreAJVogelsCB. Saliva is more sensitive for SARS-CoV-2 detection in COVID-19 patients than nasopharyngeal swabs. MedRxiv2020. https://doi.org/10.1101/2020.04.16.20067835.
19.
ToKK-WTsangOT-YYipCC-YChanK-HWuT-CChanJM-CLeungW-SChikTS-HChoiCY-CKandambyDH. Consistent detection of 2019 novel coronavirus in saliva. Clin Infect Dis2020; 71: 841–843.
20.
KutterJSSpronkenMIFraaijPLFouchierRAHerfstS. Transmission routes of respiratory viruses among humans. Curr Opin Virol2018; 28: 142–151.
21.
KillingleyBNguyen-Van-TamJ. Routes of influenza transmission. Influenza Other Resp2013; 7: 42–51.
22.
LiYQianHHangJChenXChengPLingHWangSLiangPLiJXiaoS. Probable airborne transmission of SARS-CoV-2 in a poorly ventilated restaurant. Build Environ2021; 196: 107788.
23.
JiaWWeiJChengPWangQLiY. Exposure and respiratory infection risk via the short-range airborne route. Build Environ2022; 219: 109166.
24.
MorawskaLCaoJ. Airborne transmission of SARS-CoV-2: the world should face the reality. Environ Int2020; 139: 105730.
25.
TangJLiYEamesIChanPRidgwayG. Factors involved in the aerosol transmission of infection and control of ventilation in healthcare premises. J Hosp Infect2006; 64: 100–114.
26.
XieXLiYChwangAHoPSetoW. How far droplets can move in indoor environments – revisiting the wells evaporation–falling curve. Indoor Air2007; 17: 211–225.
27.
Sze-ToGNYangYKwanJKYuSCChaoCY. Effects of surface material, ventilation, and human behavior on indirect contact transmission risk of respiratory infection. Risk Anal2014; 34: 818–830.
28.
LeiHLiYXiaoSYangXLinCNorrisSLWeiDHuZJiS. Logistic growth of a surface contamination network and its role in disease spread. Sci Rep2017; 7: 14826.
29.
WangPZhangNLeePKLiY. Quantification of Lactobacillus delbrueckii subsp. bulgaricus and its applicability as a tracer for studying contamination spread on environmental surfaces. Build Environ2021; 197: 107869.
30.
MengLHuaFBianZ. Coronavirus disease 2019 (COVID-19): emerging and future challenges for dental and oral medicine. J Dent Res202099: 481–487.
31.
PengXXuXLiYChengLZhouXRenB. Transmission routes of 2019-nCoV and controls in dental practice. Int J Oral Sci2020; 12: –6.
32.
RemingtonWDOttBCHartkaTR. Effectiveness of barrier devices, high-volume evacuators, and extraoral suction devices on reducing dental aerosols for the dental operator: a pilot study. J Am Dent Assoc2022; 153: 309–318. e301.
33.
JunevičiusJŠurnaAŠurnaR. Effectiveness evaluation of different suction systems. Stomatologija2005; 7: 52–57.
34.
SenpukuHFukumotoMUchiyamaTTaguchiCSuzukiIArikawaK. Effects of extraoral suction on droplets and aerosols for infection control practices. Dent J2021; 9: 80.
35.
NultyABLefkaditisCZachrissonPVan TonderQYarR. A clinical study measuring dental aerosols with and without a high-volume extraction device. Br Dent J2020 Nov; 12: 1–8. DOI: 10.1038/s41415-20-2274-3.
36.
Balanta-MeloJGutiérrezASinisterraGDíaz-PossoMGallegoDVillavicencioJContrerasA. Rubber dam isolation and high-volume suction reduce ultrafine dental aerosol particles: an experiment in a simulated patient. Appl Sci2020; 10: 6345.
37.
GraetzCHülsbeckVDüffertPSchorrSStraßburgerMGeikenADörferCECyrisM. Influence of flow rate and different size of suction cannulas on splatter contamination in dentistry: results of an exploratory study with a high-volume evacuation system. Clin Oral Investig2022; 26: 5687–5696.
38.
SupronoMSWonJSavignanoRZhongZAhmedARoque-TorresGZhangWOyoyoURichardsonPCarusoJ. A clinical investigation of dental evacuation systems in reducing aerosols. J Am Dent Assoc2021; 152: 455–462.
39.
ShahdadSPatelTHindochaACagneyNMuellerJ-DSeoudiNMorganCDinA. The efficacy of an extraoral scavenging device on reduction of splatter contamination during dental aerosol generating procedures: an exploratory study. Br Dent J2020; 11: 1–10.
40.
HorsophonphongSChestsuttayangkulYSuraritRLertsooksawatW. Efficacy of extraoral suction devices in aerosol and splatter reduction during ultrasonic scaling: a laboratory investigation. J Dent Res Dent Clin Dent Prospects2021; 15: 197.
41.
ChavisSEHinesSEDyalramDWilkenNCDalbyRN. Can extraoral suction units minimize droplet spatter during a simulated dental procedure?J Am Dent Assoc2021; 152: 157–165.
42.
XuJGuoHZhangYLyuX. Effectiveness of personalized air curtain in reducing exposure to airborne cough droplets. Build Environ2022; 208: 108586.
43.
XuJWangCGuoH. Effect of personalized air curtain combined with mixing ventilation on dispersion of aerosols released at different velocities from respiratory activities during close contact. J Build Eng2024; 87: 109016.
44.
LiuSCaoQZhaoXLuZDengZDongJLinXQingKZhangWChenQ. Improving indoor air quality and thermal comfort in residential kitchens with a new ventilation system. Build Environ2020; 180: 107016.
45.
TakamureKSakamotoYYagiTIwataniYAmanoHUchiyamaT. Blocking effect of desktop air curtain on aerosols in exhaled breath. AIP Adv2022; 12: 055323.
46.
ChenMHaoS. Numerical study on the cutting off performance of a novel personalized air curtain in a general consulting ward. Dev Built Environ2023; 16: 100239.
47.
YeJQianHMaJZhouRZhengX. Using air curtains to reduce short-range infection risk in consulting ward: a numerical investigation. Build Simul2021; 14: 325–335.
48.
RosaNGasparACostaJLopesAPaisJSda SilvaMG. Experimental assessment of an air curtain-sealed personal protective equipment for medical care: influence of breathing and thermal plume. Exp Therm Fluid Sci2023; 148: 110955.
49.
WeiXYiDXieWGaoJLvL. Protection against inhalation of gaseous contaminants in industrial environments by a personalized air curtain. Build Environ2021; 206: 108343.
50.
MaJQianHLiuFZhengX. Performance analysis of a novel personalized air curtain for preventing inhalation of particulate matters in industrial environments. J Build Eng2022; 58: 105014.
51.
WeiXXuYMaMCaoCNiuGCaoGGaoJ. Effect of ambient interferences on the effectiveness of a wearable ventilation for reducing pollutant exposure. J Build Eng2023; 78: 107632.
52.
YangJ-HChoH-SChoiJHwangJLeeJ-H. A study on the structure of garment-hood-embedded air curtain with fine dust protection function. Build Environ2023; 239: 110409.
53.
Al AssaadDHabchiCGhaliKGhaddarN. Effectiveness of intermittent personalized ventilation in protecting occupant from indoor particles. Build Environ2018; 128: 22–32.
XingCAiZLiuZMakCMWongHM. Characteristics of droplets emission immediately around mouth during dental treatments. Build Environ2024; 248: 111066.
56.
BergdahlM. Salivary flow and oral complaints in adult dental patients. Community Dent Oral2000; 28: 59–66.
57.
NavazeshMKumarSK. Measuring salivary flow: challenges and opportunities. J Am Dent Assoc2008; 139: 35S–40S.
58.
Von FraunhoferJSiegelSFeldmanS. Handpiece coolant flow rates and dental cutting. Oper Dent2000; 25: 544–548.
59.
WangCXuJChanKLeeHTsoCLinCSChaoCYFuS. Infection control measures for public transportation derived from the flow dynamics of obstructed cough jet. J Aerosol Sci2022; 163: 105995.
60.
LahdentaustaLSanmarkELauretsaloSKorkeeVNymanSAtanasovaNOksanenLZhaoJHusseinTHyvärinenA. Aerosol concentrations and size distributions during clinical dental procedures. Heliyon2022 October; 8: e11074.
61.
XuYYangXYangCSrebricJ. Contaminant dispersion with personal displacement ventilation, part I: base case study. Build Environ2009; 44: 2121–2128.
62.
XuJGuoHZhangYLyuX. Effectiveness of personalized air curtain in reducing exposure to airborne cough droplets. Build Environ2022; 208: 108586.
63.
RafieeACarvalhoRLunardonDFlores-MirCMajorPQuemeraisBAltabtbaeiK. Particle size, mass concentration, and microbiota in dental aerosols. J Dent Res2022; 101: 785–792.
64.
TeanpaisanRTaeporamaysamaiMRattanachonePPoldoungNSrisintornS. The usefulness of the modified extra-oral vacuum aspirator (EOVA) from household vacuum cleaner in reducing bacteria in dental aerosols. I Den J2001; 51: 413–416.
65.
GraetzCDüffertPHeidenreichRSeidelMDörferCE. The efficacy of an extraoral scavenging device on reducing aerosol particles ≤5 µm during dental aerosol-generating procedures: an exploratory pilot study in a university setting. BDJ open2021; 7: 19.
