Dental Tribune UK & Ireland

Mitigation methods currently in place are effective, study shows

By Dental Tribune International
November 17, 2020

LONDON, UK: The latest results of a promising feasibility study which demonstrated the effectiveness of mitigation methods used in dental practices during aerosol-generating procedures (AGPs) have given an insight into the current situation in the UK.

Scientists at National Physical Laboratory (NPL) have come to the conclusion that aerosol mitigation methods used in the dental surgery clinical environment are effective and that there is limited correlation between the aerosol peaks detected and the clinical treatments being conducted. As the national metrology institute for the UK, NPL’s measurement science expertise has been called upon by UK industry to independently assess the wide-ranging challenges that SARS-CoV-2 has presented.

National UK dental chain mydentist asked NPL scientists with expertise in air quality measurements to study AGPs and the associated real-time monitoring and measurement of aerosol particle concentration in a clinical space during actual patient treatments. A preliminary investigation at a mydentist surgery using an optical particle counter was conducted in order to assess the number of airborne particles present, their concentration and how they are affected by different AGPs. Current dental procedures and associated guidance are based on several assumptions linked to air quality in each clinical setting. One aim of this study was to gauge particle removal times in a real-world dental surgery where patients were being treated. This information is highly relevant for informing fallow times between AGPs.

The study identified several background aerosol peaks from other sources inside or outside of the dental surgery. All aerosol events were found to diminish to background level within 10 minutes, on average, and within 20 minutes at the upper time range, regardless of their source.

Jordan Tompkins, higher research scientist in NPL’s air quality and aerosol metrology group, stated: “This is a great first step to measure what is going on in real surgeries with real patients. I feel that NPL is well placed to bring a scientific rigour to these studies and to make sure that we have a solid base on which to build future policy.”

Dr Nyree Whitley, who is the mydentist group clinical director, added: “This study provides the most authoritative clinical evidence yet that the chain of safety measures across dental practices are highly effective and that aerosols settle within 10 minutes on average, and 20 minutes at most.”

NPL is now planning to conduct further studies using a wider range of optical particle counter instruments within multiple mydentist surgeries. These studies will further assess the impact of ventilation conditions, sampling position, mitigation and instrument types on aerosol generation, detection and behaviour. The results of these studies will provide practitioners with guidance about the suitable fallow period, personal protective equipment required and associated safe working practices across a variety of clinical environments.

From 8 June 2020, general dental practices and community dental services in England were permitted to resume face-to-face routine and urgent care for appropriate patient groups. From 26 March, there had been a period of pause on routine treatments during the height of the COVID-19 pandemic. SARS-CoV-2 has had a major impact on dentistry, and many reports have suggested that dental health may take years to return to its pre-lockdown state. This initial feasibility study provides some insight not only for the dentistry industry, which employs more than 40,000 practitioners in the UK, but also for the general public, who rely on this health service.

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