Reduction of aerosols and splatter generated during ultrasonic scaling by adding food-grade thickeners to coolants: an in-vitro study

Abstract

Objective: The effectiveness of using food-grade coolant thickener solutions on the amount of aerosols generated and splatter contamination spread distance during simulated ultrasonic scaling was examined.

Materials and methods: The study was performed using a phantom lower jaw placed on a black box. Simulated ultrasonic scaling was performed for 2 min using four coolant solutions: distilled water (control), 2% wt. polyacrylic acid (PAA), 0.4% wt. xanthan gum (XA), and 0.4% wt. carboxymethyl cellulose (CMC). The simulation was repeated 10 times for each coolant group. The generated aerosols and droplets were quantified using a handheld particle counter, and the splatter contamination spread distance was evaluated by adding tracing fluorescent dye to the coolant reservoir supplying the scaler unit. One-way multivariate analysis of variance was performed to determine the difference among coolant groups (a = .05).

Results: The amount of aerosols and droplets and splatter contamination distance (p < .001) pertaining to the three food-grade coolant thickener solutions were considerably lower than those for the distilled water (control). The PAA group exhibited a significantly lower splatter contamination distance (p < .001) and a number of generated droplets (p = .031) than those of the XA group. The CMC group exhibited a significantly lower splatter contamination distance (p < .001) than that of the XA group. No statistically significant difference was observed between the PAA and CMC in terms of the three dependent variables (p > .05).

Conclusion: The food-grade coolant thickeners could reduce the amount of generated aerosols and splatter contamination distance but not completely eliminate them. PAA and CMC solutions were more effective in reducing the aerosol/splatter during scaling compared to XA.

Clinical relevance: Many dental procedures generate aerosols and splatter, which pose a potential risk to the patients and dental personnel, especially during the current COVID-19 pandemic.

Keywords: Aerosols; Dental infection control; Food thickener; Mitigation strategies; SARS-CoV-2; Splatter.