Cross-transmission in the Dental Office: Does This Make You Ill?

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Abstract

Purpose of Review

Recently, numerous scientific publications were published which shed new light on the possible risks of infection for dental healthcare workers and their patients. This review aimed to provide the latest insights in the relative risks of transmission of (pathogenic) micro-organisms in the dental office.

Recent Findings

Of all different routes of micro-organism transmission during or immediately after dental treatment (via direct contact/via blood-blood contact/via dental unit water and aerosols), evidence of transmission is available. However, the recent results put the risks in perspective; infections related to the dental office are most likely when infection control measures are not followed meticulously.

Summary

The risk for transmission of pathogens in a dental office resulting in an infectious disease is still unknown; it seems to be limited in developed countries but it cannot be considered negligible. Therefore, maintaining high standards of infection preventive measures is of high importance for dental healthcare workers to avoid infectious diseases due to cross-contamination.

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Most cited references 73

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A scoping review on bio-aerosols in healthcare and the dental environment

Charifa Zemouri, Hans de Soet, Wim Crielaard … (2017)

Background Bio-aerosols originate from different sources and their potentially pathogenic nature may form a hazard to healthcare workers and patients. So far no extensive review on existing evidence regarding bio-aerosols is available. Objectives This study aimed to review evidence on bio-aerosols in healthcare and the dental setting. The objectives were 1) What are the sources that generate bio-aerosols?; 2) What is the microbial load and composition of bio-aerosols and how were they measured?; and 3) What is the hazard posed by pathogenic micro-organisms transported via the aerosol route of transmission? Methods Systematic scoping review design. Searched in PubMed and EMBASE from inception to 09-03-2016. References were screened and selected based on abstract and full text according to eligibility criteria. Full text articles were assessed for inclusion and summarized. The results are presented in three separate objectives and summarized for an overview of evidence. Results The search yielded 5,823 studies, of which 62 were included. Dental hand pieces were found to generate aerosols in the dental settings. Another 30 sources from human activities, interventions and daily cleaning performances in the hospital also generate aerosols. Fifty-five bacterial species, 45 fungi genera and ten viruses were identified in a hospital setting and 16 bacterial and 23 fungal species in the dental environment. Patients with certain risk factors had a higher chance to acquire Legionella in hospitals. Such infections can lead to irreversible septic shock and death. Only a few studies found that bio-aerosol generating procedures resulted in transmission of infectious diseases or allergic reactions. Conclusion Bio-aerosols are generated via multiple sources such as different interventions, instruments and human activity. Bio-aerosols compositions reported are heterogeneous in their microbiological composition dependent on the setting and methodology. Legionella species were found to be a bio-aerosol dependent hazard to elderly and patients with respiratory complaints. But all aerosols can be can be hazardous to both patients and healthcare workers.

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Dissemination of aerosol and splatter during ultrasonic scaling: A pilot study

H.R. Veena, S Mahantesha, Preethi Joseph … (2015)

Routine dental procedures produce aerosol and splatter, which pose a potential risk to the clinician and dental personnel, as well as the immunocompromised patient. Reports indicate that the ultrasonic scaler is the greatest producer of aerosol and splatter.

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Presence of biofilm containing viable multiresistant organisms despite terminal cleaning on clinical surfaces in an intensive care unit.

Kathryn Allan, A Deva, P. Valente … (2011)

Despite recent attention to surface cleaning and hand hygiene programmes, multiresistant organisms (MROs) continue to be isolated from the hospital environment. Biofilms, consisting of bacteria embedded in exopolymeric substances (EPS) are difficult to remove due to their increased resistance to detergents and disinfectants, and periodically release free-swimming planktonic bacteria back into the environment which may may act as an infection source. To establish whether reservoirs of MROs exist in the environment as biofilms. Following terminal cleaning, equipment and furnishings were removed aseptically from an intensive care unit (ICU) and subjected to culture and scanning electron microscopy (SEM). Samples were placed in 5 mL of tryptone soya broth, sonicated for 5 min before plate culture on horse blood agar, Brillance MRSA and Brilliance VRE agar plates. Samples for SEM were fixed in 3% glutaraldehyde and hexamethyldisilizane (HMDS) prior to sputter-coating with gold and examination in an electron microscope. Biofilm was demonstrated visually on the sterile supply bucket, the opaque plastic door, the venetian blind cord, and the sink rubber, whereas EPS alone was seen on the curtain. Viable bacteria were grown from three samples, including MRSA from the venetian blind cord and the curtain. Biofilm containing MROs persist on clinical surfaces from an ICU despite terminal cleaning, suggesting that current cleaning practices are inadequate to control biofilm development. The presence of MROs being protected within these biofilms may be the mechanism by which MROs persist within the hospital environment. Copyright © 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

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Author and article information

Contributors

J. J. de Soet: J.d.soet@acta.nl

Journal

Journal ID (nlm-ta): Curr Oral Health Rep

Journal ID (iso-abbrev): Curr Oral Health Rep

Title: Current Oral Health Reports

Publisher: Springer International Publishing (Cham )

ISSN (Electronic): 2196-3002

Publication date (Electronic): 25 October 2018

Publication date PMC-release: 25 October 2018

Publication date (Print): 2018

Volume: 5

Issue: 4

Pages: 221-228

Affiliations

[1 ]ISNI 0000000084992262, GRID grid.7177.6, Department of Preventive Dentistry, Academic Centre for Dentistry of Amsterdam (ACTA), , University of Amsterdam and Vrije Universiteit Amsterdam, ; Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands

[2 ]ISNI 0000000084992262, GRID grid.7177.6, Department of Oral Kinesiology, Academic Centre for Dentistry of Amsterdam (ACTA), , University of Amsterdam and Vrije Universiteit Amsterdam, ; Amsterdam, The Netherlands

Article

Publisher ID: 201

DOI: 10.1007/s40496-018-0201-3

PMC ID: 6244620

PubMed ID: 30524929

SO-VID: 07b03474-19e5-4019-929b-c7af9861652c

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Funding

Funded by: Academic Center for Dentistry Amsterdam (ACTA)

Custom metadata

Keywords: infectious disease transmission,dental infection control,cross infection,health care associated infection,bacteria,viruses

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Keywords: infectious disease transmission, dental infection control, cross infection, health care associated infection, bacteria, viruses

Cross-transmission in the Dental Office: Does This Make You Ill?

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Abstract

Purpose of Review

Recent Findings

Summary

Related collections

Decoding Infection and Transmission

Most cited references 73

A scoping review on bio-aerosols in healthcare and the dental environment

Dissemination of aerosol and splatter during ultrasonic scaling: A pilot study

Presence of biofilm containing viable multiresistant organisms despite terminal cleaning on clinical surfaces in an intensive care unit.

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