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Evaluation of individual and combined effect of tempered pre-procedural mouth rinse and maintaining the minimum required distance between two consecutive dental chairs in minimizing aerosol contamination produced by using ultrasonic scalar in patients wit

Author: 
Dr. Vijay Apparaju, Dr. VaibhaviJoshipura, Dr. Sarita Joshi Narayan, Dr. Sheetal S., Dr.Yashica Reddy Mopala and Dr. Lakshmi Navyatha Sajja
Subject Area: 
Health Sciences
Abstract: 

Background: Aerosols, produced during ultrasonic instrumentation during a dental procedure are contaminative and should be assessed and controlled qualitatively and quantitatively. It is well known that pre-procedural 0.2% chlorhexidine rinse will reduce microbial count in an aerosol. But very little is known about maintaining the safest distance between two dental chairs, the efficacy of tempered (45ºC) chlorhexidine, and the combined effect of these two protocols in effective reduction of aerosols spread in a dental operating room. Aims: To investigate the individual and combined effect of tempered chlorhexidine (45 ºC) as a pre-procedural mouth rinse and maintaining the safest distance between two consecutive dental chairs for reducing aerosol contamination produced by an ultrasonic scalar. Materials and Methods: Thirty patients were randomly divided into 3 groups (Test I, Test II, and placebo) of 10 patients each to be administered with tempered chlorhexidine, non-tempered chlorhexidine, sterile water respectively, as a pre-procedural mouth rinse for 60 seconds. In all groups the aerosol contamination by the ultrasonic scalar was collected at 2 feet, 4 feet and 6 feet positions at 3’O clock positions on blood agar plates incubated 37ºC for 48 hours. Colony forming units (CFUs) were counted. Standardization of microbial load was done by checking pre-procedural operating room and salivary sample CFUs. Statistical Analysis: Paired t-test for mean CFUs comparisons within groups and one-way ANOVA with Post-hoc Turkey HSD test for comparing mean differences among groups. p value ≤0.05 was taken as significant. Results: Mean CFUs in Test 1 group and Test II group were significantly reduced when compared to placebo group at all distances. Also, CFU in Test 1 group was significantly reduced when compared to Test II group (P<0.001). Blood agar plates at 6 feet distance shown significantly less mean CFUs compared to 4 feet and 2 feet distance in all three groups. CFUs reduction below suggested levels was also found at 4 feet distance with tempered chlorhexidine. Conclusion: Safest distance between two consecutive dental chairs is 6 feet for minimal cross infection. Still, this distance can be reduced to 4 feet if tempered Chlorhexidine is used as the pre-procedural mouth rinse. Tempered chlorhexidine is effective compared to its non-tempered counterpart. Synergistic effect of tempered chlorhexidine and maintaining safe chair distance effectively controlled aerosol qualitatively and quantitatively.

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