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Aerosols and splatter in dentistry
REGULATORY AND LEGAL CONCERNS
The ADA and CDC have recommended that all blood-contaminated aerosols and splatter should be minimized.29 Occupational Safety and Health Administration regulations state that “all procedures involving blood or other potentially infectious materials shall be performed in such a manner as to minimize splashing, spraying, spattering, and generation of droplets of the these substances.”37 In the guidelines for infection control in dental health-care settings that was published recently by the CDC, all of these recommendations were retained. The use of rubber dams and HVEs are considered to be “appropriate work practices”—precautions that always should be followed during dental procedures.38
By following the simple and inexpensive recom mendations for controlling aerosols and splatter outlined in this article, dental practitioners will be in compliance with these recommendations and will minimize any legal or regulatory risks that may exist.
The aerosols and splatter generated during dental procedures have the potential to spread infection to dental personnel and other people in the dental office. While, as with all infection control procedures, it is impossible to completely eliminate the risk posed by dental aerosols, it is possible to minimize the risk with relatively simple and inexpensive precautions. We feel that the following procedures are appropriate as universal precautions whenever an aerosol is produced:
universal barrier precautions should be followed;
a preprocedural rinse should be used before treatment;
a rubber dam should be used where possible;
an HVE should be used for all procedures. The use of these precautions should reduce the risk of an aerosolized spreading of infection to a minimal level. Further, the universal application of these infection control strategies will reduce the employer's legal exposure to the lowest possible level.
Harrel, S. K., & Molinari, J. (2004). Aerosols and splatter in dentistry: a brief review of the literature and infection control implications. Journal of the American Dental Association (1939), 135(4), 429–437. https://doi.org/10.14219/jada.archive.2004.0207