Splatter during dental treatment is nothing new; however, airborne contamination is greatest when using the ultrasonic scaler. Bacteria from the patient’s mouth and contamination from dental unit water lines appear to be 2 major sources for this risk to healthcare providers and patients. If the ultrasonic scaler is attached to a self-contained reservoir or if the water line has a bacterial filter, the risk of contamination is smaller than if the ultrasonic scaler is an older type and is attached directly to the water connection on the dental unit. A greater risk for airborne contamination comes directly from bacteria present in the patient’s mouth. When periodontal disease or areas of infection are present, direct use of the ultrasonic scaler can spread bacteria more dangerous than those from poorly maintained water lines. The most common bacteria—staphylococci—can be very pathogenic but is not associated with a spread of infection. Other bacteria and viruses which are found in crevicular fluids and saliva are most likely associated with blood spatter from ultrasonic instrumentation, and the risk of infection rises with the amount of aerosol and splatter. While there is no “clear evidence” of risk to patients or clinicians, viruses such as hepatitis, herpes simplex, and methicilllin-resistant Staphylococcus aureus are found in the oral cavity and may become airborne when ultrasonic scalers are used. Since there are no studies at present which link ultrasonic aerosols and transmission of disease, there is a potential for risk. The CDC reports that aerosols need to be controlled by use of a high- speed evacuator when using ultrasonic scalers. A saliva ejector isn’t enough.
(Source: Dimensions of Dental Hygiene, June 2008)
