Reduction of Aerosols at the Source is the Best Mitigation Strategy

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The COVID-19 pandemic has shone a bright light on the significant threat of aerosols in dentistry. Aerosol generating procedures (AGPs) cannot be avoided and dental aerosols, which are constantly being generated during dental procedures, can contaminate up to six feet and live in ambient air for up to 30 minutes.

What is the most effective way to prevent these dental aerosols?

Dr. Martin Koch, the lead biotechnology expert at Air Techniques and Dürr Dental, set out to answer that question. His team recently conducted a study to understand dental aerosols and the best mitigation strategies to eliminate those dental aerosols by intraoral evacuation.

Understanding the critical importance of this determination for the entire dental industry, Dr. Koch, partnered with Air Techniques to pioneer this pilot study which yielded critical data. Now, Dr. Koch and his team are sharing the results for the benefit of others.

The study examined and scientifically evaluated:

  • intraoral evacuation
  • flow rate and vacuum of suction systems
  • design of the HVE
  • suction techniques

Furthermore, the study addressed questions like:

  • What happens if you use a turbine running with 400,000 revolutions per minute?
  • What happens if you use a powder jet handpiece and compare different evacuation possibilities (saliva ejector, high volume, low volume, high vacuum, and low vacuum.)

Analyzing dental aerosols with a new method, ‘shadow imaging,’ it was determined that increasing the flow rate of suction less than 7 standard cubic feet per minute (SCFM) provided no aerosol reduction. But there is a tipping point at a flow rate of about 7 SCFM and at a flow rate of about 10 SCFM, there is no longer any detection of aerosols.

Until the recent outbreak of SARS-CoV2, high suction power (negative pressure) was the metric used to determine a vacuum’s performance, but now that most offices are more concerned with removing aerosols, flow rate is the true measure of your vacuum’s ability. A saliva ejector is not efficient to remove all aerosols.

The study proved that reduction of aerosols at the source is the best mitigation strategy:

  • No particles were detectable using HVE suction (>10 SCFM)
  • A suction of (<7 SCFM) is too weak to avoid aerosols

Normally, the flow rate is fixed. It’s a physical parameter that depends on the diameter and layout of the piping, tubes, adapters and HVE. Both negative pressure and high flow must be achieved for aerosol reduction.

The primary focus of the practice should be containing aerosols where they begin, in the oral cavity.

When using a high-volume suction system and correct suction techniques, the spread of particles decreases by an average of 65%. The higher the flow, the more effective the vacuum pump is in removing airborne particles from in and around the patient’s oral cavity.

The best protection for your team and patients is your mechanical equipment. There is one product that delivers more flow than any other product available and uses regenerative side channel blower technology to achieve the key combination of both negative pressure and flow: Mojave.

The Mojave system can remove aerosols from the oral cavity – where they start – at a greater rate than any other wet or dry dental vacuum system currently available. Additionally, the negative pressure stays consistent across the widest range of vacuum demands, sustaining high levels of flow for multiple users without compromise.

Air Techniques not only offers state-of-the-art systems like Mojave, it also provides maintenance for existing systems. Due diligence with maintenance is critical to infection prevention. It is essential to have flow meters measure the flow at the tip of the HVE. Air Techniques representatives are equipped to test flow rate to ensure optimization.

Aerosol prevention can be accomplished through intraoral spray mist suction.

  • Intraoral suction system that offers not just high negative pressure, but high flow rates between 7-10 SCFM
  • Large suction HVE for maximum flow rates
  • Optimal suction technique directly at the treatment area

Understand the importance of flow rate
to the
aerosol containment process.

Download your free copy of Dr. Koch’s whitepaper:
“Aerosol reduction by means of an intraoral spray mist suction
– first findings from an experimental pilot study.”

Dr. Martin Koch is Head of Technical Academy at Air Techniques and Durr Dental

1986-1992     Study of biology, University  of Hohenheim, Germany

1992-1996     Doctorate of RWTH Aschen University, Department of Biotechnology, Germany

1997-1998     Lecturer at RWTH Aschen University, Department of Biotechnology

1998-2001    Trainer at Durr denal

since 2001    Amongst others, trainings for practice hygiene, x-ray, periodontics, ergonomics

since 2001    Head of Technical Academy at Durr Dental

2015-2019    Lecturer at the Cologne University of Applied Sciences, Germany

2020              Lead Biotechnology Advisor at Air Techniques and Durr Dental

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