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Aerosols in the Dental Office: Best Practices for Patient and Practitioner Safety

Course Number: 619

Infectious Diseases Associated with Aerosols

In addition to the common cold (caused by rhinoviruses, coronaviruses, and other viruses), several types of bacteria and viruses have demonstrated airborne person-to-person transmission (Table 2).32,46-49

Chart listing the known diseases to be spread by droplets or aerosols.

Table 2. Diseases Known to be Spread by Droplets or Aerosols.32

For many of these microorganisms, the overall microbial load within aerosols, splash, and splatter vary greatly predicated on disease status and the particular microorganism.11-13,25 While SARS-Cov-2 has been isolated from the saliva of asymptomatic patients, dental aerosols from such patients had undetectable SARS-CoV-2 viral loads.45 It is well-established the reproduction number (R0) differs significantly between microorganisms and that as a microorganism mutates, the R0 may be altered.50 The R0 is the number of cases, on average, an infected patient will cause during their infectious period. This number, from a public health perspective, is also influenced by the overall susceptibility within the population (e.g., vaccination rates, previous infection rates, cross-immunity from similar diseases, the novelty of a pathogen).50 Lastly, the likelihood of transmission is also influenced by the susceptibility of the host and related factors such as, overall health status, genetic influences, immunocompetence, vaccination/infection history, and previous exposure to similar diseases.47,48 In fact, emerging evidence suggests that pre-existing oral diseases may increase the risk for developing severe forms of COVID-19.51-53