Evaluation of aerosol contamination during debonding procedures

The aim of this study was to show how the aerosol generated by the use of an air turbine handpiece during debonding procedures increases the potential risk factor for the distribution of infectious agents. A second aim of the study was to evaluate the effectiveness of a preprocedural chlorhexidine mouth rinse in reducing the number of colony forming units (CFU) found in aerosol samples. Blood agar plates were attached to the face shields and the dental chair table and were used for collecting the aerosol samples. In the first part of the study, 260 samples were collected for the baseline group in an empty room, 36 samples were collected for the control group (C), in which the orthodontist, dental assistant, and the patient were in the operatory room, and 42 samples were collected for the debonding group (DB). The microbiologic analysis showed significant differences between the baseline group and the control group (P < .05). Furthermore, aerosol contamination increased significantly during the debonding procedure when compared with the control group (P < .01). In the second part of the study, an air turbine handpiece was used to remove excess adhesive from the tooth surface on one side of the mouth and air samples were collected. The patients then were instructed to rinse their mouths with 0.2% chlorhexidine gluconate for 1 minute, and the orthodontist worked on the other side of the mouth and the air sampling was repeated. An insignificant reduction was found in the number of colony forming units following the chlorhexidine mouth rinse. Results of this study indicated that orthodontists are exposed to high levels of aerosol generation and contamination during the debonding procedure, and preprocedural chlorhexidine gluconate mouth rinse appears to be ineffective in decreasing the exposure to infectious agents. Therefore, barrier equipment should be used to prevent aerosol contamination.