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Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols

On March 16, 2020, 198,000 dentists in the United States closed their doors to patients, fueled by concerns that aerosols generated during dental procedures are potential vehicles for transmission of respiratory pathogens through saliva. Our knowledge of these aerosol constituents is sparse and glea...

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Autores principales: Meethil, A.P., Saraswat, S., Chaudhary, P.P., Dabdoub, S.M., Kumar, P.S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258727/
https://www.ncbi.nlm.nih.gov/pubmed/33977764
http://dx.doi.org/10.1177/00220345211015948
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author Meethil, A.P.
Saraswat, S.
Chaudhary, P.P.
Dabdoub, S.M.
Kumar, P.S.
author_facet Meethil, A.P.
Saraswat, S.
Chaudhary, P.P.
Dabdoub, S.M.
Kumar, P.S.
author_sort Meethil, A.P.
collection PubMed
description On March 16, 2020, 198,000 dentists in the United States closed their doors to patients, fueled by concerns that aerosols generated during dental procedures are potential vehicles for transmission of respiratory pathogens through saliva. Our knowledge of these aerosol constituents is sparse and gleaned from case reports and poorly controlled studies. Therefore, we tracked the origins of microbiota in aerosols generated during ultrasonic scaling, implant osteotomy, and restorative procedures by combining reverse transcriptase quantitative polymerase chain reaction (to identify and quantify SARS-CoV-2) and 16S sequencing (to characterize the entire microbiome) with fine-scale enumeration and source tracking. Linear discriminant analysis of Bray-Curtis dissimilarity distances revealed significant class separation between the salivary microbiome and aerosol microbiota deposited on the operator, patient, assistant, or the environment (P < 0.01, analysis of similarities). We also discovered that 78% of the microbiota in condensate could be traced to the dental irrigant, while saliva contributed to a median of 0% of aerosol microbiota. We also identified low copy numbers of SARS-CoV-2 virus in the saliva of several asymptomatic patients but none in aerosols generated from these patients. Together, the bacterial and viral data encourage us to conclude that when infection control measures are used, such as preoperative mouth rinses and intraoral high-volume evacuation, dental treatment is not a factor in increasing the risk for transmission of SARS-CoV-2 in asymptomatic patients and that standard infection control practices are sufficiently capable of protecting personnel and patients from exposure to potential pathogens. This information is of immediate urgency, not only for safe resumption of dental treatment during the ongoing COVID-19 pandemic, but also to inform evidence-based selection of personal protection equipment and infection control practices at a time when resources are stretched and personal protection equipment needs to be prioritized.
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spelling pubmed-82587272021-07-20 Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols Meethil, A.P. Saraswat, S. Chaudhary, P.P. Dabdoub, S.M. Kumar, P.S. J Dent Res Research Reports On March 16, 2020, 198,000 dentists in the United States closed their doors to patients, fueled by concerns that aerosols generated during dental procedures are potential vehicles for transmission of respiratory pathogens through saliva. Our knowledge of these aerosol constituents is sparse and gleaned from case reports and poorly controlled studies. Therefore, we tracked the origins of microbiota in aerosols generated during ultrasonic scaling, implant osteotomy, and restorative procedures by combining reverse transcriptase quantitative polymerase chain reaction (to identify and quantify SARS-CoV-2) and 16S sequencing (to characterize the entire microbiome) with fine-scale enumeration and source tracking. Linear discriminant analysis of Bray-Curtis dissimilarity distances revealed significant class separation between the salivary microbiome and aerosol microbiota deposited on the operator, patient, assistant, or the environment (P < 0.01, analysis of similarities). We also discovered that 78% of the microbiota in condensate could be traced to the dental irrigant, while saliva contributed to a median of 0% of aerosol microbiota. We also identified low copy numbers of SARS-CoV-2 virus in the saliva of several asymptomatic patients but none in aerosols generated from these patients. Together, the bacterial and viral data encourage us to conclude that when infection control measures are used, such as preoperative mouth rinses and intraoral high-volume evacuation, dental treatment is not a factor in increasing the risk for transmission of SARS-CoV-2 in asymptomatic patients and that standard infection control practices are sufficiently capable of protecting personnel and patients from exposure to potential pathogens. This information is of immediate urgency, not only for safe resumption of dental treatment during the ongoing COVID-19 pandemic, but also to inform evidence-based selection of personal protection equipment and infection control practices at a time when resources are stretched and personal protection equipment needs to be prioritized. SAGE Publications 2021-05-12 2021-07 /pmc/articles/PMC8258727/ /pubmed/33977764 http://dx.doi.org/10.1177/00220345211015948 Text en © International & American Associations for Dental Research 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Research Reports
Meethil, A.P.
Saraswat, S.
Chaudhary, P.P.
Dabdoub, S.M.
Kumar, P.S.
Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols
title Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols
title_full Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols
title_fullStr Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols
title_full_unstemmed Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols
title_short Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols
title_sort sources of sars-cov-2 and other microorganisms in dental aerosols
topic Research Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258727/
https://www.ncbi.nlm.nih.gov/pubmed/33977764
http://dx.doi.org/10.1177/00220345211015948
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