Abstract
ObjectivesSurgical masks are usually contaminated during dental treatment. So far it has not been investigated whether a surgical mask itself can be a source of microbial transmission. The aim of this study was therefore to investigate the microbiological contamination of surgical masks during dental treatment and the transfer of microorganisms from the mask to the hands.Materials and methodsFive dental treatment modalities were studied: carious cavity preparation (P-caries, n = 10), tooth substance preparation (P-tooth, n = 10), trepanation and root canal treatment (P-endo, n = 10), supragingival ultrasonic application (US-supra, n = 10), and subgingival periodontal ultrasonic instrumentation (US-sub, n = 10). Bacterial contamination of mask and gloves worn during treatment was tested by imprinting on agar plates. Additionally, before masks were tested, their outer surface was touched with a new sterile glove. This glove was also imprinted on agar. Bacteria were identified by MALDI TOF mass spectrometry. Colony-forming units (CFU) were scored: score 0: 0 CFU, score 1: < 102 CFU, score 2: > 102 CFU, score 3: dense microbial growth.ResultsAll masks and all gloves used during treatment displayed bacterial contamination (sample scores 0/1/2/3: masks 0/46/3/1 and gloves 0/31/10/9). After touching the masks with new sterile gloves, microorganisms were recovered with the following contamination scores: P-caries: 4/6/0/0, P-tooth: 2/8/0/0: P-endo: 7/3/0/0, US-supra: 0/9/1/0, US-sub: 2/8/0/0. No statistically significant differences were detected between the treatment modalities. Streptococci spp. and Staphylococci spp. representing the oral and cutaneous flora dominated.ConclusionsSurgical masks are contaminated after aerosol-producing dental treatment procedures. Used masks have a potential to be a source of bacterial contamination of the hands.Clinical relevanceDental staff should avoid touching the outer surface of masks with their hands to prevent transmission of pathogens. It is recommendable to change the mask after each treated patient followed by hand disinfection.
Highlights
Dental health care professionals are exposed to numerous risk factors [1]
Aerosols are released in numerous dental treatment modalities [8]
Five typical dental treatment modalities in which aerosol release has to be expected were included in the study
Summary
Dental health care professionals are exposed to numerous risk factors [1]. Mostly important are transmissions of infectious agents such as bacteria and viruses [2], and the exposure to solvents, nanoparticles, and other substances can occur [3].The transfer of microorganisms does not necessarily result in a risk to dental professionals. Aerosols are released in numerous dental treatment modalities [8] These are cleaning of oral surfaces with airwater spray, preparation of carious and non-carious tooth substances with high-speed handpieces, supra- and subgingival cleaning of biofilm contaminated tooth surfaces with ultrasonic devices or powder-water spray, and endodontic and oral surgery using ultrasonic instruments [9]. These aerosols may contain microorganisms from the oral cavity or from biofilms of the dental unit, as well as blood droplets and blood-borne viruses [1, 2, 6, 10, 11]. The treatment of numerous patients per day exposes dental staff to a high frequency to this contaminative agent [12]
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