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Ultrasonic Scaler Use and Aerosol

Featuring the clinical work of Elena Francisco, RDH*, as well as Brooke Agado, RDH, BS

Ultrasonic scalers are an essential and widely used instrument in the administration of dental hygiene care. Research shows that significant amounts of contaminated aerosols are generated during ultrasonic scaling, including blood and pathogenic bacteria. These contaminated aerosols remain suspended in the air for up to thirty minutes following ultrasonic procedures, and, therefore, could potentially be aspirated or contaminate a variety of surfaces (eg, computer keyboards, clothing, charts). Approved methods for reducing and virtually eliminating potentially harmful aerosols include the use of high-volume evacuators (HVEs) and antimicrobial preoperative mouthrinses. This article reviews and summarizes findings from the literature concerning aerosols produced during ultrasonic scaling and the methods for reducing or eliminating potential exposure to contaminated aerosols.

Learning Objectives:

After listening to this podcast, the listener should:

  • See how ultrasonic scalers can be used in maintaining proper oral hygiene
  • Understand proper methods for using an ultrasonic scaler

Related Reading:

  1. Harrel SK, Barnes JB, Rivera-Hidalgo F. Aerosol and splatter contamination from the operative site during ultrasonic scaling. J Am Dent Assoc 1998;129(9):1241-1249.
  2. Taggart JA, Palmer RM, Wilson RF. A clinical and microbiological comparison of the effects of water and 0.02% chlorhexidine as coolants during ultrasonic scaling and root planing. J Clin Periodontol 1990;17(1):32-37.
  3. Timmerman MF, Menso L, Steinfort J, et al. Atmospheric contamination during ultrasonic scaling. J Clin Periodontol 2004;31(6):458-462.
  4. Al Maghlouth A, Al Yousef Y, Al Bagieh N. Qualitative and quantitative analysis of bacterial aerosols. J Contemp Dent Pract 2004;5(4):91-100.
  5. Todar K. The bacterial flora of humans. 2007. Available at: http://www.textbookofbacteriology.net/normalflora.html. Accessed April 1, 2008.
  6. Bennett BL. Using power scaling to improve periodontal therapy outcomes. Contemp Oral Hyg 2007;7(6):14-21.
  7. Darby ML, Walsh MM (eds). Dental Hygiene Theory and Practice. 2nd Ed. St. Louis, MO: Saunders; 2003.
  8. Olsen I, Socransky SS. Ultrasonic dispersion of pure cultures of plaque bacteria and plaque. Scand J Dent Res 1981;89(4):307-312.
  9. King TB, Muzzin KB. A national survey of dental hygienists’ infection control attitudes and practices. J Dent Hyg 2005;79(2):8.
  10. Mohammed CI, Manhold JH, Manhold BS. Efficacy of preoperative oral rinsing to reduce air contamination during use of air turbine handpieces. J Am Dent Assoc 1964;69:715-718.
  11. Veksler AE, Kayrouz GA, Newman MG. Reduction of salivary bacteria by pre-procedural rinses with chlorhexidine 0.12%. J Periodontol 1991;62(11):649-651.
  12. Wyler D, Miller RL, Micik RE. Efficacy of self-administered preoperative oral hygiene procedures in reducing the concentration of bacteria in aerosols generated during dental procedures. J Dent Res 1971;50(2):509.
  13. Hererra D, Roldán S, Santacruz I, et al. Differences in antimicrobial activity of four commercial 0.12% chlorhexidine mouthrinse formulas: An in vitro contrast test and salivary bacterial counts study. J Clin Periodontol 2003;30:307-314.
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