Regular dental work is key to maintaining oral health. Tooth and gum conditions can be difficult to treat, so preventive cleanings and common procedures like fillings can help stop cavities, gum disease, and tooth decay early on.
But dental practices can be subject to a variety of indoor air quality issues that can expose dentists, patients, and staff to biological contaminants and infectious pathogens.
And infection risks have become even more pronounced during the COVID-19 pandemic, exposing dental workers and patients to even more critical risks beyond typical dental practice hazards.
Download our eBook to explore research and current findings on the topic of airborne infections, biological contaminants, and mercury vapor exposure inside dental practices:
- A review of potential health effects of biological contaminants, airborne aerosols and micro-droplets carrying viral and bacterial material, and mercury vapor exposure
- The level of biological contaminants released during dental drilling and other procedures involving high-speed instruments, such as ultrasonic scaling
- Environmental exposure to airborne aerosols carrying viruses and bacteria among dental workers
- Current research on mercury vapor exposure and precautions to take even as amalgam fillings are removed
- Sensible solutions, including extraoral suction and infection control, you can put in place at your practice
Fill out the form on this page to get instant access.
Air quality in dental practices
Why should you be concerned about the air quality in your dental practice?
Dental practices and operatories experience specific air quality problems that can expose dentists, hygienists, and patients to infectious airborne pathogens, such as biological contaminants and viruses, as well as other unhealthy pollutants like chemicals, volatile organic compounds (VOCs), and ultrafine particles produced from high-speed instruments.1
According to Dental Research Journal and the United States Department of Labor, dental work is one of the most hazardous occupations because of high risk of exposure to infections like COVID-19, toxic substances, and radiation for dentists, hygienists, and patients.2,3
Here are some of the possible air quality hazards that a dental worker or patient can face in a dental practice or operatory:
- viral infections from splattering liquid, droplets, or aerosols from high-speed drilling and cleaning instruments that can carry viral material for viruses like COVID-19, human immunodeficiency virus (HIV), and hepatitis B
- biological contaminants, such as bacteria, that can be spread through airborne dental aerosols, improperly sterilized tools and surfaces, or from close, direct contact with a patient with an active bacterial infection, such as tuberculosis and syphilis
- allergies to substances in dental tools and equipment, such as latex in gloves, detergents used to clean equipment, and chemicals used to develop X-rays
- chemicals from disinfectants and cleaning supplies used to sterilize tools and the dental practice environment
- airborne mercury vapor from amalgam filling removal and disposal that can cause respiratory and neurological damage (less common in modern dental practices)
Extraoral suction system and infection control
Extraoral suction systems are an important first-line defense in ensuring that any dental aerosols carrying infected viral or bacterial matter are captured at the source – the patient’s mouth – when they result from high-speed instrumentation procedures that increase the concentration of airborne aerosols.
High-speed dental instruments, such as those used for cavity drilling and ultrasonic scaling techniques during cleanings, often generate millions of microscopic dental aerosols and tiny micro-droplets that can contain highly infectious bacterial or viral pathogens from the patient’s mouth, including COVID-19.4,5
Once airborne, these aerosols and droplets can make contact with the clothes of patients, hygienists, staff, and dentists.
These infected particles can stay on clothing for up to several days. This increases the risk that infectious pathogens are transferred from clothes into the respiratory system when, for example, a dental worker touches their face.
Airborne aerosols can also remain in the air for hours before bacterial or viral material settles on surfaces.
While they’re airborne, aerosols can also be inhaled by anyone in the dental practice and cause respiratory infections, such as COVID-19. As a result, the American Dental Hygienists’ Association has recommended that aerosol-producing procedures should be avoided whenever possible.6
Modern mercury (Hg) removal techniques and newer, non-mercury filling materials have reduced the exposure of many dental workers and patients to harmful mercury vapor toxins.
The Occupational Safety and Health Administration (OSHA) establishes the absolute permissible exposure limit (PEL) to mercury at 0.1 milligrams per cubic meter of air (mg/m³). The National Institute for Occupational Safety and Health (NIOSH) recommends exposure to no more than 0.5 mg/m³ during a 10-hour workday.7,8
But studies suggest that many dentists and their staff still experience exposure to mercury beyond these safe levels. This is primarily because of the continued practice of removing amalgam fillings and, in some cases, placing new amalgam fillings.
As a result, dentists and their staff have consistent, prolonged exposure to mercury that’s settled on surfaces throughout the dental practice from years of use as well as to mercury vapor that can be inhaled during mercury removal procedures that involve high-speed drilling.
Prolonged exposure leads to demonstrably higher than average levels of inorganic mercury in the blood and urine of dentists and their staff. Over time, inhalation of mercury can increase the risk of harm to the digestive, nervous, and immune system as well as kidney and cognitive dysfunction.
According to the World Health Organization (WHO), exposure to levels of airborne mercury vapor around 20 μg/m3 over a period of years can cause nervous system toxicity and kidney conditions, including kidney failure.9
Disinfectants are critical to keeping a dental practice clean, especially from infectious viruses like COVID-19 that can spread through contact with surfaces.10 Disinfectants are also important for sterilizing dental unit water lines (DUWL) used in cleanings, where bacteria can build up in thin layers called biofilms.11
But disinfectant chemicals, such as glutaraldehyde and peracetic acid, can produce volatile organic compounds (VOCs) that result in unpleasant odors.
And over time, exposure to VOCs can result in chemical sensitivity that can produce severe symptoms in both staff and patients, including skin irritation (dermatitis) and asthma.12
This sensitivity can also reduce immune system function and increase dental worker risk for COVID-19 and other airborne infections in dental practices.13
Air purifier for dental practices
IQAir Dental Series air purifiers for dental practices are rated as the best air purifiers for dental practices, designed for a wide range of air cleaning needs in dental practices, including extraoral suction systems, infection control, and customizable modules that can enable dentists to create negative pressure environments in the dental practice during procedures where aerosols, mercury, and other infectious material can become airborne.
The modular design of Dental Series dental air purifiers makes them ideal for designing a dental operatory where no infected aerosols, droplets, or other harmful substances like mercury vapor can escape using the following components:
- Dental air purifier with HyperHEPA filtration, such as the HealthPro Plus, to capture up to 99.5% of all airborne particles down to 0.003 microns, including aerosols and particulate matter, as well as gas-phase filters for chemical and odors
- Extraoral suction system, such as the VM FlexVac suction arm kit, to capture aerosols and infectious material at the source with suction adjacent to the patient’s mouth for immediate capture
- Negative pressure equipment, such as the FlexVac extraoral suction extraction system, that can be combined with an extraoral suction system to immediately capture airborne pathogens and biological contaminants and remove them from the dental practice environment