Cochrane · intervention · CD013686

Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases

Kumbargere Nagraj, S, Eachempati, P, Paisi, M, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Oral Health Dental public health and special care2 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 9 · 23.1%Ungraded 7 · 17.9%Very low 23 · 59%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Dental healthcare providers (dentist, dental surgery assistant, dental hygienist, dental technologist, dental laboratory staff, dental aide or dental trainee) and their patients undergoing a dental AGP	425 participants across 16 studies; aged 5 to 69 years; two studies recruited only children, nine studies recruited adults only, four did not report age; one study female only
Intervention	Any method, procedure or policy that aimed to reduce contaminated aerosols in dental clinics compared to any other method including no treatment or combination of methods. Categories: methods to prevent contaminated aerosols escaping from the mouth; local ventilation; general ventilation; decontamination of aerosols in the air; combination of methods	High-volume evacuation/HVE (n=5); Combination system/Isolite (n=3); Rubber dam (n=4); Air cleaning system (n=1); Laminar air flow with HEPA filter (n=1); Antimicrobial coolants - chlorhexidine, povidone iodine, cinnamon (n=2)
Comparison	Any other method including no treatment or combination of methods	No HVE (n=5); Conventional dental suction/LVE (n=1); Saliva ejector (n=1); Rubber dam + HVE (n=1); HVE (n=1); No rubber dam (n=3); Cotton roll + HVE (n=1); No ACS (n=1); Without laminar flow or filter (n=1); Distilled water/control coolant (n=2); Antimicrobial coolant B (n=2)
Outcomes	Primary: Incidence of infection of dental staff or patients; Reduction in volume of contaminated aerosols in the operative environment; Reduction in level of contamination in aerosols in the operative environment. Secondary: Costs for the interventions used; Acceptability and feasibility of the intervention to patients and dentists	Reduction in level of contamination in aerosols measured as bacterial CFU (n=16); Reduction in volume of contaminated aerosols (n=2 measured, not analyzable); Incidence of infection (n=0); Costs (n=0); Acceptability/feasibility (n=0)
Study designs	RCTs and CCTs conducted in a dental environment, including randomized and pseudo-randomized (alternation) split-mouth studies; unit of randomization dental professionals, participants, quadrants (split-mouth), dental units or practices; excluded laboratory studies with mannequins not including real patients	RCT (n=11); CCT (n=5)
Timing	Not reported	Not reported

Search date: 2020-09. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid; Embase Ovid; WHO COVID-19 Global literature on coronavirus disease database; US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov); Cochrane COVID-19 Study Register

Questions and results

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Any method, procedure or policy to reduce contaminated aerosols in dental clinics vs Any other method, no treatment or combination of methods

Population: Dental healthcare providers (dentist, dental surgery assistant, dental hygienist, dental technologist, dental laboratory staff, dental aide or dental trainee) and their patients undergoing a dental AGP

4 questions

Outcome	Effect	Evidence	Status / GRADE
Costs for the interventions used same question in other reviews	no estimate extracted	0 studies	No studies
Acceptability and feasibility of the intervention to patients and dentists same question in other reviews	no estimate extracted	0 studies	No studies
Reduction in volume of contaminated aerosols in the operative environment same question in other reviews	Reduction in volume of contaminated aerosols in the operative environment: Not reported (row present in all Summary of findings tables)	0 studies	No studies
Incidence of infection of dental staff or patients same question in other reviews	Rate of infection of dental staff or patients: Not reported (row present in all Summary of findings tables)	0 studies	No studies