Abstract
Microbe laden air particles, known as bio-aerosols, are routinely generated, in clinical dentistry due to the operative instrumentation within a milieu rich in salivary organisms. As the major mode of transmission of SARS-CoV-2 appears to be airborne aerosols and droplets, there has been an intense focus on such aerosol generating procedures (AGP). As there has been no systematic reviews on the efficacy of bio-aerosol reducing measure in dentistry, the objective of this systematic review was to evaluate the literature on three major AGPs, rubber dam application, pre-procedural oral rinse, and high-volume evacuation (HVE) aimed at reducing dental bio-aerosols. Method: PubMed via Ovid MEDLINE, EBSCO host, Cochrane Library, and Web of Science databases between January 01, 1985, and April 30, 2020, were searched.Results: A total of 156 records in the English language literature were identified, of which 17 clinical studies with 724 patients were included in the final analyses. The eligible reviewed articles revealed the inadequacy of the afore mentioned three principal AGPs used in contemporary dental practice to minimise bio-aerosols. HVE appears to be the most efficacious method, although no single approach provides total elimination of bio-aerosols. Conclusion:This, the first systematic review on methods of controlling bio-aerosols in dental operatory settings, indicates that employing combination strategies of rubber dam, with a pre-procedural antimicrobial oral rinse, and HVE can significantly minimize bio-aerosols. As the quality of the currently available data on dental bio-aerosols are rather poor, further, controlled, multi-centre studies are essential to address this critical issue.