The Impact of Hydrogen Peroxide (H2O2) Fumigation on Bacterial Levels in Dental Office Environments: A Randomized Clinical Trial Investigation

Strategies for preventing aerosol-generated microbial contamination in dental procedures: A systematic review and meta-analysis

BACKGROUND

Aerosol generation in dental practice is a significant concern in infection control. This study aimed to investigate the strategies for controlling and preventing aerosol-generated microbes during dental procedures.

METHODS

A comprehensive literature search was performed using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines through electronic databases (PubMed, ScienceDirect, Cochrane Library, Google Scholar, and Scopus) for studies reporting interventions, including mouthwash and suction devices, that were effective against pathogens generated during dental procedures. Predefined criteria identified eligible studies. Pooled efficacy was estimated using RevMan 5.4's random-effects model.Quality assessments were performed using RoB-2.0 and the Robvis web application.

RESULTS

This systematic review and meta-analysis included 19 papers. Cetylpyridinium chloride, chlorhexidine, chlorine dioxide, hydrogen peroxide, botanical medicines, and suction devices are the most used dental therapies to minimise microbial contamination. Overall, these treatments showed success with a pooled effectiveness of -46.64 (95% CI: -60.89 to -32.38, I2=100%, p<0.00001).

CONCLUSIONS

This study emphasises the need for a multifaceted approach that uses antiseptic mouthwash and suction devices to reduce cross-contamination and infection transmission during aerosol-generated dental procedures, safeguarding patients and dental workforce.

Sterilization and Disinfection: Ensuring Infection Control in Dental Practices

Effective sterilization and disinfection are critical for infection control in dental practices, reducing healthcare-associated infections and ensuring patient safety. This review explores the principles, applications, and limitations of various sterilization and disinfection methods used in dentistry, including heat sterilization (steam and dry heat), chemical sterilization (ethylene oxide, hydrogen peroxide), and radiation methods (ultraviolet (UV) and gamma rays). Emphasis is placed on the effectiveness of each method against a range of pathogens, their suitability for different dental instruments, and advancements in technology such as vaporized hydrogen peroxide systems and antimicrobial coatings. Autoclave sterilization remains a cornerstone due to its reliability, while methods like UV rays and ozone offer innovative, material-friendly alternatives. The importance of verifying sterilization efficacy through biological indicators and maintaining proper storage protocols to ensure sterility is also highlighted. By integrating traditional techniques with emerging technologies, dental practices can enhance infection control standards while adapting to modern challenges.

New Insights Regarding the Use of Relevant Synthetic Compounds in Dentistry

Worldwide, synthetic compounds are used for both in-office and at-home dental care. They are a valuable resource for both prophylactic and curative treatments for various dental problems, such as tooth decay, periodontal diseases, and many more. They are typically preferred due to their broad range of actions and ability to produce targeted, rapid, and long-lasting effects. Using a 0.12% chlorhexidine mouthwash is capable of reducing the plaque index from 47.69% to 2.37% and the bleeding index from 32.93% to 6.28% after just 2 weeks. Mouthwash with 0.1% OCT is also highly effective, as it significantly lowered the median plaque index and salivary bacterial counts in 152 patients in 5 days compared to a control group (p < 0.0001), while also reducing the gingival index (p < 0.001). When povidone-iodine was used as an irrigant during the surgical removal of mandibular third molars in 105 patients, it resulted in notably lower pain scores after 2 days compared to a control group (4.57 ± 0.60 vs. 5.71 ± 0.45). Sodium hypochlorite is excellent for root canal disinfection, as irrigating with 1% NaOCl completely eliminated the bacteria from canals in 65% patients. A 0.05% CPC mouthwash proved effective for perioperative patient care, significantly decreasing gingival bleeding (p < 0.001) and suppressing Streptococcus levels even one week post-surgery. Lastly, a 6% H2O2 paint-on varnish and 6% H2O2 tray formulations successfully bleached the teeth of 40 patients, maintaining a noticeably whiter appearance up to the 6-month follow-up, with significant color differences from the baseline (p < 0.005). Synthetic compounds have a large research base, which also provides a greater awareness of their mechanism of action and potential adverse effects. For a better understanding of how they work, several methods and assays are performed. These are protocolary techniques through which a compound's efficacy and toxicity are established.

An overview of the bacterial microbiome of public transportation systems-risks, detection, and countermeasures

When we humans travel, our microorganisms come along. These can be harmless but also pathogenic, and are spread by touching surfaces or breathing aerosols in the passenger cabins. As the pandemic with SARS-CoV-2 has shown, those environments display a risk for infection transmission. For a risk reduction, countermeasures such as wearing face masks and distancing were applied in many places, yet had a significant social impact. Nevertheless, the next pandemic will come and additional countermeasures that contribute to the risk reduction are needed to keep commuters safe and reduce the spread of microorganisms and pathogens, but also have as little impact as possible on the daily lives of commuters. This review describes the bacterial microbiome of subways around the world, which is mainly characterized by human-associated genera. We emphasize on healthcare-associated ESKAPE pathogens within public transport, introduce state-of-the art methods to detect common microbes and potential pathogens such as LAMP and next-generation sequencing. Further, we describe and discuss possible countermeasures that could be deployed in public transportation systems, as antimicrobial surfaces or air sterilization using plasma. Commuting in public transport can harbor risks of infection. Improving the safety of travelers can be achieved by effective detection methods, microbial reduction systems, but importantly by hand hygiene and common-sense hygiene guidelines.