aerosols C D A J O U R N A L , V O L 4 8 , Nº 1 0
Decoding Dental Aerosols in the Age of COVID-19 Anthony D. Mair, DDS, MCID; Paul H. Korne, DDS, MCID; and Mohamed-Nur Abdallah, BDS, MSc, PhD
a b s t r a c t The conflation with medical aerosols in the age of COVID-19 has
created an inaccurate and potentially dangerous argument in dentistry.
AUTHORS Anthony D. Mair, DDS, MCID, is an adjunct professor in graduate orthodontics at Western University in London, Ontario, and a clinical associate in graduate orthodontics at the University of Toronto. He is a past president of the Ontario Association of Orthodontists. Conflict of Interest Disclosure: None reported.
Paul H. Korne, DDS, MCID, is a faculty lecturer at McGill University in Montreal. He is a past president and member of the Canadian Association of Orthodontists. Conflict of Interest Disclosure: None reported. Mohamed-Nur Abdallah, BDS, MSc, PhD, is an orthodontics and dentofacial orthopedics resident at the Faculty of Dentistry at the University of Toronto. Conflict of Interest Disclosure: None reported.
T
he outbreak of SARS-CoV-2 has negatively impacted society over the past few months.1 The shutting of economies and the introduction of “physical distancing” was a necessary response to reduce the rate of new infections and prevent overloading of our health care systems. As such, dental clinics, along with most other nonessential businesses, were asked to cease operations to reduce social contacts and, in turn, protect the public. In North America, dental offices are undergoing phased reopening. It is at this critical juncture that a new controversy has risen to prominence — the possible risk of dental aerosols and aerosol-generating dental procedures (AGDPs).2 In the past few months, some members of the dental community have expressed concern that AGDPs could facilitate the infective transmission of SARS-CoV-2 and endanger dental staff and patients.3
Virus Transmission Versus Disease Infection
SARS-CoV-2 is the causative virus for the resultant disease COVID-19. It is important to note that transmission is necessary for infection, but infection does not inevitably follow exposure.4,5 It is established that SARS-CoV-2 can infect a host via droplet and, to a lesser degree, contact transmission, whereas acquiring COVID-19 disease via airborne transmission remains unlikely.1,2,5–8 The viral load can be defined as the number of viral particles in a given volume of droplets. The minimal infective dose is the lowest number of viral particles that can initiate disease.4,5,9 The minimal infective dose for each virus varies with host susceptibility and immune response. Furthermore, it has been shown that the probability of getting infected as well as the severity of disease are dose-dependent.4,5,9,10 However, the OC TOBER 2 0 2 0 501
