The efficacy of bio-aerosol reducing procedures used in dentistry: a systematic review

Acta Odontol Scand. 2021 Jan;79(1):69-80. doi: 10.1080/00016357.2020.1839673. Epub 2020 Dec 14.


Background and objective: Bio-aerosols, are routinely generated and airborne in clinical dentistry due to the operative instrumentation within an oral environment bathed in salivary organisms. SARS-CoV-2 transmission being responsible for the current pandemic, appears through airborne aerosols and droplets, thus, there has been an intense focus on such aerosol-generating procedures, and their reduction. Hence the objective of this systematic review was to evaluate available data on three major measures: rubber dam application, pre-procedural oral rinse, and high-volume evacuators (HVE) aimed at reducing bio-aerosols.

Method: PubMed via Ovid MEDLINE, EBSCO host, Cochrane Library and Web of Science databases were searched between 01 January 1985 and 30 April 2020.

Results: A total of 156 records in English literature were identified, and 17 clinical studies with 724 patients included in the final analysis. Eligible articles revealed the inadequacy of three principle approaches used in contemporary dental practice to minimize such bio-aerosols, rubber dam application, pre-procedural oral rinses, and HVE. The latter is an extremely effective method to reduce bio-aerosols in dentistry, although no single method can provide blanket cover.

Conclusion: Present systematic review indicates that employing combination strategies of rubber dam, with a pre-procedural antimicrobial oral rinse, and HVE may contain bio-aerosols during operative procedures.

Keywords: Bio-aerosol; dentistry; procedures; reduction; rubber dam application.

Publication types

  • Systematic Review

MeSH terms

  • Aerosols
  • COVID-19*
  • Humans
  • Mouthwashes
  • Rubber Dams
  • SARS-CoV-2*


  • Aerosols
  • Mouthwashes