Instead of a theoretical debate about either side of the aerosol and exposure risk concerns, let us focus on the bigger picture. What does the evidence show this year, relative to past years, about the risk of disease spread in dentistry?
If we look at most healthcare providers, we see they tend to get sick less often than the general public. Why? It’s likely because our exposure to so many things boosts our immune system, somewhat like teachers who are exposed to many children.
Those who have been in dentistry for a long time understand COVID-19 is not the first major respiratory virus outbreak. We have been through SARS, Ebola, H1N1, Influenza, Hepatitis and others. Yet, none of these virulent diseases spread through dental offices. Hepatitis C has been the most concerning because even a small amount of saliva can transmit it.
But these are just anecdotal. What about real data?
The Centers for Disease Control and Prevention (CDC) keeps contact tracing of every viral outbreak. It has tracked how COVID-19 is spreading and has this to say about dentistry:
"To date in the United States, clusters of healthcare personnel who have tested positive for COVID-19 have been identified in hospital settings and long-term care facilities, but no clusters have yet been reported in dental settings or among dental healthcare providers.1"
Because this virus is not spreading through dental offices and teams, and dental professionals are not getting sick, what is it about aerosols that prevent them from being a source for spreading viruses?
Is it because ultrasonics disrupt viral particles? Is it because COVID-19 viral particles tend to reside in the throat/lungs and not around dental structures? Is it because standard precautions are enough? Is it because the only place in the country with better infection control than a dental office is a hospital operating room? Or, is it simply because we do not treat symptomatic patients?
The true reason is up to scientists to figure out. The great news is dental professionals are not getting sick more than the general public, and so the reason aerosols are not a problem is only academic. We should be vigilant but rational and follow the evidence instead of the fear.
These are the real questions we need to ask ourselves at this stage:
Are we comfortable dealing with the same exact risks that have been in dentistry since before most of us entered the profession?
Are we willing to continue to focus on treating oral disease in our communities?