Nadia in white coat stood in dental lab

From standstill to ‘splatter’ – helping out during the pandemic

Nadia Rostami is a Research Associate at Newcastle University and works on the DMT-funded project A Prebiotic Approach to Control Periodontitis, led by Dr Nick Jakubovics. Here, Nadia shares some of the vital work she has been doing to inform the re-opening of student dental clinics post-lockdown.

Newcastle University logo

Like most people in the scientific community, I had a strong sense of wanting to apply my expertise in the fight against the virus

Nadia Rostami

When the pandemic started spreading and the UK went into lockdown my research was brought to a standstill. Along with most people in the scientific community, I had a strong sense of wanting to apply my expertise and technical skills in the fight against the virus. When there was a call across Newcastle University for volunteers to help with testing for the disease, I jumped at the opportunity. There was an amazing response amongst my colleagues in the University and there was an overwhelming number of volunteers offering to help. My own experience of the techniques being used for testing was not quite as extensive as others, so I was not chosen and like most of the country I found myself trapped in my home!

My laboratory is based in Newcastle University’s School of Dental Sciences and Dental Hospital and whilst I typically work in molecular microbiology we’ve fostered close links with the clinicians working in the building. As life very gradually began to return to some sort of normality we were approached by the dentists working in the hospital to see if we could help understand how to make dental work as safe as possible for both the patients and the medical staff.

For the safe re-opening of dental clinics, it was essential to understand the behaviour of the aerosols and ‘splatter’ that come out of the mouth during dental work.

Dental work is a messy business – drilling in a wet environment like the mouth means there is a lot of splatter! Dentists have been restricted on what procedures they are allowed to do due to the potential infection risk for everyone involved.  

In particular, dental schools and hospitals have faced challenges in resuming providing training to dental students because they often have large open clinics with bays that are not completely isolated from one another. For the safe re-opening of these spaces, it was therefore essential to understand the behaviour of the aerosols and splatter that come out of a mouth during dental work. With my colleagues I helped develop methodologies to track and quantify where the splatter from dental work spread to during different types of dental work (see the example heatmap below).

On the left, a dentist performs a mock procedure whilst a fluorescent dye is introduced into the ‘patient’s’ mouth – this dye allowed us to visualise the splatter from the procedure. On the right, a heatmap of the distribution of this dye following one such procedure. Each black spot represents a measurement point, consisting of a disc of filter paper that captures the splatter of the dye. The heatmap provides a visual representation of the intensity of the dye from heavy contamination (dark blue) at the centre to little or no dye (pale yellow/green) at around one metre out from the patient.

From this work we were able to publish papers and preprints on the production of aerosols during dental work.1,2,3 We now better understand where the splatter and aerosols go and how far they travel during different procedures and settings. We also started to understand how dental aerosols settle over time, which has helped inform cross-infection control procedures (i.e. knowing when it is suitable to clean a surgery after making an aerosol). The results led to the team developing a new clinic configuration to allow the safe return of dental students and their patients – and they’ve also helped inform national guidance and recommendations.4,5

It’s been fantastic to play a role in the response to the coronavirus pandemic and to see such immediate and tangible results. It was a great feeling to be able to directly support my community as a scientist.

I am incredibly grateful to the Dunhill Medical Trust and their support during these difficult and challenging times, and for enabling me to engage in such an important project.

References

  1. Allison J R, Currie C, Edwards D C, Bowes C, Coulter J, Pickering K, Kozhevnikova E, Durham J, Nile C J, Jakubovics N, Rostami N, Holliday R (2020) Evaluating aerosol and splatter following dental procedures: addressing new challenges for oral healthcare and rehabilitation. Journal of Oral Rehabilitation. https://doi.org/10.1111/joor.13098
  2. Holliday R, Allison J R, Currie C, Edwards D, Bowes C, Pickering K, Reay S, Durham J, Rostami N, Coulter J, Nile C, Jakubovics, N (2020) Evaluating dental aerosol and splatter in an open plan clinic environment: implications for the Covid-19 pandemic. OSF Preprint: https://osf.io/md49f
  3. Llandro H, Allison J R, Currie C, Edwards D, Bowes C, Durham J, Rostami N, Coulter J, Jakubovics N, Holliday R (2020) Evaluating aerosol and splatter during orthodontic debonding: implications for the COVID-19 pandemic. OSF Preprint: https://doi.org/10.31219/osf.io/djcus
  4. Dental Schools Council and Association of Dental Hospitals (2020) Covid-19: Planning return to Open Plan Clinics: Guiding Principles to mitigate risk. https://www.dentalschoolscouncil.ac.uk/news/covid-19-planning-return-to-open-plan-clinics-guiding-principles-to-mitigate-risk/
  5. Scottish Dental Clinical Effectiveness Programme (2020) Mitigation of Aerosol Generating Procedures in Dentistry – A Rapid Review. https://www.sdcep.org.uk/published-guidance/covid-19-practice-recovery/rapid-review-of-agps/
Share: