How to Reduce Aerosols During Routine Procedures

Introduction

Aerosol management has always been an important part of dental care, but recent years have increased awareness around safety, infection control, and overall air quality in dental operatories. Even the most routine procedures can produce significant aerosols, which can spread microorganisms and increase risks for both patients and staff.

Fortunately, there are many effective and easy-to-implement methods that dental teams can use to reduce aerosol levels during everyday procedures. Here are the most reliable strategies used across modern dental practices.

1. Use proper patient positioning

The position of the patient directly influences how aerosols move. If the patient is too upright or too reclined for the specific procedure, aerosols may disperse in a wider arc.

Positioning tips:

• Recline the patient appropriately for the arch being treated.

• Adjust the headrest to create a clear pathway to the working field.

• Position yourself and your assistant to maintain good visibility while staying close to the oral cavity.

Good positioning keeps aerosols contained and easier to capture.

2. Improve suction technique during high-aerosol procedures

High-volume suction is one of the most effective tools for reducing aerosol spread. However, technique matters just as much as equipment.

Best practices include:

• Place the suction tip as close to the working area as possible.

• Keep the tip steady without obstructing the dentist’s view.

• Use proper angling to capture debris and water spray efficiently.

• Work with steady, controlled movements to prevent unnecessary splatter.

Consistent technique can significantly reduce airborne particles.

3. Use the correct suction device for each procedure

Different procedures require different suction needs. Choosing the wrong device increases aerosol production and reduces control.

For example:

• Use high-volume evacuation during ultrasonic scaling, crown preps, and restorative procedures.

• Use standard saliva ejectors for low-aerosol tasks only.

• Switch devices depending on the type of handpiece or material used.

Matching the suction tool to the procedure improves overall aerosol management.

4. Rinse the patient’s mouth before beginning treatment

A simple pre-procedural rinse can reduce the microbial load in the oral cavity.

Common recommendations include:

• Antimicrobial rinses such as chlorhexidine or cetylpyridinium chloride

• A 30 to 60 second rinse for effectiveness

• Asking the patient not to swallow the rinse

This step decreases the number of microorganisms released when aerosols form.

5. Use isolation techniques when appropriate

Isolation methods help control moisture and limit aerosol spread.

Examples include:

• Rubber dams

• Cotton rolls with adequate drying

• Isolation systems designed for moisture control

These methods keep the working field dry, which leads to fewer droplets and splatter.

6. Maintain instrumentation and handpieces

Worn or poorly maintained instruments create inconsistent spray and higher aerosol levels. Handpieces that leak or spray irregularly increase particle dispersion.

Daily habits that help:

• Inspect handpieces for wear.

• Ensure all attachments are secure.

• Use proper lubrication and sterilization protocols.

• Replace tips or instruments that show signs of damage.

Smooth, well-maintained tools create more predictable aerosol patterns.

7. Position the dental light correctly

Lighting affects visibility, which influences how close you can position suction, instruments, and hands during procedures. Poor lighting often forces the team to adjust repeatedly, which can increase aerosol spread.

Lighting strategies:

• Aim the light directly at the working area.

• Adjust brightness to avoid shadows.

• Reposition the light during each phase of the procedure.

Clear lighting creates a more controlled environment.

8. Keep the operatory organized

Cluttered counters or crowded tray setups make it harder to work efficiently. Every unnecessary motion increases the chance of splatter or aerosol spread.

What helps:

• Keep only necessary instruments and materials on the tray.

• Maintain a clean and organized counter.

• Position items within easy reach.

• Remove obstacles that force awkward movements.

Organization supports precision and better aerosol control.

9. Evaluate your operatory ventilation

Good ventilation helps remove lingering aerosols from the air. Many operatories already have ventilation systems in place, but simple adjustments can improve efficiency.

Ventilation considerations include:

• Ensuring regular HVAC filter changes

• Maximizing airflow without creating drafts

• Considering additional HEPA air filtration units

• Checking air exchange rates in treatment rooms

Clean, circulated air reduces the overall presence of airborne particles.

Conclusion

Reducing aerosols during routine dental procedures requires a combination of good technique, the right equipment, proper patient positioning, and consistent communication between the dentist and assistant. By adopting these habits, dental teams can create a safer, more efficient operatory environment that supports both patient care and team wellbeing.

Simple changes lead to measurable improvements in air quality and overall procedural control.