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In this prospective clinical study, the authors evaluated bacterial contamination of dental professionals’ facial skin (unprotected forehead) before and 60 minutes after aerosol-generating dental procedures. They compared these findings with those based on examining used surgical masks 60 minutes after aerosol-generating dental procedures. Obligate and facultative oral bacteria frequencies and bacterial growth were measured.
Bacteria were detected in 95.5% of forehead skin swabs and 79% in mask samples after dental procedures. Obligate oral bacteria were found on the forehead skin in 3% before and in 6% after dental procedures and in 25% of the samples from surgical masks. Facultative oral species were found in 21% of the forehead skin swabs and in 26% of mask samples after treatment but not before treatment. The authors reported that this is the first study showing microbiota changes on dental professionals’ foreheads after performing aerosol-generating dental procedures and recommend continued general use of face shields, currently widely adopted during the COVID-19 pandemic.
Bacterial contamination of dental professionals' facial skin and protective equipment from treatment-related aerosols and droplets are poorly studied.
This prospective study analyzed samples from 67 consecutive aerosol-producing dental treatments. Sterile nylon swabs served to collect samples from dental professionals' foreheads before and after exposure. Contact samples were obtained from used surgical masks. Samples were incubated on agar under aerobic and anaerobic conditions. Bacteria were classified by MALDI-TOF mass spectrometry. We determined the frequencies of obligate and facultative oral bacteria and scored bacterial growth (0: none; 1: < 100 colonies; 2: >100 colonies; 3: dense).
Bacteria were detected in 95% of skin-swab and 76% of mask samples. Median bacterial scores were 2 for forehead samples before and after treatment, and 1 for masks. Obligate and facultative oral bacteria were more frequent (6% and 30%) in samples from exposed forehead skin, which also showed increased bacterial scores (28%). 5% of samples contained methicillin-sensitive Staphylococcus aureus; 3% contained obligate anaerobes.
Exposed forehead skin was significantly less contaminated with obligate oral bacteria than expected based on surgical mask findings. Exposed forehead skin showed increased contamination attributable to aerosol-producing procedures. The forehead's physiological skin microbiota may offer some protection against bacterial contamination.