Air Quality in the Dental Clinic: Dis-infecting the “Toxic Cloud” – Part 2

Read part one here.

Air Pollution at the Dentist’s Office

In just about any indoor environment — schools, offices, laboratories — toxic chemical gases are emitted by furniture, flooring, cabinetry, and cleaning products. But dental clinics are at greater risk for indoor air pollution because of the materials used in treatments.

Among the most toxic may be methyl methacrylate, a monomer of acrylic resin used in dentures and cement and known, according to Taiwanese researchers, for its “strong acrid smell and volatile character.”

Other toxic gases and vapours are released by metal casting, grinding and polishing acrylic materials, removing amalgam fillings, and creating crowns, bridges, and dental prostheses.

When the Taiwanese team recorded total VOC concentrations at a university dental clinic, all six areas tested exceeded the indoor air-quality standards of the Taiwan Environmental Protection Agency.

“The dental departments of the hospital had serious total VOC pollution,” the authors concluded.

VOCs were particularly high in the periodontal department, which the authors attributed to bleaching solvent used to disinfect the boxes used for collecting surgery devices.

Similarly, in a study at Athens University dental school, researchers found total VOC concentrations “far exceeded the [recommended] recommended limit for the indoor environment.” Indoor particulate-matter concentrations were 12 times higher than nearby outdoor concentrations.

Cleaning the Air in Dental Clinics

Warning that bacterial and viral infections are under-reported in dentistry, Dutch researchers offered this guiding principle for dental clinics: “Every patient should be treated as potentially infectious.”

The same might be said of every dental-unit waterline, patient chair, sink, and instrument.

That’s why clinics must take every precaution to prevent the spread of infectious bioaerosols, as well as the emission of toxic gases and vapours.

It is becoming increasingly clear that traditional prevention methods, while important, are wholly inadequate.

For example, dental personnel are urged to wear face masks, though masks are not designed to eliminate air leakage around the edges and don’t filter out submicron particles.

“Surgical masks offer some protection for the mucous membranes of the nose and mouth of the wearer from large droplets and splashes but will not protect against the inhalation of aerosols,” American researchers concluded.

Similarly, dental practices must follow strict protocols for cleaning dental-unit waterlines, though diligent disinfection, draining, and water testing won’t eliminate risk.

As French researchers found, even when dental-unit waterlines were submitted to stringent disinfection, “results clearly suggested that patients and dental staff remained exposed to potential infectious risk.”

The limits of hand hygiene and surface cleaning have long been documented, which makes one important precaution all the more critical: air dis-infection, via ultra-low-energy plasma technology by Novaerus.

Commonly installed in hospital emergency rooms, waiting areas, ICUs, and operating theatres, Novaerus technology has recently become more prevalent in dental clinics.

The technology is proven to eradicate airborne pathogens — including MRSA, influenza, and gram-negative bacteria like Legionella — as well as VOCs and particulate matter.

For example, the NV800 has been shown to reduce 99.99% of MRSA bacteria over four hours, and the NV1050 has been shown to reduce Staphylococcus epidermidis (a surrogate for MRSA) by 99.9% within 15 minutes of operation.

In the dental setting, ultra-low-energy plasma technology is a critical complement to ventilation and filtration.


As a Greek study concluded, typical dentistry ventilation systems are insufficient, causing the “accumulation and trapping of air pollutants in certain areas of the room.” And whereas conventional HVAC filters capture only large particles, Novaerus units destroy the smaller and more dangerous ones.

Novaerus technology is safe for continuous use around vulnerable patients, and as a welcome bonus, the units eliminate even the most noxious odours.

And it’s one reason Wassan Specialty Dental Centre in Muscat, Oman, has been so pleased with Novaerus technology.

Shortly after installation, the dental staff noticed a reduction in odours that had originated from within the clinic and from nearby restaurants. Patients, too, noted a fresh quality to the air inside the clinic.

Of course, staff were also reassured to know that Novaerus technology was operating continuously in the background to eliminate airborne pathogens and pollutants.

“We know we are providing a safer practice to our patients and safer workspace to our staff,”.

Novaerus