The use of a surgical microscope and bag barrier drape, HVE, and extraoral suction device result in the lowest concentration of aerosolized particles, according to a recent study published in the Journal of the American Dental Association.
The COVID-19 pandemic has increased the importance of minimizing exposure to aerosols generated during dental procedures. The authors' objective was to measure the aerosolized particles in the breathing zone of operators using several facial protection and filtration methods.

Twenty-one dentists performed maxillary anterior incisor veneer preparations using a microscope and drape and loupes with or without a face shield. In each test condition, the following 3 levels of filtration were tested: no filtration, a high-volume evacuator [HVE], and an HVE with an extraoral suction device. Measurements were made using a mass monitor attached to the operator's chest with inlet within 10 inches of the operator's face.
The results of the study are:
The authors found that the microscope and drape provided the lowest levels of aerosolized particles compared with loupes with or without a face shield (P < .001). There was no detectable difference in the concentration of particles between operators wearing a face shield and wearing loupes alone (P = .47). The particles in each test condition were lowered when an HVE was used (P < .001) and further lowered with an extraoral suction device.
Thus, the findings of this study suggest that the use of a surgical microscope and bag barrier drape, HVE, and extraoral suction device result in the lowest concentration of aerosolized particles. The face shield did not appear to offer any protection from aerosolized particles. HVE and extraoral suction were effective in decreasing aerosols regardless of the type of facial protection used. Dentists can reduce exposure to aerosols with a drape, HVE, and extraoral suction.
Reference:
Effectiveness of barrier devices, high-volume evacuators, and extraoral suction devices on reducing dental aerosols for the dental operator: A pilot study by Wayne David Remington, et al. published in The Journal of the American Dental Association.
DOI: https://doi.org/10.1016/j.adaj.2021.08.011
Keywords:
The Journal of the American Dental Association, microscope, drape, aerosolized particles, microscope and bag barrier drape, HVE, and extraoral suction device, COVID-19, surgical microscope, Wayne David Remington, Brian Chandler Ott, Thomas Ryan Hartka,