| AimUltrasonic scaling, treated with mouth disease, generates aerosol(contains a large number of microbes such as germs), which may exert potential danger on doctors, nurses and patients. Therefore, in the study, clinic patients with gingivitis and mild-to-moderate chronic periodontitis that need ultrasonic scaling were used as objects, and bacterial colony were used as representatives to further explore the effect of using different mouth rinse during ultrasonic scaling on reducing bacterial concentration in air and the meaning of sustainable protection during and after the treatment. Thus, we can effectively decrease the incidence of cross-infection and find the best method to reduce the incidence of cross-infection. MethodsA total of 90 patients who diagnosed with mild-to-moderate gingivitis at the School and Hospital of stomatology, Jilin University from June 2015 to October 2015 were examined. Ninety patients with an age range between 22-50 years(mean age=34) participated in this study, including male 41 cases and female 49 cases. Inclusion criteria:1. Aged 20 to 55, residual teeth more than 20 in mouth.2. Diagnosed with gingivitis and mild-to-moderate chronic periodontitis.3. No drug allergy history and not taking antibiotics in 4 weeks before ultrasonic scaling.4. Healthy body and no systemic disease.5. Women had no pregnancy and do not lactating.6. Patients informed consent. Exclusion criteria:1. Patients accompanied by systemic disease such as active angina pectoris, and ictal myocardial infarct within half a year and hypertension and heart failure failing to effectively control etc;2. Oral prophylaxis such as coagulation disturbance, bleeding disease and hematologic diseases such as acute leukemia, aplastic anemia, wearing cardiac pacemaker and active infectious diseases such as acute hepatitis activities at active stage etc;3. Pregnancy women;4. Patients unwilling to participate in the study. According to visiting sequence, the patients were divided into 3 groups according to random number table with 30 cases in each group.Group A(control group): treated with water gargle before ultrasonic scaling(15ml for 1 min);Group B(experimental group): treated with chlorhexidine gargle before ultrasonic scaling(with 15 ml for 1 min);Group C(experimental group): treated with chlorhexidine gargle before ultrasonic scaling(with 10 ml for 1 min), with chlorhexidine gargle 5ml gargle for 1 min while scaling. Experimental 1Taking patient oral cavity as the center and a radius of 30 cm, at the equal-height of the patient head, 12 o’clock ahead, 9 o’clock on the left, 3 o’clock on the right, i.e. the patient with chest, the doctor’s location, the assistant’s location, three sampling point were set up. Sampling bacteria in the air in blood agar culture dish with different gargle, i.e. before ultrasonic scaling, two dimensions after ultrasonic scaling, end of the ultrasonic scaling, 10 minutes after the ultrasonic scaling, with 5 minutes for each; Experimental 2Taking patient oral cavity as the center and a radius of 1m, set three sampling points at the equal-height of the patient head, 12 o’clock ahead, 9 o’clock on the left, 3 o’clock on the right, sampling bacteria in the air in blood agar culture dish with different gargle, i.e. before ultrasonic scaling, two dimensions after ultrasonic scaling, end of ultrasonic scaling, 10 minutes after the ultrasonic scaling, with 5 minutes for each time point. Experimental Group 3(n=30)standardized locations included were chest of patient, on a tray of dental chair, 30 centimeters away from subjects’ mouth, at the equal-height of the patient head, 12 o’clock ahead, sampling bacteria in the air in blood agar culture dish with different gargle during the experimental procedure. Results1. Sex ratio and age difference in group A, B and C did not have statistical significance(P>0.05).2. The number of the bacteria that at a distance range 30 centimeters from patients before ultrasonic scaling was collected in the air which was statistically not-significant(P>0.05).The number of the bacteria that at a distance range 30 centimeters from patient was collected in the air in the first part of the process, at the end of ultrasonic scaling, at the end of 10 minutes ultrasonic scaling which was statistically significant(p<0.05). On Inter-group comparison the difference in microbial growth between Group A and Group B was statistically significant(p<0.05), and between Group A and Group C the number was statistically significant(p<0.05), but between Group A and Group C the number was statistically not-significant(p>0.05).3. The number of the bacteria that at a distance range 1 meter from patients before ultrasonic scaling was collected in the air which was statistically not-significant(P>0.05).The number of the bacteria that at a distance range 1 meter from patient was collected in the air in the first part of the process, at the end of ultrasonic scaling, at the end of 10 minutes ultrasonic scaling which was statistically significant(p<0.05). On Inter-group comparison the difference in microbial growth between Group A and Group B was statistically significant(p<0.05), and between Group A and Group C the number was statistically significant(p<0.05), but between Group A and Group C the number was statistically not-significant(p>0.05).4. The number of the bacteria that at a distance range 30 centimeters during the experimental procedure from patient was collected in the air which were statistically significant(p<0.05). On Inter-group comparison the difference in microbial growth between Group A and Group B was statistically significant(p<0.05), and between Group A and Group C the number was statistically significant(p<0.05), but between Group A and Group C the number was statistically not-significant(p>0.05).5. Gram staining was carried out on the typical colonies, which were in three groups of air sampling at different time points after blood agar bacteria in a petri dish, the bacteria in three groups all can detect the existence of aureus, bacillus, streptococcus. Conclusions1. Bacterial aerosols contamination generated from ultrasonic scaling has already become a potential infection risk.2. treatment areas centered on patient oral cavity continued to exist a large number of bacteria in the process of ultrasonic scaling, which threaten seriously the health of health workers and patients and increased the risk of cross infection, thus the personnel protection should be strengthened.3. A fourfold increase of airborne bacteria has been observed in areas where aerosol producing equipment was used. Aerosols can flat in air for considerable time and flat in the air with a wide range of space before being inhaled by dental staff and other patients, so we should strengthen the disinfection extend to the operating area and the air disinfection should be enhanced at the same time.4. It could be effectively reduced the number of bacteria after using mouth rinses in the ultrasonic scaling and cut down the risk of cross contamination between medical staff and patients.5. In the process of experiment, we required the same amount of mouth rinse. It showed that pre-procedural use of Chlorhexidine mouth rinse alone or pre-procedural use of Chlorhexidine mouth rinse and the process dual-use compound both can significantly reduce the number of the bacteria in the air in the process of ultrasonic scaling. However, regard to the effect of reduce the number of bacteria in the air, the latter is better than the former, at the same time, it has great significant about reduce the number of bacteria and cut down the risk of cross contamination between medical staff and patients. It also has positive significance to protect health workers from cross contamination in the process of ultrasonic scaling. |
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