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Aerosol-Generating Procedures and Simulated Cough in Dental Anesthesia
Brian Chanpong DDS, MSc,,
 Michelle Tang DDS, MSc,,
 Alexander Rosenczweig DMD,
 Patrick Lok DDS, and
 Raymond Tang MD, MSc
Article Category: Research Article
Volume/Issue: Volume 67: Issue 3
Online Publication Date: Jun 18, 2020
DOI: 10.2344/anpr-67-03-04
Page Range: 127 – 134

in pulmonary secretions. The virus spreads primarily by droplet and contact contamination and by aerosols during aerosol-generating procedures (AGPs). The close proximity and contact with these oropharyngeal structures put dental professionals at high risk. AGPs such as the use of high-speed handpieces, ultrasonic scalers, and air-water syringes increase the extent of exposure and risk of infection. In anesthesia-based dental practices, AGPs including intubation, extubation, manual ventilation, and tracheal suctioning further add to this risk. 2 In addition to

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Figure 2. ; Splatter on dentist after aerosol-generating procedures, with the majority evident on arms.
Brian Chanpong,
 Michelle Tang,
 Alexander Rosenczweig,
 Patrick Lok, and
 Raymond Tang
Figure 2. 
Figure 2. 

Splatter on dentist after aerosol-generating procedures, with the majority evident on arms.

Figure 3. ; Splatter on dental assistant after aerosol-generating procedures, with the majority evident on arms and legs.
Brian Chanpong,
 Michelle Tang,
 Alexander Rosenczweig,
 Patrick Lok, and
 Raymond Tang
Figure 3. 
Figure 3. 

Splatter on dental assistant after aerosol-generating procedures, with the majority evident on arms and legs.

Figure 1.; Reusable electronic cigarette components. Reusable e-cigarettes are composed of a plastic or glass tank which allows the user to store a greater volume of e-liquid. The heating element is typically an atomizer which allows for greater generation of aerosols. Reusable e-cigarettes contain a larger battery compared with disposable ones. A larger power supply to the heating element allows for a greater volume of aerosol to be generated with each puff.
Zachary A. Heller,
 Edward C. Adlesic MS, and
 Jason E. Portnof DMD
Figure 1.
Figure 1.

Reusable electronic cigarette components. Reusable e-cigarettes are composed of a plastic or glass tank which allows the user to store a greater volume of e-liquid. The heating element is typically an atomizer which allows for greater generation of aerosols. Reusable e-cigarettes contain a larger battery compared with disposable ones. A larger power supply to the heating element allows for a greater volume of aerosol to be generated with each puff.

Figure 2.; Components of a disposable electronic cigarette. Disposable e-cigarettes do not contain a tank and instead store their e-liquid in a saturated piece of cotton. Aerosols are generated by a rudimentary wick and coil which is heated by a low voltage battery. The processor recognizes when the user is taking a puff and triggers the battery to supply power to the coil. The processor is set to a predetermined number of puffs. The device will stop generating aerosols once that number is reached or the battery runs out of power, whichever comes first.
Zachary A. Heller,
 Edward C. Adlesic MS, and
 Jason E. Portnof DMD
Figure 2.
Figure 2.

Components of a disposable electronic cigarette. Disposable e-cigarettes do not contain a tank and instead store their e-liquid in a saturated piece of cotton. Aerosols are generated by a rudimentary wick and coil which is heated by a low voltage battery. The processor recognizes when the user is taking a puff and triggers the battery to supply power to the coil. The processor is set to a predetermined number of puffs. The device will stop generating aerosols once that number is reached or the battery runs out of power, whichever comes first.

Figure 1. ; Splatter captured during the use of an air-water syringe and continuous high-volume evacuation suction.
Brian Chanpong,
 Michelle Tang,
 Alexander Rosenczweig,
 Patrick Lok, and
 Raymond Tang
Figure 1. 
Figure 1. 

Splatter captured during the use of an air-water syringe and continuous high-volume evacuation suction.

Figure 4. ; Plume and splatter captured during the simulated cough.
Brian Chanpong,
 Michelle Tang,
 Alexander Rosenczweig,
 Patrick Lok, and
 Raymond Tang
Figure 4. 
Figure 4. 

Plume and splatter captured during the simulated cough.

Figure 5. ; Splatter on anesthesiologist after a simulated cough, covering head, face, body, arms, and legs.
Brian Chanpong,
 Michelle Tang,
 Alexander Rosenczweig,
 Patrick Lok, and
 Raymond Tang
Figure 5. 
Figure 5. 

Splatter on anesthesiologist after a simulated cough, covering head, face, body, arms, and legs.

Implications of Electronic Cigarettes on the Safe Administration of Sedation and General Anesthesia in the Outpatient Dental Setting
Zachary A. Heller DO, DMD,
 Edward C. Adlesic MS DMD, and
 Jason E. Portnof DMD MD
Article Category: Research Article
Volume/Issue: Volume 69: Issue 2
Online Publication Date: Jul 18, 2022
DOI: 10.2344/anpr-69-02-16
Page Range: 41 – 52

a vaporizable solution that typically contains nicotine, a heating element or an atomizer, and a mouthpiece through which the user inhales or “puffs” ( Figures 1 and 2 ). 3 Electronic cigarettes create aerosols when the user draws in air through the mouthpiece. This triggers the device to begin drawing liquid solution from the tank or reservoir and pass it over the internal heating element. The liquid is then vaporized by the heating element, which operates at temperatures ranging between 100°C and 300°C depending on the device's construction and power output

Superior Laryngeal Nerve Block for Intubation in Patients With COVID-19
Yuki Kojima DDS, PhD and
 Mitsutaka Sugimura DDS, PhD
Article Category: Article Commentary
Volume/Issue: Volume 68: Issue 1
Online Publication Date: Apr 07, 2021
DOI: 10.2344/anpr-68-01-09
Page Range: 50 – 51

virally infected aerosols in a relatively closed environment. 1 Once generated, these aerosols reportedly remain suspended in the air for up to 3 hours. 2 Certain clinical procedures such as intubation and extubation are particularly known to generate potentially contagious aerosols that could infect medical personnel. 3 Canelli et al 4 recently invented an “aerosol box,” a barrier that can be easily fabricated, to reduce the risk of viral transmission and infection via exposure to contaminated aerosols for clinicians performing intubation- and extubation

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