{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:02:14Z","timestamp":1790348534250,"version":"4.1.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004329","name":"The Slovenian Research and Innovation Agency","doi-asserted-by":"publisher","award":["P3-0293"],"award-info":[{"award-number":["P3-0293"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004329","name":"The Slovenian Research and Innovation Agency","doi-asserted-by":"publisher","award":["P3-0154"],"award-info":[{"award-number":["P3-0154"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004329","name":"The Slovenian Research and Innovation Agency","doi-asserted-by":"publisher","award":["P3-0083"],"award-info":[{"award-number":["P3-0083"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004329","name":"The Slovenian Research and Innovation Agency","doi-asserted-by":"publisher","award":["Z3-50124"],"award-info":[{"award-number":["Z3-50124"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oral Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Dental procedures generate dental spray that can transmit microorganisms. Substituting conventional coolants with antiseptics may mitigate this risk by preventing the transmission of infectious particles at the source. The aim of this\n                      <jats:italic>in vitro<\/jats:italic>\n                      study was to evaluate the efficacy of electrolyzed saline (EOS), a hypochlorous acid (HOCl) based antiseptic as a coolant for mitigating bacterial spray deposition during ultrasonic scaling (USS) in stimulated dental procedure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The bactericidal activity of EOS (pH 7.0, 200\u2005ppm) and 0.2% chlorhexidine digluconate (CHX) was tested against\n                      <jats:italic>Streptococcus mitis, Streptococcus pneumoniae, Streptococcus pyogenes,<\/jats:italic>\n                      and\n                      <jats:italic>Haemophilus influenzae<\/jats:italic>\n                      using a static antibacterial assay. Changes in bacterial morphology were visualized using transmission electron microscopy. A bacteria-laden dental spray model was used to simulate a patient undergoing plaque debridement procedure with ultrasonic scaler in standardized airborne transmission tunnel. Due to safety concerns, pathogen-free consortium of oral streptococci was used. Mitigation of bacterial deposition was quantified using a culture-based method. In addition, the biocompatibility of antiseptics was tested with exposure to human gingival fibroblasts (hGF) and human gingival keratinocytes (hOK).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the static assay, CHX reduced all tested bacteria species to \u226410\u2005CFU\/mL within 10\u2005s of exposure, irrespective of the presence of saliva. In contrast, EOS was generally less effective after 10\u2005s but exhibited near-complete antibacterial activity after 30\u201360\u2005s, with delayed efficacy in the presence of saliva. During USS procedures, no culturable bacteria were detected in splatter generated with either CHX or EOS. However, compared with saline EOS reduced bacteria-laden droplets\/aerosol (CFU\/cm\n                      <jats:sup>2<\/jats:sup>\n                      ) deposition by 92% vs. 81% with CHX (both,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), with no significant difference between the antiseptics (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.607). Both antiseptics effectively reduced bacterial deposition at short range. Nevertheless, only EOS maintained consistent mitigation efficacy over greater distances dominated by aerosol. EOS exhibited minimal cytotoxicity to hGF and moderate effects on hOK, while CHX substantially reduced viability of both cell types.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EOS demonstrated rapid contact-bactericidal activity and comparable dental spray deposition reduction to CHX. As a reasonably biocompatible, broad-spectrum agent, EOS may represent a promising coolant candidate for infection prevention control, warranting further clinical evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/froh.2026.1961598","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:28:50Z","timestamp":1790346530000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Electrolyzed saline coolant mitigates bacterial airborne deposition in dental procedures"],"prefix":"10.3389","volume":"7","author":[{"given":"Haris","family":"Munjakovi\u0107","sequence":"first","affiliation":[{"name":"Department of Oral Medicine and Periodontology, University Medical Centre Ljubljana","place":["Ljubljana, Slovenia"]},{"name":"Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Mikuleti\u010d","sequence":"additional","affiliation":[{"name":"Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Merhar","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Periodontology, University Medical Centre Ljubljana","place":["Ljubljana, Slovenia"]},{"name":"Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naiera","family":"Zayed","sequence":"additional","affiliation":[{"name":"Department of Oral Health Sciences, University of Leuven (KU Leuven)","place":["Leuven, Belgium"]},{"name":"Department of Microbiology and Immunology, Faculty of Pharmacy, Menoufia University","place":["Menoufia, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Kolenc","sequence":"additional","affiliation":[{"name":"Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damjan","family":"Manevski","sequence":"additional","affiliation":[{"name":"Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Triglav","sequence":"additional","affiliation":[{"name":"Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ale\u0161","family":"Fidler","sequence":"additional","affiliation":[{"name":"Department of Endodontic and Restorative Dentistry, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]},{"name":"Department of Endodontic and Restorative Dentistry, University Medical Centre Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim","family":"Teughels","sequence":"additional","affiliation":[{"name":"Department of Oral Health Sciences, University of Leuven (KU Leuven)","place":["Leuven, Belgium"]},{"name":"Dentistry Service, University Hospitals Leuven","place":["Leuven, Belgium"]},{"name":"Department of Periodontology, Faculty of Dentistry, Chulalongkorn University","place":["Bangkok, Thailand"]},{"name":"Department of Restorative Dentistry, Faculty of Dentistry, University Malaya","place":["Kuala Lumpur, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Seme","sequence":"additional","affiliation":[{"name":"University Clinic of Respiratory and Allergic Diseases Golnik","place":["Golnik, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rok","family":"Ga\u0161per\u0161i\u010d","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Periodontology, University Medical Centre Ljubljana","place":["Ljubljana, Slovenia"]},{"name":"Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1111\/joor.13098","article-title":"Evaluating aerosol and splatter following dental procedures: addressing new challenges for oral health care and rehabilitation","volume":"48","author":"Allison","year":"2021","journal-title":"J Oral Rehabil"},{"key":"B2","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1177\/00220345211015948","article-title":"Sources of SARS-CoV-2 and other microorganisms in dental aerosols","volume":"100","author":"Meethil","year":"2021","journal-title":"J Dent Res"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1080\/20002297.2025.2537439","article-title":"Digital PCR outperforms quantitative real-time PCR for the detection and quantification of major periodontal pathobionts","volume":"17","author":"Munjakovi\u0107","year":"2025","journal-title":"J Oral Microbiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1016\/j.chom.2017.03.011","article-title":"The landscape ecology and microbiota of the human nose, mouth, and throat","volume":"21","author":"Proctor","year":"2017","journal-title":"Cell Host and Microbe"},{"key":"B5","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1177\/0022034520979644","article-title":"Mechanisms of atomization from rotary dental instruments and its mitigation","volume":"100","author":"Sergis","year":"2021","journal-title":"J Dent Res"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1220","DOI":"10.1177\/00220345211020270","article-title":"COVID-19: seroprevalence and vaccine responses in UK dental care professionals","volume":"100","author":"Shields","year":"2021","journal-title":"J Dent Res"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1080\/20002297.2022.2107316","article-title":"Dental unit water content and antibiotic resistance of Pseudomonas aeruginosa and Pseudomonas species: a case study","volume":"14","author":"Tesauro","year":"2022","journal-title":"J Oral Microbiol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1080\/20002297.2024.2365965","article-title":"Colonization of bacterial and viral respiratory pathogens among healthcare workers in China during COVID\u201319 pandemic","volume":"16","author":"Yang","year":"2024","journal-title":"J Oral Microbiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s00784-023-05034-x","article-title":"Aerosol in the oral health-care setting: a misty topic","volume":"27","author":"Van der Weijden","year":"2023","journal-title":"Clin Oral Investig"},{"key":"B10","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1007\/s10266-023-00848-3","article-title":"Bacterial contamination potential of personal protective equipment itself in dental aerosol-producing treatments","volume":"112","author":"Gund","year":"2024","journal-title":"Odontology"},{"key":"B11","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1177\/00220345211056287","article-title":"Local exhaust ventilation to control dental aerosols and droplets","volume":"101","author":"Allison","year":"2022","journal-title":"J Dent Res"},{"key":"B12","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/s00784-023-04953-z","article-title":"Preprocedural mouthwashes for infection control in dentistry\u2014an update","volume":"27","author":"Weber","year":"2023","journal-title":"Clin Oral Investig"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1080\/20002297.2021.1881361","article-title":"Aerosols modification with H2O2 reduces airborne contamination by dental handpieces","volume":"13","author":"Ionescu","year":"2021","journal-title":"J Oral Microbiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1177\/00220345221110444","article-title":"Preprocedural mouthwashes for reduction of SARS-CoV-2 viral load and infectivity","volume":"101","author":"Cieplik","year":"2022","journal-title":"J Dent Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1590\/1807-3107BOR-2017.vol31.0021","article-title":"Effectiveness of a pre-procedural mouthwash in reducing bacteria in dental aerosols: randomized clinical trial","volume":"31","author":"Retamal-Valdes","year":"2017","journal-title":"Braz Oral Res"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e116","DOI":"10.1002\/JPER.21-0335","article-title":"Virus transmission by ultrasonic scaler and its prevention by antiviral agent: an in vitro study","volume":"93","author":"Fidler","year":"2022","journal-title":"J Periodontol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1177\/00220345241296071","article-title":"Electrolyzed saline prevents virus transmission in dental procedures: an in vitro study","volume":"104","author":"Munjakovi\u0107","year":"2025","journal-title":"J Dent Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1177\/00220345231169434","article-title":"HOCl rapidly kills corona, flu, and herpes to prevent aerosol spread","volume":"102","author":"Guan","year":"2023","journal-title":"J Dent Res"},{"key":"B19","doi-asserted-by":"publisher","first-page":"ZC53","DOI":"10.7860\/JCDR\/2016\/20017.8173","article-title":"Comparative evaluation of two different ultrasonic liquid coolants on dental aerosols","volume":"10","author":"Jawade","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"B20","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1186\/s12903-022-02528-0","article-title":"Electrolyzed water for the microbiologic control in the pandemic dental setting: a systematic review","volume":"22","author":"C\u00e1rdenas","year":"2022","journal-title":"BMC Oral Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1002\/JPER.23-0674","article-title":"How well do antimicrobial mouth rinses prevent dysbiosis in an in vitro periodontitis biofilm model?","volume":"95","author":"Zayed","year":"2024","journal-title":"J Periodontol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"2641","DOI":"10.3390\/s18082641","article-title":"Salivary detection of dengue virus NS1 protein with a label-free immunosensor for early dengue diagnosis","volume":"18","author":"Wasik","year":"2018","journal-title":"Sensors"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.4103\/ijehe.ijehe_15_20","article-title":"Evaluation of the bactericidal activity of some disinfectant agents against carbapenem-resistant Klebsiella pneumoniae isolates","volume":"9","author":"Ozturk","year":"2020","journal-title":"Int J Env Health Eng"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1128\/msystems.01182-20","article-title":"Quantifying live microbial load in human saliva samples over time reveals stable composition and dynamic load","volume":"6","author":"Marotz","year":"2021","journal-title":"mSystems"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1007\/s11222-023-10217-3","article-title":"Maximum softly-penalized likelihood for mixed effects logistic regression","volume":"33","author":"Sterzinger","year":"2023","journal-title":"Stat Comput"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-024-10039-2","article-title":"Incidence of serious respiratory tract infections and associated characteristics in a population exposed to immunosuppressive therapies: a register-based population study","volume":"24","author":"Etienne","year":"2024","journal-title":"BMC Infect Dis"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e1003","DOI":"10.1016\/S2214-109X(20)30264-3","article-title":"Global, regional, and national estimates of the population at increased risk of severe COVID-19 due to underlying health conditions in 2020: a modelling study","volume":"8","author":"Clark","year":"2020","journal-title":"Lancet Glob Health"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1080\/20002297.2023.2223477","article-title":"First water safety plan approach applied to a dental clinic complex: identification of new risk factors associated with Legionella and P. aeruginosa contamination, using a novel sampling, maintenance and management program","volume":"15","author":"Marino","year":"2023","journal-title":"J Oral Microbiol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1111\/jre.12937","article-title":"Differences in chlorhexidine mouthrinses formulations influence the quantitative and qualitative changes in in-vitro oral biofilms","volume":"57","author":"Zayed","year":"2022","journal-title":"J Periodontal Res"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2024.1429692","article-title":"Chlorhexidine digluconate mouthwash alters the oral microbial composition and affects the prevalence of antimicrobial resistance genes","volume":"15","author":"Bartsch","year":"2024","journal-title":"Front Microbiol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1111\/prd.70006","article-title":"Nitrate metabolism and periodontal health: the roles of nitric oxide in microbial killing and immunoregulation","author":"Rosier","year":"2025","journal-title":"Periodontol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1177\/00220345231216660","article-title":"Electrolyzed saline targets biofilm periodontal pathogens in vitro","volume":"103","author":"Zayed","year":"2024","journal-title":"J Dent Res"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1002\/jper.70070","article-title":"Electrolyzed saline as an alternative to chlorhexidine: antimicrobial and biofilm volume outcomes in a 4-day non-brushing randomized controlled clinical trial","volume":"97","author":"Pov\u0161i\u010d","year":"2026","journal-title":"J Periodontol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-48441-6","article-title":"The effects of exposure to O2\u2212 and HOCl\u2212 nanobubble water on human salivary microbiota","volume":"13","author":"Sagara","year":"2023","journal-title":"Sci Rep"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1080\/20002297.2025.2557959","article-title":"Hypochlorous acid solution serves as a potential anti-biofilm therapy for periodontitis via targeting quorum sensing of periodontal pathogens","volume":"17","author":"Lv","year":"2025","journal-title":"J Oral Microbiol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1098\/rsif.2020.0967","article-title":"Aerosol formation due to a dental procedure: insights leading to the transmission of diseases to the environment","volume":"18","author":"Mirbod","year":"2021","journal-title":"J R Soc Interface"},{"key":"B37","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1902\/jop.2013.120616","article-title":"Efficacy of preprocedural mouth rinsing in reducing aerosol contamination produced by ultrasonic scaler: a pilot study","volume":"85","author":"Gupta","year":"2014","journal-title":"J Periodontol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"226","DOI":"10.4103\/jisp.jisp_517_18","article-title":"Comparative evaluation of the chlorhexidine and cinnamon extract as ultrasonic coolant for reduction of bacterial load in dental aerosols","volume":"23","author":"Sethi","year":"2019","journal-title":"J Indian Soc Periodontol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-06716-9","article-title":"Inactivation mechanism of escherichia coli induced by slightly acidic electrolyzed water","volume":"7","author":"Ye","year":"2017","journal-title":"Sci Rep"},{"key":"B40","doi-asserted-by":"publisher","first-page":"109609","DOI":"10.1016\/j.foodcont.2023.109609","article-title":"Mechanisms of acidic electrolyzed water killing bacteria","volume":"147","author":"Wang","year":"2023","journal-title":"Food Control"},{"key":"B41","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1177\/00220345251388914","article-title":"The IADR policy statement on antimicrobial resistance","volume":"105","author":"Thompson","year":"2026","journal-title":"J Dent Res"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/microorganisms8081220","article-title":"Surviving reactive chlorine stress: responses of gram-negative bacteria to hypochlorous acid","volume":"8","author":"da Cruz Nizer","year":"2020","journal-title":"Microorganisms"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1128\/jb.00064-23","article-title":"Expression of RcrB confers resistance to hypochlorous acid in uropathogenic Escherichia coli","volume":"205","author":"Crompton","year":"2023","journal-title":"J Bacteriol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"102228","DOI":"10.1016\/j.jwpe.2021.102228","article-title":"Electrolyzed water as a disinfectant: a systematic review of factors affecting the production and efficiency of hypochlorous acid","volume":"43","author":"Ampiaw","year":"2021","journal-title":"J Water Process Eng"},{"key":"B45","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1111\/ger.12712","article-title":"Electrolysed oxidising water as a multi-purpose biocide in dental healthcare\u2014a scoping review","volume":"40","author":"Krishnan","year":"2023","journal-title":"Gerodontology"}],"container-title":["Frontiers in Oral Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/froh.2026.1961598\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:28:51Z","timestamp":1790346531000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/froh.2026.1961598\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,25]]},"references-count":45,"alternative-id":["10.3389\/froh.2026.1961598"],"URL":"https:\/\/doi.org\/10.3389\/froh.2026.1961598","relation":{},"ISSN":["2673-4842"],"issn-type":[{"value":"2673-4842","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,25]]},"article-number":"1961598"}}