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Dental health care workers are in close contact to their patients and are therefore at higher risk for contracting airborne infectious diseases. The transmission rates of airborne pathogens from patient to dental health care workers are unknown. With the outbreaks of infectious diseases, such as seasonal influenza, occasional outbreaks of measles and tuberculosis, and the current pandemic of the coronavirus disease COVID-19, it is important to estimate the risks for dental health care workers. Therefore, the transmission probability of these airborne infectious diseases was estimated via mathematical modeling. The transmission probability was modeled for Mycobacterium tuberculosis, Legionella pneumophila, measles virus, influenza virus, and coronaviruses per a modified version of the Wells-Riley equation. This equation incorporated the indoor air quality by using carbon dioxide as a proxy and added the respiratory protection rate from medical face masks and N95 respirators. Scenario-specific analyses, uncertainty analyses, and sensitivity analyses were run to produce probability rates. A high transmission probability was characterized by high patient infectiousness, the absence of respiratory protection, and poor indoor air quality. The highest transmission probabilities were estimated for measles virus (100%), coronaviruses (99.4%), influenza virus (89.4%), and M. tuberculosis (84.0%). The low-risk scenario leads to transmission probabilities of 4.5% for measles virus and 0% for the other pathogens. From the sensitivity analysis, it shows that the transmission probability is strongly driven by indoor air quality, followed by patient infectiousness, and the least by respiratory protection from medical face mask use. Airborne infection transmission of pathogens such as measles virus and coronaviruses is likely to occur in the dental practice. The risk magnitude, however, is highly dependent on specific conditions in each dental clinic. Improved indoor air quality by ventilation, which reduces carbon dioxide, is the most important factor that will either strongly increase or decrease the probability of the transmission of a pathogen.

The heterogeneous bacterial group known as oral streptococci was screened for the presence of cellular polyglycerolphosphate-containing lipoteichoic acid. This compound was detected in phenol extracts of lyophilized cells by an immunoassay in which polyglycerolphosphate-specific monoclonal antibody was used. Polyglycerolphosphate-containing lipoteichoic acid occurred in all 86 strains of oral streptococci examined except the Streptococcus mitis and Streptococcus oralis strains. This confirms the findings of Rosan (B. Rosan, Science 201:918-920, 1978) and Hamada et al. (S. Hamada, J. Mizuno, S. Kotani, and M. Torii, FEMS Microbiol. Lett. 8:93-96, 1980), is consistent with the results of the taxonomic study of oral streptococci performed by Kilian et al. (M. Kilian, L. Mikkelsen, and J. Henrichsen, Int. J. Syst. Bacteriol. 39:471-484, 1989), who emended the descriptions of Streptococcus sanguis, S. oralis, and S. mitis, and reflects the phylogenetic relationship among S. mitis, S. oralis, and Streptococcus pneumoniae.