Sir, to reduce the risk of cross infection through aerosol generation we recommend a modified aerosol box design for viable dentistry.

The modified design (Figs 1a-b) comprises a reduced base width for adequate accommodation on a dental chair (without being hindered by the spittoon or arm rest). The patient end of the box is made 10 cm wider to accommodate wide shouldered and hefty clients. Other than two circular working ports on the doctor's end in a normal aerosol box, the dental box also has two similar working ports on the surface which is on the right side of the patient (Fig. 1c). Which is placed parallel to the U-frame base for convenient working and another single working port on the surface which is on the left side of the patient for getting assistance from that side.

Fig. 1
figure 1

Modified aerosol box design for viable dentistry

Full size image

The height of the box is kept at 50 cm to provide for adequate manoeuvrability, along with a front panel to reduce aerosol scatter in front of the patient. The extra 5 cm length of the frame downwards from the base U-plate will make the box more stable vertically and prevent sliding down on a tilted table (Fig. 1d). The top front 10 cm is attached to the posterior plate with a hinge mechanism so that it can be raised for making the patient sit up for spitting in between the procedure. Another modification to avoid the hinge mechanism is adding an arch shape to the plate over the client's neck. There is also a 2 cm hole on the top surface of the box to attach an aerosol suction device which can absorb the droplets from the top of the hood. It could be connected to a regular office-based suction device or a high suction aerosol suction device.

We acknowledge that the presence of the box would hinder the way a lot of procedures are performed and that there would be a learning curve to master these. However, in the wake of the current situation it would be better to not consider this device as a hindrance but more as a necessary physical infection control barrier.