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. 2026 Mar 13;38(3):30. doi: 10.1007/s44445-026-00139-x

Micro and nanoplastics in dentistry: emerging sources, health implications, and mitigation pathways: a narrative review

Manisha Chaudhary 1, Akash Kumar Giri 1,✉, Anjali Giri 2
PMCID: PMC12982721  PMID: 41820647

Abstract

Micro and nanoplastics (MNPs) released from dental materials and oral-care products are an emerging concern at the intersection of dentistry and environmental health. This narrative review synthesizes evidence on dentistry-related sources of MNPs, exposure pathways, biological interactions, detection approaches, and environmental dissemination, with emphasis on practical mitigation. Resin-based composites and acrylic prosthetics, as well as routine consumer products such as toothbrushes, toothpastes, floss, and clear aligners, are identified as potential sources of microscopic polymer debris. Exposure may occur during everyday use, predominantly via ingestion with saliva and, in some contexts, inhalation of fine procedure-generated aerosols. Experimental in vitro and in vivo studies indicate that MNPs can be internalized by oral cells and may trigger oxidative stress and inflammatory responses, although direct human clinical evidence linking dental-origin exposure to disease remains limited. Proposed associations with periodontal inflammation, oral carcinogenesis, or systemic outcomes are biologically plausible but unconfirmed. Environmental studies have reported polymer-containing particulate in oral-care rinse water and dental wastewater, suggesting dentistry may represent a small but potentially addressable point source of microplastic release. We summarize mitigation options including effective chairside evacuation, upstream filtration and trap maintenance, dust control for laboratory processes, and patient guidance toward lower-shedding products, and we note the relevance of evolving regulation, including the EU REACH 2023/2055 restriction on intentionally added microplastics.

Keywords: Microplastics, Nanoplastics, Micro and nanoplastics, Occupational health, Oral cavity, Dental materials, Dental sources, Oral care products, Environmental exposure

Introduction

Plastics sit at the center of everyday dentistry, from disposable barriers and suction tips to resin fillings and polymer-based prostheses, which means the field likely contributes to plastic debris over time. (Tanna and Bhandary 2025).

Microplastics (MPs, < 5 mm) and nanoplastics (NPs, < 1 μm), together termed micro-nanoplastics (MNPs), are widespread pollutants found across ecosystems and inside the human body which are detected in blood, placenta, lung tissue, breast milk, and stool, demonstrating their bioavailability and ability to cross epithelial barriers and disperse systemically. (Prata et al. 2021; Prüst et al. 2020; Leslie et al. 2022) Recent studies even found plastic particles embedded in human heart tissues during cardiac surgery and accumulating as nanoscale fragments in decedents’ brain and liver samples. (American Chemical Society, n.d.; Nihart et al. 2025).

A growing body of evidence suggests that MNPs are not biologically inert; rather, they behave as active environmental toxicants that can carry other chemicals, disrupt cellular homeostasis, and possibly contribute to long-term diseases, including cancer. (Deng et al. 2025; Wang et al. 2019) Experimental studies indicate that MNP exposure can trigger oxidative stress and inflammation, damage cells, and disturb immune function. It also appears to shift gut microbiota, impair fertility, and cause developmental neurotoxic effects, with evidence of particle passage across both the brain and placental barriers. (Luo et al. 2019; Cannatà et al. 2024; Su et al. 2019).

Oral health sits at a still underexplored intersection of this issue: people continuously ingest and inhale MNPs shed from dental materials and everyday oral care products. Based mainly on in vitro work, these particles may irritate oral mucosa, influence microbial ecology, and show cytotoxic or genotoxic signals in oral epithelial cells and fibroblasts, although the real-world clinical relevance is not yet established. Chronic oral exposure has been discussed as a possible contributor to periodontal inflammation or carcinogenesis, but epidemiological confirmation is currently lacking and much of the concern rests on mechanistic and indirect evidence rather than direct clinical outcomes. (Di Spirito et al. 2025) Resin-based composites (e.g. PMMA, Bis-GMA, UDMA) widely used in place of amalgam can release microscopic fragments during placement, finishing, and everyday wear. Common dental tools and products also contribute: polishing pastes, dental floss, toothbrush bristles, toothpaste, and clear orthodontic aligners all shed microdebris with routine use. Dentistry has moved away from traditional materials like metal and ivory toward high-grade plastics for good reasons, but the unintended release of micro- and nanoplastics during routine care and hygiene carries potential health and environmental costs that deserve closer study. (Saha et al. 2025).

Therefore, this narrative review aims to summarize current evidence on the sources of MNP release in dentistry, the mechanisms of particle generation and characteristics of these particles, and the toxicological and biological effects associated with dental-derived MNP exposure. We focus on MNPs originating from dental materials (e.g. composite resins, clear aligners, prosthetic devices, impression materials) and oral care products (e.g. toothpastes, mouthrinses). We also explore how oral exposure might interact or work together with wider environmental microplastic exposure. Particular attention is given to how these particles might affect oral tissues and overall health, while also pointing out the existing knowledge gaps and areas that need further research. This review comes at a time of heightened awareness where global initiatives are pushing to curb plastic pollution (e.g. a UN plastics treaty under negotiation for 2024) and new regulations (such as the EU’s 2023 microplastic restriction) are redefining what counts as microplastic in consumer products. Our aim is to give dental and medical professionals a current understanding of this emerging issue and to guide future directions in both clinical practice and research.

Materials and methods

This narrative review was prepared doing a literature search conducted between July 2025 and November 2025. We searched PubMed/MEDLINE, Web of Science and Google Scholar using combinations of keywords. Core terms included microplastics, nanoplastics, micro-nanoplastics, dentistry, oral cavity, dental materials, resin composites, acrylic/PMMA, aligners, toothpaste, toothbrush, floss, dental aerosols, occupational exposure, and dental wastewater, along with related synonyms. We included English-language publications relevant to dentistry and oral-care sources of MNPs, including studies addressing particle release or characterization, exposure pathways in home and clinical settings, and related occupational, environmental, and regulatory considerations. In addition to the electronic search, we performed manual citation searching by screening the reference lists of relevant articles to identify additional sources.

Peer-reviewed original studies and reviews were eligible if they reported micro or nanoplastic detection, release, or characterization from dental materials, dental procedures, oral-care products, or dental clinical environments, and/or toxicological or biological interaction evidence directly relevant to oral or dental exposure pathways. We excluded studies focused exclusively on non-oral plastics with no plausible dental/oral exposure pathway and articles lacking sufficient methodological detail to interpret contamination control or particle verification. Where polymer identification was a primary objective, studies without polymer confirmation were not prioritized.

As this was a narrative review, we did not conduct independent dual screening or a structured risk-bias assessment. Rather, we did a thematic synthesis from the retrieved literature and used a simple evidence grading system to understand the certainty of key findings (Table 1). Each key finding was graded based on the highest level of evidence available, considering directness to dental/oral exposure and outcomes, study design and real-world relevance, consistency across studies, and methodological robustness. The evidence grading system was intended to make interpretation, not to exclude studies. Key data were extracted on.

  • (i)

    dental and oral-care sources of particle release,

  • (ii)

    particle characteristics and detection approaches,

  • (iii)

    reported biological interactions and health implications,

  • (iv)

    occupational and environmental considerations and

  • (v)

    mitigation strategies and regulatory developments.

Table 1.

Simplified evidence-grading system applied in this narrative reviews

Grade Typical evidence base in this topic Suggested statement strength

A

(Higher)

 Human clinical/epidemiologic evidence linking dental MNP exposure to outcomes “is associated with/shows evidence of”

B

(Moderate)

 Human exposure/biomonitoring in relevant settings or multiple consistent in vivo studies “suggests/indicates”

C

(Low)

 Bench simulation, in vitro, ex vivo, material characterization, limited sampling “may/could/is plausible”

D

(Very low)

 Hypothesis, expert opinion, narrative extrapolation without direct measurement “hypothesized/theoretical”
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Sources of MP/NP particles in dentistry

Modern dental practice and home oral care introduce many opportunities for MNPs release. These sources can be grouped into daily oral-care products used by the general public and clinical or laboratory procedures within dental offices. (Table 2).

Table 2.

Home-care oral products and clinical dental materials known to release MNPs (Di Spirito et al. 2025; Wang et al. 2025; Saiyed et al. 2025)

Product Type Microplastic Type Released Particle Size Range Context of Use Estimated Quantity Released Exposure Route Evidence grade (A–D)
Toothbrush bristles Polypropylene (PP), nylon (PA), PET (depends on bristle material); fragments from bristle wear Mostly < 100 µm; many 0–50 µm (PP bristles) Daily brushing abrasion  ≥ 23.3 × 105 particles/year/person (model/simulation; varies by material and method) Ingestion (swallowed with saliva); minimal inhalation C
Toothpaste (dentifrice) Polyethylene (PE) microbeads or fragments (where present); PEVA/EVA, PET, PP, PTFE, PMMA reported as additives (product-dependent) Typically ~ 10–200 µm (irregular fragments; few spherical microbeads) Brushing (ingredient in paste) Up to 11.83 × 105 particles/year/person (brand-dependent); one study reported PE ~ 22% and PEVA ~ 78% Ingestion (partial swallowing during brushing) C
Dental floss PTFE (Teflon) filaments, UHMW-polyethylene, or waxed nylon strands (product-dependent) Fibres/fragments (nano- to ~ 100 µm range) Flossing (friction against teeth/restorations) Not quantified (limited direct particle-count data; microscopy suggests shedding) Ingestion (fragment swallowed with saliva) D
Mouthrinse microcapsules Polymeric microcapsules/microbeads in some specialty formulations (many phased out; formulation-dependent) Tens to few hundred µm (if present; may dissolve or disintegrate) Rinsing (flavor/active microcapsules in select products) Not quantified; likely minor in current formulations (market-dependent) Ingestion (if residual rinse swallowed) D
Composite resin (filling) Methacrylate-based resin matrix (e.g., Bis-GMA/UDMA/TEGDMA systems) with inorganic filler; wear debris from finishing/polishing Ultrafine aerosol peak ~ 40–70 nm during high-speed polishing; larger debris < 100 µm also generated Finishing/polishing of restorations (drilling, grinding)  > 106 particles/cm3 (breathing-zone aerosol number concentration during polishing; includes resin/filler particles; polymer confirmation varies by study) Inhalation (aerosol by dentist & patient); ingestion (particles mix with saliva) C
Denture base (PMMA) Polymethyl methacrylate acrylic (PMMA) Mostly microparticles < 50 µm Trimming and polishing of dentures/prostheses Not quantified; visible acrylic dust generated per adjustment; fine particles settle on surfaces Inhalation (technician/dentist during grinding); ingestion (settled particles in oral cavity) C
Polishing paste (prophy) Polymer microbeads/capsules in some polishing formulations (where used); fragments during use  ~ 10–100 µm (if polymer abrasives are present) Professional tooth polishing (during dental cleaning) Not quantified; polymer residues may be captured in suction filters/traps (study-dependent) Ingestion (swallowed with saliva/rinse); inhalation (splatter aerosol) D
Polishing cup (prophy cup) Synthetic elastomer (rubber/silicone-based; product-dependent)  ~ 10–500 µm (abrasive wear debris) Professional tooth polishing (rotating cup on teeth with paste) Not quantified; minor polymer wear per use may contribute to aerosol/trap debris Ingestion (via saliva); inhalation (rubber dust aerosol) D
Clear aligner (orthodontic) Thermoplastic polymer (PET-G, polyurethane; product-dependent)  ~ 5–20 µm (majority of particles); occasional < 5 µm Continuous intraoral wear (plus trimming of aligners)  ~ 1.1 × 103–5.8 × 103 particles per aligner over usage period (in vitro aging/wear studies) Ingestion (fragments in saliva swallowed); inhalation (during trimming/polishing of aligner) C
Disposable suction tip Polyethylene or polypropylene (often with other polymers; product-dependent) Not quantified during use; secondary MPs formed via environmental fragmentation; fine particles possible with thermal degradation Saliva ejector/high-volume suction (single-use device; plastic waste) No direct shedding quantified during use; contributes to secondary MPs via waste stream (disposal-dependent) Environmental pathway (secondary exposure via waste handling/disposal) D
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Daily oral-care products

Toothbrush

Most toothbrush bristles are made from synthetic polymers such as polypropylene (PP), polyamide (nylon, PA), polyethylene (PE), or polyethylene terephthalate (PET). During normal use, bristle filaments undergo surface abrasion, microcracking, and tip fracture, releasing small plastic fragments into the brushing slurry. These shed particles tend to be irregular granules or short fibrils rather than long fibers, with smaller size fractions dominating (many fragments < 100 μm, often within the 0–50 μm range). Quantitative estimates vary by method, a recent analysis estimated toothbrush-associated releases of at least 23.3 × 105 particles/year/person, with detected MPs dominated by < 100 μm (~ 63%) and including a substantial PP fraction (~ 22%). Particle release increases with brushing frequency and brush age: as a brush head wears down, more MNPs is generated per use. Materials and usage patterns also matter. Comparative studies indicate PET bristles often develop more obvious coarse damage at the tips, whereas PP and nylon bristles fragment into finer debris; although all bristle types shed some MNPs under normal use. Brushing conditions such as applied pressure, duration, and the abrasiveness of toothpaste can affect the wear rate. In practical terms, virtually all toothbrushes do shed MNPs during ordinary home care. The health relevance of this chronic, low-level exposure remains under active investigation, but it establishes a baseline intake of plastic particles even before any clinical dental procedures. (Saha et al. 2025; Wang et al. 2025).

Toothpastes

Unlike toothbrushes, MNPs release from toothpaste is linked to the formulation itself. Many commercial toothpaste brands contain synthetic polymers such as PE, ethylene–vinyl acetate (EVA), PET, PP, polytetrafluoroethylene (PTFE), and polymethyl methacrylate (PMMA), as verified by FTIR and Raman spectroscopy analyses. (Muthu 2021; McConnell and Varsha 2025) Across studies, results vary widely. Early analyses found on the order of 0.4–1% PE by weight in a minority of products and as much as ~ 100 mg of PE per 100 mL in one high-use brand. Texture, abrasive type, and binder composition differ widely between markets. For example, whitening pastes often contain harder synthetic abrasives, whereas “herbal” and gel formulations may rely on alternatives like hydrated silica, complicating detection and quantification. (Muthu 2021; McConnell and Varsha 2025).

Modern analytical workflows combine Nile Red fluorescent dye screening with micro-Raman or micro-FTIR confirmation, which has clarified that many supposedly “plastic-free” toothpastes still contain trace polymer fragments. In an analysis, toothpaste associated releases were reported as high as 11.83 × 105 particles/year/person (method-dependent). The dominant identified toothpaste polymers were PE (~ 22%) and PEVA (~ 78%). Recent market surveys in India and Europe illustrate a mosaic: PE remains the dominant microplastic found, but EVA, PTFE, and PMMA also appear in niche or specialty formulations. Particle sizes in toothpastes typically range ~ 10–200 μm, with irregular fragments far outnumbering the once-common perfectly spherical “microbeads”. (Wang et al. 2025; Muthu 2021; McConnell and Varsha 2025).

Regulatory attention on toothpaste microplastics is gradually expanding. Earlier microbead bans applied mainly to spherical, rinse-off cosmetics, leaving irregular fragments in some oral-care pastes outside their scope. The EU’s new REACH Regulation 2023/2055 now defines synthetic polymer microparticles as any insoluble, non-degradable plastic under 5 mm, effectively bringing many toothpaste polymers into scope. This regulation mandates a stepwise phase-out with category-specific transition periods. Lastly, it is worth noting that toothpaste composition can influence toothbrush bristle wear: depending on abrasive hardness and binder chemistry, certain formulations may reduce filament damage slightly. (Wang et al. 2025; Commission 2023).

Dental floss filaments and coatings

Dental floss materials are primarily PTFE (Teflon), ultra-high-molecular-weight polyethylene (UHMW-PE), or waxed nylon, chosen for their tensile strength and low friction. (Tanna and Bhandary 2025) With repeated sliding across rough interproximal tooth contacts or over defective restorations, these polymers can fibrillate and shed slender fragments. Direct particle-count data are scarce, but microscopy of used floss confirms that micro-fibrils and debris abrade off, particularly from PTFE and PE-based flosses. (Stavrakis et al. 2022) These filaments are chemically inert and persist in oral rinse water and sink effluent; their smooth fluoropolymer surfaces make them highly resistant to biodegradation. A recent evaluation notes that UHMW-PE and PTFE flosses, though marketed as “gentle,” can release nanoscale fibrils when stressed or nicked. (Shahnawaz et al. 2024).

Mouthrinses and microcapsules

Modern mouthrinses are generally microbead-free, but earlier or specialty rinse products sometimes employed encapsulated flavor beads or active-agent microspheres. These polymeric microcapsules, typically made of gelatin, cellulose acetate, or occasionally polyethylene, serve as controlled-release carriers. (Šimunović et al. 2025) Recent reviews on microplastic contamination reiterate that while most mainstream mouthrinses have been reformulated, some whitening or “burst-bead” formulas still contain encapsulated additives. (Shahnawaz et al. 2024) Recent analyses of over 90 oral-care products estimated the highest microplastic release in mouthwash (74 billion particles/day), followed by toothpaste (~ 33.4 billion particles/day), toothpowder (~ 22 billion particles/day), and oral fresheners (~ 360 million particles/day). (Wang et al. 2025).

Clinical and laboratory sources

Restorative and polishing procedures

Finishing or polishing resin-based composites is a routine part of placing restorations, but it can generate MNPs debris. Studies using particle counters show that high-speed finishing produces an ultrafine aerosol with peak diameters around 40–70 nm, and during composite polishing, breathing-zone particle number concentrations can exceed 10⁶ particles/cm3, indicating a dense short-lived exposure burst. This aerosol may include both resin-derived fragments and inorganic filler dust, with the relative contribution depending on the procedure and analytical confirmation methods. One contributing factor is incomplete monomer-to-polymer conversion in composite resins (typically ~ 70–75%), leaving residual monomers that can undergo hydrolytic and enzymatic degradation over time. This may potentially facilitate fragmentation during later grinding or wear. Occupational exposure is therefore a consideration. While high-volume evacuation (HVE) can capture a substantial fraction of the generated dust, it does not eliminate exposure entirely. (Di Spirito et al. 2025; Shahnawaz et al. 2024; Landuyt et al. 2014).

Prosthodontic and denture work

Trimming and polishing of acrylic appliances such as PMMA (polymethyl methacrylate) denture bases, orthodontic retainers, or provisional restorations generates visible acrylic “dust” and fine particulate debris, including microplastic-sized particles that are often < 50 µm and can settle on clinic surfaces or be inhaled during grinding. Experimental studies have reported oxidative stress, inflammation, and cytotoxic responses in human oral keratinocytes and macrophages, supporting biological plausibility for local tissue irritation from repeated contact with resin-derived debris. While the clinical significance for patients is not yet clear, these findings support a mechanistic rationale that chronic exposure to PMMA-related debris could contribute to localized inflammatory responses in susceptible denture wearers. Proper suction and protective equipment during grinding can reduce immediate exposure, but fine particles may persist on surfaces and in the operatory air if environmental cleaning and dust control are inadequate. (Saha et al. 2025; Saiyed et al. 2025).

Orthodontic and aligner systems

The rise of clear aligner therapy and routine orthodontic adjustments has introduced additional potential sources of MNPs. Thermoplastic aligners commonly manufactured from PETG (glycol-modified PET) or polyurethane-based blends, may generate particulate during fabrication steps such as trimming and polishing, producing fine shavings. During intraoral wear, aligners are also subjected to repeated mechanical stress and chemical exposure. Certain cleaning or disinfection practices and elevated temperatures may accelerate surface degradation and micro-cracking. Over weeks of use, aged aligners can shed microdebris that may be detectable in saliva and/or in cleaning solutions. (Di Spirito et al. 2025; Šimunović et al. 2025) In fixed orthodontics, debonding brackets and removing residual resin adhesive involves fracturing and grinding polymeric materials, which can also generate particulate. Analytical studies of used aligners and associated rinse/soak solutions have reported trace polymer-related material (e.g., PETG- or polyurethane-associated signals) and microscopic debris, with SEM-based observations of aligner-derived particles on the order of ~ 5 µm in some reports, supporting plausible chronic, low-level ingestion exposure during therapy. (Di Spirito et al. 2025; Šimunović et al. 2025; Chojnacka and Mikulewicz 2025; Quinzi et al. 2023).

Preventive and prophylactic materials

Many routine dental prophylaxis materials contain polymer components that may contribute to microplastic release during use. For example, pit and fissure sealants are resin-based materials, and curing and subsequent finishing/polishing can generate fine resin debris or microdroplets. (Saha et al. 2025) Polishing pastes used in professional cleanings may contain polymeric beads/capsules or polymer-based carriers, and vigorous application followed by rinsing can plausibly leave trace particulate residues that enter saliva and wastewater streams. (Šimunović et al. 2025) Fluoride gels and foams may also contain polymer thickeners that can contribute to polymer-containing residues in clinical effluent. Evidence from clinic waste capture systems, including suction filters/traps, suggests that prophylaxis procedures can generate recoverable particulate, supporting the concept that some fraction is either captured by evacuation or dispersed into the operatory environment and drainage system. High-volume evacuation helps reduce immediate splatter and aerosol, but very fine particles may still become transiently airborne during polishing. (Šimunović et al. 2025; Saiyed et al. 2025) Consistent with this, wet polishing with adequate water irrigation has been recommended as a practical mitigation approach to reduce dust generation. (Akhtar et al. 2024).

Laboratory and CAD/CAM waste

Dental laboratory procedures may represent an additional and sometimes less regulated source of microplastic-containing particulate. Milling or grinding of CAD/CAM resin blocks (used for inlays, crowns, guides) produces a fine powder comprising polymer matrix and filler particles. Without proper ventilation or vacuum, these powders can settle on surfaces or be washed down sinks. Trimming of 3D-printed dental models or removal of resin supports also generates shards and dust. Many dental models are now printed in acrylic resins that, when scraped or ground, yield microplastics. If technicians pour the waste slurry from model trimming down the drain, those particles enter wastewater directly. (Saiyed et al. 2025) Studies have identified particles < 50 µm with resin signatures in dental wastewater and sink traps, supporting the view that material fabrication steps in dentistry are an unrecognized source of MNPs pollution. (Saha et al. 2025; Saiyed et al. 2025).

Operatory airborne spread (Dental Aerosols)

High-speed instruments (handpieces, ultrasonic scalers, air polishers) create a mixture of aerosol and splatter that contains water and biological material and can also include polymer-containing particulate when restorative or appliance materials are cut, finished, or polished. These airborne particles may remain suspended for minutes before settling on operatory surfaces and instruments or being inhaled by occupants. Even with high-volume evacuation (HVE), some fraction of fine particles (including respirable fractions < 10 µm) may escape capture. Investigators have applied microscopy and FTIR spectroscopy to filter samples placed around the operatory and within suction systems, reporting resin-associated fragments and polymer dust distinguishable from other debris. (Di Spirito et al. 2025; Saiyed et al. 2025) One study described these episodic spikes as “transient high concentrations” superimposed on the chronic background from daily life. An exposure study in a busy dental operatory estimated an average inhalation intake of approximately 20–30 microplastic particles/day per person, with many identified as PET and other common polymers. Good HVE technique and immediate post-procedure decontamination (surface cleaning, and where available, air filtration) can reduce persistence of particulate in the clinic environment. (Saha et al. 2025; Wang et al. 2025).

Combining home and clinic exposures

It is useful to put the home-derived and clinic-derived microplastic exposures into perspective. Daily home care provides a steady, low-level input of particles (toothbrushing, etc.), whereas dental procedures produce short-lived but intense bursts of exposure. For context, background human exposure estimates report a median overall intake of ~ 833 MPs/day in adults and ~ 553 MPs/day in children, while atmospheric inhalation alone has been estimated at ~ 6–272 MPs/day (equivalently ~ 104–105 particles/year in some regions), suggesting that both home- and clinic-related contributions add onto a substantial pre-existing environmental baseline. Although study metrics are not directly comparable (counts vs mass, different size cutoffs, and variable confirmation methods), available values suggest that dental clinic inhalation in a busy operatory (~ 20–30 MPs/day/person) is of the same order of magnitude as reported background inhalation estimates (~ 6–272 MPs/day), while home oral-care products may contribute large release estimates (~ 105–10⁶ particles/year/person) whose absorbed fraction remains uncertain. (Šimunović et al. 2025; Dąbrowska et al. 2025; Parobková et al. 2024).

Cumulatively, a person’s true exposure over months or years will be the sum of these contributions. From a health standpoint, cumulative dose is likely more relevant than any single exposure episode. Reviews emphasize this cumulative view: rather than focusing only on one procedure or product, researchers consider the aggregate burden of microplastics from daily life plus dentistry. (Saha et al. 2025; Wang et al. 2025) Importantly, even though the spikes from dentistry are acute, the baseline exposure from home is constant, so reducing either one could help lower overall load. In practice, clinicians can minimize what they add using mitigation strategies discussed later, and patients can make informed choices in their oral care to slightly reduce daily inputs.

Detection, characterization, and quantification of MNPs in dental contexts

Detecting MNPs in dental settings is challenging by nature. Unlike environmental or industrial samples, dental matrix such as saliva, composite dust, toothpaste, and chairside wastewater contains a complex mix of organic and inorganic components that can mask or interfere with polymer detection. Across the reviewed studies, researchers note that the main challenge is not simply confirming the presence of MNPs but accurately identifying, separating, and measuring them within these complex mixtures. (Shahnawaz et al. 2024; Dąbrowska et al. 2025; Parobková et al. 2024; Barceló et al. 2023).

Spectroscopic and imaging techniques

FTIR and Raman spectroscopy remain key tools for identifying plastics by their chemical bonds. For example, Fourier-transform infrared (FTIR) spectroscopy can detect characteristic bonds in dental plastics (such as the carbon–hydrogen and carbonyl groups in PMMA or PET). (Barceló et al. 2023) Raman microscopy has higher resolution (down to about 1 µm) and can tell apart similar plastics (like PET, PMMA, and PTFE) based on their unique vibration patterns. (Parobková et al. 2024).

Electron and scanning-probe microscopies add morphological and elemental depth. Scanning electron microscopy (SEM) with energy-dispersive X-ray spectroscopy (EDS) shows the shape and elemental makeup of tiny resin debris or filler particles. Transmission electron microscopy (TEM) and atomic force microscopy (AFM) can visualize even smaller fragments (below 100 nm), though they are costly and slow. Nile Red staining is used as a quick check to highlight hydrophobic (water-repelling) particles. It makes potential plastic pieces glow, so they can be isolated and later confirmed with FTIR or Raman. (Saha et al. 2025).

Recent advances scan a surface or sample area to get spatial and chemical information at once. For example, hyperspectral imaging and confocal Raman mapping can create “chemical maps” showing where different plastics are located in a dental composite or tissue sample. Combining these maps with machine-learning spectral libraries (trained on known polymers) improves accuracy. One recent study showed that a confocal Raman + machine-learning approach could distinguish blended dental resin components (like Bis-GMA mixed with TEGDMA) that are hard to separate otherwise. (Hogan et al. 2025).

Sample preparation and digestion

Proper pre-treatment is needed to remove organic materials. Before analysis, samples often need digestion to break down biological material (saliva, cells, etc.) without destroying plastics. Common methods include oxidative chemicals (hydrogen peroxide or Fenton’s reagent) and enzymes (proteinase K, lipase, etc.). These break down proteins, lipids, and other organics while leaving most plastics intact. (Dąbrowska et al. 2025).

Dental materials introduce unique complications: silica abrasives in toothpaste and calcium-phosphate fillers in composites interfere with IR spectra, requiring selective dissolution or ultrafiltration through 0.2–10 µm membranes. (McConnell and Varsha 2025) Aerosols and chairside dust are usually captured directly on polycarbonate filters for microscopy. (Di Spirito et al. 2025) To minimize cross-contamination, researchers emphasize clean-bench protocols and the use of glass or metal rather than plastic labware. (Shao et al. 2025).

Quantification and nanoscale challenges

Quantification lacks standardization. Toothpaste and rinse products are reported in mg plastic per 100 mL or % w/w, whereas aerosol and wastewater analyses use particle counts per cm3 or m2. Converting between units is unreliable due to density and aggregation variability. (Muthu 2021).

Detecting nanoplastics (< 1 µm) remains the frontier challenge. The optical diffraction limits of FTIR (~ 10 µm) and Raman (~ 1 µm) exclude this fraction. Pyrolysis–GC/MS identifies polymers chemically but sacrifices particle sizing. (Dąbrowska et al. 2025) Innovative hybrid approaches, such as thermal desorption-mass spectrometry (TD-MS) and AF4-MALS (asymmetric-flow field-flow fractionation with multi-angle light scattering) are emerging to close this gap. A 2025 study applied an offline AF4-MALS + Py-GC/MS workflow to environmental wastewater and successfully identified and quantified polystyrene nanoplastics down to ~ 50 nm; polymers such as PET were below detection limits in that analysis. (Hayder et al. 2025).

Relevance to dental research

Used toothbrush bristles analyzed via micro-FTIR and Raman reveal PET, PA, and PP fragments < 100 µm. Toothpaste residues have been found to contain microbeads or fragments of PE, EVA, and PMMA (especially in older formulations). Polishing and drilling aerosols show fractured composite resin particles enriched with silica and barium–aluminum silicate filler dust. In clinical wastewater, particles of PE, PMMA, and PTFE have been identified alongside calcium phosphate debris, confirming these plastics originate from dental procedures. (Wang et al. 2025; Saiyed et al. 2025).

Despite this progress, standardization of detection methods in dentistry remains limited. There is currently no ISO or ADA standardized workflow defining acceptable detection limits, digestion reagents, or contamination controls specifically for oral/dental matrices. Many studies still rely on manual particle isolation and small sample volumes, and they risk contamination from ambient microplastics (airborne dust, lab consumables) that can inflate particle counts. These factors make it difficult to compare results between studies. (Shao et al. 2025).

Overall, while the tools for microplastic analysis have matured substantially, their adaptation to dental research is still partial. Reliable quantification of MNPs from dental sources demands harmonized protocols: standardized sample digestion, calibrated particle sizing, rigorous contamination controls, and the use of complementary analytical techniques. The most forward-looking recommendations call for multimodal analysis (combining imaging, spectroscopy, and chemical profiling) to accurately characterize plastic emissions across the continuum from home-care products to clinical environments. (Muthu 2021; Shahnawaz et al. 2024).

Discussion

Biological interactions and health implications

Crucially, MNPs from dental sources are not necessarily the same as “background” environmental microplastics. Dental sources are often derived from methacrylate composite matrices and PMMA acrylics, which are produced by fresh mechanical abrasion during finishing/polishing rather than weathering. During composite finishing, particle release can include a large ultrafine/nanoscale component (reported peaks around 40–70 nm) and a mixed aerosol that can include both polymer debris and inorganic filler dust, which may be facilitated by incomplete monomer-to-polymer conversion and subsequent hydrolytic/enzymatic degradation of the resin matrix. In contrast, many environmental MPs are aged, oxidized, and biofilm-covered, while dental debris may have “clean” reactive surfaces and be produced in tandem with residual monomers/additives. Orthodontic materials (such as PETG/polyurethane) may break down by micro-cracking and mechanical forces during wear and trimming, producing microdebris that is more reflective of high-friction intraoral aging conditions than environmental weathering. (Di Spirito et al. 2025; Saha et al. 2025; Šimunović et al. 2025).

Direct dental and oral evidence

MNPs released during oral care may interact with oral tissues, but the strength and type of evidence vary widely across the literature. In vitro studies report that MNPs can be internalized by oral epithelial cells and may induce oxidative stress, inflammatory responses, and genotoxic signaling, including pathways such as NF κB, MAPK, and Nrf2. At the same time, leachable additives associated with plastics (for example, bisphenol A, phthalates, and brominated flame retardants) may contribute to these responses, which makes it difficult in many experiments to separate particle driven effects from chemical effects. Particulates from resin based dental materials, including PMMA, may also release residual monomers that irritate mucosa and support a combined particle plus chemical mechanism of local irritation. (Muthu 2021) Although laboratory models and some animal evidence report cellular uptake and mild cytotoxic or oxidative effects from composite and acrylic derived fragments, direct evidence of oral pathology in humans attributable to MNP exposure remains limited. (Saha et al. 2025; Saiyed et al. 2025) For this reason, suggested links with longer term outcomes such as periodontal inflammation or oral carcinogenesis should be interpreted as hypotheses rather than established clinical consequences. (Shao et al. 2025).

Microplastic exposure may disturb the oral microbiome and immune balance. Particles can provide surfaces for bacterial colonization and may cause micro-abrasion of mucosa, potentially shifting the oral biofilm toward dysbiosis. At the same time, plastic additives and particle-induced stress may contribute to a more sustained inflammatory milieu in gingival tissues and saliva, and this has been hypothesized to interact with broader host inflammatory pathways, including the oral–gut axis. Oral microbiome studies link dysbiosis with heightened local inflammation and, in susceptible hosts, an increased systemic inflammatory burden. (Francis and Reddy n.d.; Rajasekaran et al. 2024) In periodontal models, researchers have reported similarities between microplastic-associated effects and those induced by harmful oral bacteria; both can trigger DNA damage and disturb immune function in gingival tissues, and microplastics have been suggested to potentially worsen bacterial pathogenicity in experimental settings. (Francis and Reddy n.d.) Moreover, MNPs can adsorb and transport co-contaminants (such as lipophilic pollutants or microbial toxins) on their surfaces. This proposed vector effect could modulate host responses or deliver harmful substances into the oral mucosa; however, the magnitude of such effects in humans remains debated and likely context-dependent. (Saha et al. 2025; Lu et al. 2019) Overall, available biological evidence suggests that MNPs are not inert in the oral environment and can provoke cellular stress and inflammatory responses, but translating these findings into real-world health risk requires careful consideration of exposure levels and clinical context. (Di Spirito et al. 2025; Saha et al. 2025).

Dose relevance remains a central uncertainty when interpreting these biological effects. Available exposure estimates are derived mainly from procedure simulations and clinic environmental sampling, and they vary strongly with procedure type, distance from the working site, ventilation, and particle-capture methods; therefore, these figures should be interpreted as scenario-based estimates rather than definitive patient dose. (Chen et al. 2025) In a dental healthcare unit study, settled microplastic load was reported at 587 ± 184.9 MPs/g/day in clinical dental units and 1083.8 ± 133.7 MPs/g/day in teaching-hospital dental units, and the same study estimated an average inhalation intake risk of ~ 20.23 MPs/day (clinical units) and ~ 29.45 MPs/day (teaching-hospital units). (Akhtar et al. 2024) Separately, particle-count monitoring in a dental clinic has reported airborne particles in the 14–700 nm size range reaching ~ 3 × 10⁶ particles/cm3 during the daily working period, underscoring that high number concentrations of fine particles can occur during routine clinic activity (particle counts do not directly translate to microplastic mass or polymer identity). (Shin et al. 2020) In simulated clinical grinding of resin-based materials, microplastics were detected in settled deposits with concentrations decreasing as distance increased from 25 to 100 cm, and substantial within-day particle accumulation was reported in the clinic environment. (Chen et al. 2025).

Many in vitro studies demonstrating MNP toxicity have used high particle concentrations or ultrafine sizes that far exceed the levels currently quantified during typical dental product use or procedures. (Šimunović et al. 2025; Shao et al. 2025) Such disparities complicate risk extrapolation to patients, highlighting the need for dose‐matched and clinically realistic research models. Technical limitations also cloud the exposure picture: standard analytical methods struggle to detect particles in the low-nanometer range amidst complex oral matrices (toothpaste silicas, calcium phosphates from saliva, etc.), meaning actual patient exposure may be under- or mis-estimated. Harmonized reporting of microplastic exposure in terms of particle counts, size distribution, and mass is recommended by recent methods papers to improve comparability and hazard assessment. (Dąbrowska et al. 2025; Parobková et al. 2024; Barceló et al. 2023; Shao et al. 2025) The precise threshold at which such exposure becomes clinically deleterious remains undefined, underscoring the need for more data.

Overall, the most direct dentistry-relevant evidence currently concerns particle release from dental materials and oral-care products and experimental findings in oral models, whereas human evidence for systemic outcomes attributable to dental-origin exposure remains limited.

Systemic evidence (non-dental exposure contexts)

This subsection summarizes systemic findings from the broader MNP literature, which largely reflects non-dental exposure sources (dietary, airborne, or general occupational). A small number of human observational studies have reported MNPs in diseased tissues and associated clinical outcomes. For example, microplastics have been detected in atherosclerotic plaques and were associated with higher 3-year cardiovascular event rates in one cohort. However, these findings are not specific to dental-origin exposure and do not establish causality. (Marfella et al. 2024) Systemic translocation of MNPs is biologically plausible based primarily on experimental models and human biomonitoring, rather than dental-specific clinical studies. In dentistry-relevant pathways, particles may be swallowed with saliva or inhaled as fine aerosols during procedures; once ingested or inhaled, a fraction of smaller particles may cross gastrointestinal or pulmonary barriers and enter the circulation. (Saha et al. 2025; Francis and Reddy n.d.) Animal studies using oral exposure models report multi-organ distribution of microplastics. In oral contexts, impaired mucosal integrity (e.g., periodontal inflammation) may further increase susceptibility to particle uptake, although evidence in humans remains limited. (Saha et al. 2025; Rajasekaran et al. 2024).

Occupational exposure in dental settings

Dental professionals may experience recurrent occupational exposure during routine abrasion of polymer-based materials (e.g., resin composites, PMMA acrylics, aligners, and resin appliances). Simulation studies of clinical steps such as resin grinding and denture handling/cleaning report measurable microplastic release and rapid within-day accumulation of settled particles in clinic environments, supporting an occupational exposure scenario. (Chen et al. 2025) Real-world sampling further indicates higher microplastic loads in high-throughput teaching settings compared with routine clinical units, with polymer identification frequently including PET and estimated inhalation intake values in the tens of particles per day range. (Akhtar et al. 2024) In addition, particle monitoring during dental work has documented very high number concentrations in the nanometer size range in operatory air, highlighting that fine-particle exposure can be substantial during routine clinic activity. (Shin et al. 2020).

Environmental dissemination

Beyond direct health implications, dentistry can contribute to environmental microplastic loading through wastewater pathways. Microplastic-containing debris generated during oral hygiene and dental procedures is typically transported into wastewater via saliva expectoration, sink rinsing, and dental suction systems, including material retained in chairside traps and plumbing. Unless captured at the source, these particles enter municipal wastewater infrastructure. (Wang et al. 2025; Šimunović et al. 2025).

Engineering controls can intercept a substantial fraction upstream. Recommended measures include routine maintenance of suction filter traps, installation of finer mesh screens or cartridge filtration in suction lines where feasible, and procedural practices that limit free debris during grinding or adjustment steps, thereby reducing discharge to wastewater. (Šimunović et al. 2025; Saiyed et al. 2025) Once particles enter sewer systems, wastewater treatment removes some fraction into sewage sludge, but smaller particles (including < 100 μm) may pass through and be released with treated effluent; the net outcome is often redistribution rather than complete removal. Environmental aging and interaction with wastewater constituents may further allow particles to associate with co-contaminants or microorganisms, supporting their role as potential transport vectors. (Shahnawaz et al. 2024).

Mitigation strategies and policy responses

Mitigation efforts in dentistry aim to reduce MNPs generation, exposure, and release through a combination of chairside controls, laboratory dust containment, patient guidance, and evolving product regulation. In clinical settings, priority interventions focus on capturing debris at source during aerosol-generating steps. Recommended measures include consistent use of high-volume evacuation (HVE) during finishing/polishing and adhesive removal, keeping suction close to the working area, and preferring wet finishing with copious irrigation over dry grinding. Routine maintenance of chairside suction traps and in-line filters is also important to preserve capture efficiency and reduce discharge to wastewater. (Di Spirito et al. 2025).

For laboratory and bench-top processes (and selected chairside adjustments), controlling dust at source is critical. Trimming and grinding of PMMA appliances, aligner materials (PETG/PU), and CAD/CAM resin blocks can generate fine polymer-containing debris. Whenever feasible, these tasks should be performed under local exhaust ventilation or enclosed extraction, and wet methods can further reduce particle dispersion. Fine debris and grinding sludge should be collected using filters/traps and disposed of appropriately rather than rinsed directly into sinks. (Saha et al. 2025; Mulligan et al. 2021).

Patient education can additionally reduce avoidable home-derived inputs. Practical steps include replacing worn toothbrushes, using gentle brushing pressure, and selecting formulations marketed as microplastic-free where feasible. For aligner users, advising against harsh solvents and high-heat cleaning may help limit material wear. (Wang et al. 2025; McConnell and Varsha 2025).

Beyond voluntary measures, policy and regulation are increasingly addressing microplastics in consumer products, including those related to oral care. The European Union REACH restriction (Commission Regulation EU 2023/2055) broadly defines and limits the use of “synthetic polymer microparticles” and introduces phased restrictions and labeling requirements. This regulatory trajectory is expected to accelerate reformulation of some oral-care products and may influence procurement and material choices in dentistry. (Commission 2023; Kukkola et al. 2024) Summarized recommendations for clinical practice to reduce MNP exposure in dentistry are presented in Fig. 1.

Fig. 1.

Fig. 1

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Recommendations for clinical practice to reduce micro and nanoplastic exposure in dentistry

Evidence gaps and future directions

Most dentistry-specific conclusions currently fall within Grades C–B, reflecting a literature dominated by simulations and in vitro studies with limited direct human outcomes (Table 1). Priority next steps include well-designed longitudinal studies in high-exposure groups (e.g., dental professionals and long-term denture or aligner users) and targeted clinical sampling strategies to link oral exposure markers with relevant health endpoints. (Marfella et al. 2024).

A key research need is dose-realistic exposure assessment. Experimental studies should align particle sizes and concentrations with those measured in dental settings and consumer oral-care use, and methods papers emphasize harmonized workflows that minimize contamination and combine screening with confirmatory techniques (e.g., fluorescent screening followed by μFTIR/μRaman and microscopy) to generate comparable datasets. (Di Spirito et al. 2025; Barceló et al. 2023; Shao et al. 2025) Researchers should also report detection limits and uncertainty transparently, particularly for sub-micron particles where analytical constraints remain significant. (Commission 2023).

Intervention studies in real-world settings are also needed to quantify the effectiveness of mitigation controls. Pilot trials could compare airborne and wastewater-associated particle loads before and after implementing specific measures (e.g., standard suction versus HVE; dry versus wet finishing), helping translate best-practice recommendations into evidence-based guidelines. (Saiyed et al. 2025) In parallel, standardized biomonitoring approaches for dentistry-relevant matrices (saliva, oral swabs, dental plaque, or rinse samples) could enable exposure tracking over time, building on the demonstrated feasibility of detecting microplastics in human specimens such as blood, placenta, and exhaled air. (Shao et al. 2025).

Continued surveillance of products and materials remains important as formulations evolve. Periodic market screening can verify that oral-care products remain compliant with restrictions and do not introduce problematic substitutes, noting variability across brands and regions. (Wang et al. 2025; McConnell and Varsha 2025) Finally, dental-material innovation should prioritize “safer-by-design” approaches, including formulations more resistant to fragmentation and exploration of biobased or degradable alternatives and non-plastic abrasives, supported by interdisciplinary validation of safety and performance. (Muthu 2021; Shahnawaz et al. 2024).

Limitations

As a narrative review, study selection and synthesis were not performed under a registered protocol, and we did not apply formal risk-of-bias scoring for individual studies. The evidence base is methodologically diverse, with variable lower size cutoffs and inconsistent reporting units (mass versus particle counts), limiting direct comparability across studies. Publication bias is possible because studies reporting positive detection or higher particle counts may be more likely to be published, and grey literature was not systematically searched. Finally, MNP analysis is particularly susceptible to contamination during sampling and processing; where primary studies lacked procedural blanks and contamination controls, reported counts may be inflated.

Important gaps remain in the current evidence base on dental MNPs. Human epidemiological data directly linking oral microplastic exposure to clinical health outcomes are scarce, making causal associations difficult to establish. Much of the available evidence also comes from laboratory studies using high doses or idealized conditions that may not mirror real-world exposures, complicating extrapolation to clinical scenarios. Detecting and quantifying ultrafine particles in complex dental matrices remains challenging with current methods, and the regulatory and product landscape is evolving such that new materials or policies may alter exposure risks over time. These factors warrant cautious interpretation and underscore the need for ongoing research.

Conclusion

Routine dental materials and oral-care products can release MNPs through wear, finishing, and everyday use, contributing to patient exposure and to wastewater-associated environmental loading. The magnitude and clinical relevance of these exposures under real-world conditions remain uncertain, and current evidence should be interpreted as biologically plausible rather than definitive. A precautionary approach is therefore justified: where feasible, dentistry should reduce avoidable emissions through effective chairside particle capture, appropriate waste and wastewater handling, and selection of lower-shedding or microplastic-free alternatives when performance and safety are comparable. Continued interdisciplinary research particularly dose-realistic studies and harmonized analytical workflows will be essential to define exposure thresholds, refine risk profiles, and support evidence-based clinical guidance and policy.

Author contributions

MC contributed to conception, design, data acquisition and interpretation, drafted and critically revised the manuscript. AKG equally contributed to conception, design, data acquisition and interpretation, drafted and critically revised the manuscript. AG contributed to literature review, reference verification, and assisted in manuscript editing and formatting.

Funding

There is no funding support received for this case report.

Data availability

The data is available on request to corresponding author.

Declarations

Ethical approval

Not applicable.

Patient consent

Not applicable being a narrative review.

Permission to reproduce material from other sources

Not applicable.

Clinical trial registration

Not applicable.

Competing interests

The authors declare no competing interests.

Footnotes

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Associated Data

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Data Availability Statement

The data is available on request to corresponding author.

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