“You Down with PPE, Yeah, You Know Me”
It may not have the same swagger rolling off the tongue as the 2007 hit song, “OPP” from the Grammy Award-winning American hip hop trio Naughty By Nature, but “PPE” is all the talk these days, for great reason, and the dental industry is no different. In fact, as most dental practices deliberate when and how they will reopen their doors in a COVID-19 recovery, dental professionals everywhere are scrambling to make sure they have adequate and appropriate personal protective equipment (PPE). One risk poignant to dentistry is the spread of infection through aerosols.
Real concerns arise from what dental professionals’ face as they return to reopen their offices following the COVID-19 worldwide event.
Dental practices have known for decades the effects of dental aerosols and have operated day-to-day somewhere between casually aware to acutely concerned, but the alarm, though louder now, has been sounding for years. In a 2006 article for Dentistry IQ, Rella Christensen, PhD wrote,
“Yes, dental aerosols are a concern. These airborne particles are composed of debris and microorganisms propelled into the air from the oral cavities of the many people treated throughout the day within the office. These particles range from relatively harmless to highly infectious. When inhaled, their small size allows penetration to the alveoli of the lower respiratory tract, where infectivity is greatly increased. Dentistry’s invisible aerosols are inhaled inadvertently by all who enter the office - clinicians, staff, patients, people accompanying patients, service people, etc.”
Perhaps dental professionals have grown languid to this fact as they treat patients day-in and day-out. Patients may feel fine and pre-symptomatic or asymptomatic during the incubation phase of illness. And with most of these particles not visible to the naked eye, longer incubation periods make it difficult to pinpoint infection to a specific moment or patient. Dentists and staff are consummate professionals and are accustomed to delivering what is needed or desired for the patient’s well-being while likely inadvertently ignoring the potential risks associated with doing so. Some may even believe that being exposed to such conditions year-after-year has helped them develop an immune system able to fight off many illnesses. Unfortunately, it took a global pandemic to get our attention.
What We Know
With a heighted awareness to the importance of personal protection, hygienists remain concerned for their own safety as they are asked to return to work. Below are some metrics worth remembering as we examine what happens at the patient and operatory level, and how we can take added precautions going forward.
· During dental treatment, there is a 5x greater risk of bacterial aerosols (1)
· Ultrasonic instrumentation can transmit 100,000 microbes per cubic foot with aerosolization of up to six feet, and can last anywhere from 35 minutes to 17 hours (2)
· Most risk occurs from splatter and droplet transmission to the midface of the dentist and assistant, as well as the nasal area of the patient (3)
· While surgical masks protect mucous membranes of the mouth and nose from droplet spatter, they do not completely prevent inhalation of airborne infectious agents.
Dental practice owners are looking to invest in new solutions to ensure that both their staff and patients are safe and feel confident to return to the dental chair. One new product that can aid in protection is shieldVAC™, the first line of defense in reducing airborne bacterial contamination. The shieldVAC is designed to add an additional layer of protection for patients and staff in advance of PPE. It is easily retrofitted to every operatory chair and utilizes existing HVE. The adjustable arm perfectly positions a 12" concaved anti-fog, anti-glare shield, which allows high-volume suction from the HVE to capture up to 95% of dental aerosols and splatter generated from dental procedures.
As dentists and staff return to the new normal following COVID19, the ultimate goal is to remain safe and provide the confidence and peace-of-mind that patients and staff expect.
To learn more about shieldVAC, visit www.shieldvac.com.
- Al Maghlouth A, Al Yousef Y, Al Bagieh N. Qualitative and Quantitative Analysis of Bacterial Aerosols. J Contemp Dent Pract 2004 November;(5)4:091-100.
- Nejatidanesh F, Khosravi Z, Goroohi H, Badrian H, Savabi O. Risk of contamination of different areas of dentist’s face during dental practices. Int J Prev Med. 2013;4(5):611-615.
- Harrel SK, Molinari J. Aerosol and splatter in dentistry: a brief review of the literature and infection control implications. J Am Dent Assoc. 2004;135(4):429-437. doi:10.14219/jada.archive.2004.0207