Since the beginning of the COVID-19 pandemic, the US had reported49.4 million confirmed cases and 790,000 deaths(1). Due to the close contact with the patient's mouth and the use of aerosol-generating procedures, dental health providers are constantly exposed to potential infection. The SARS-CoV-2 outbreak has raised the danger of infection much further. Dental health practitioners were placed in the "extremely high exposure risk" category for SARS-CoV-2 by the Occupational Safety and Health Administration (OSHA) in 2020. (2)
To ensure appropriate clinical practice, dentists must follow biosafety guidelines to protect themselves and their patients by wearing protective barriers during each procedure, such as gowns, gloves, protective eyewear, and more important than ever, masks.
As the more contagious Omicron variant starts to spread in the U.S., dental health providers need to mask up, with the right type of masks —even if fully vaccinated. While large healthcare systems and hospitals have dedicated infection control experts to select the most suitable PPEs to protect their employees, most dental offices are not well equipped to select the best products for their practices. Here we will discuss the types of masks and why some are significantly better than others.
Surgical/procedural Masks, Industrial N95 and Surgical N95
Level II or level III surgical/procedural masks were already commonly used in dental offices even before the pandemic. These masks need to pass ASTM F1862 liquid resistance tests where they are tested against high pressure synthetic blood penetration. These masks are designed to protect the clinician from direct infection from contaminated fluid or debris generated during procedures.
Surgical masks are not meant to provide respiratory protection to the wearer since they are not tightly fitted around the face. According to a study published in 2006, surgical masks are primarily designed to protect the environment from the wearer, whereas respirators are designed to protect the wearer from the environment.
An N95 mask is "a negative pressure particulate respirator with a filter as an integral part of the facepiece or the entire facepiece composed of filtering medium." According to OSHA. N95 masks offer a significantly higher level of respiratory protection against airborne particles than surgical masks because these are designed to be tight-fitting and can filter both large and small particles, including aerosols.
However, most N95 respirators are manufactured for use in construction, metalwork and other industrial-type jobs that expose workers to dust and small particles. Surgical N95 respirator is a subset of N95 intended for use in a healthcare setting. They are class II medical devices regulated by the FDA, under 21 CFR 878.4040, and CDC NIOSH under 42 CFR Part 84. Compared to the standard N95 masks, the surgical N95 masks are fluid-resistant and meet ASTM F1862, the same test pressurized synthetic blood test also applies to surgical masks (3).
Which masks are the best choice for dentists?
The CDC has regularly updated “Infection Prevention & Control in Dental Settings” since the start of the pandemic. The latest guidance recommends that all oral healthcare providers to wear Surgical N95 or higher level filtering facepiece respirators, as well as a face shield or goggles. The FDA temporarily authorized the use of non-surgical N95 in healthcare settings in 2020 due to the extreme N95 shortage. With the increased availability of surgical N95 respirators, the use of non-surgical N95 is no longer recommended.
With many dental practices started to use N95 during the past year, many may not have realized that they are using the industrial version, thus missing out on the benefit of liquid protection provided by their traditional surgical masks. Surgical N95 is the only commonly available PPE that provides the combined benefits of surgical masks and N95 respirators.
In a dental practice, the health of the dentists, associates and patients are all extremely important. Covid-19 infection of the dentist, even in a mild flu-like form as many vaccine breakthrough cases would be, would prevent the dentist from practicing for two weeks or longer, would likely result in a financial cost to the practice in the range of $20,000 to $40,000. Infection of associates may result in the loss of productivity, workers’ comp claim and raise the practice’s long-term workers’ comp premium. and the infection of patients would likely not only result in the loss of patients but expose the practice to additional potential liabilities.
Since the early days of the pandemic, many patients are scared to make dental visits. The use of best available PPE would give patients more confidence in returning to regular dental care.
SEATTLEPPE provides the highest quality personal protective gear to hospitals, nursing homes, governments, businesses, and the general public.
During this time, SeattlePPE has worked together with our manufacturing partners to supply millions of N95, KN95, and 3-ply masks to healthcare workers. Masks have provided an invaluable line of defense against Covid for our frontline doctors and nurses, long before the first vaccinations were available and continuing up to today. We offer 4 different made in the USA NIOSH/FDA approved surgical N95 respirators that will meet the need of any dental practice and for as low as $0.79/each (after 20% off first time customer discount code DENTAL20)
While the effectiveness of the vaccines varies significantly—depending on the make of the vaccine, the Covid variant, time lapsed since vaccination, and the health condition of the recipient—the Covid prevention performance of good masks does not change. We don’t need to invent, reinvent, manufacture or buy a new kind of mask for each new variant. Good masks provide the most consistent protection for everyone, including people with underlying or chronic conditions or even those who are immunocompromised. Get a high-performance respirator mask that fits you well, wear it consistently and it will help protect you and the people around you. While it seems that the Delta variant has passed its peak, we now have the potentially as dangerous Omicron variant. The mask you purchase today is effective against the Delta and Omicron variants—and it will be effective against Sigma, Upsilon, Omega, and any other variants that may come.