MASKS AND RESPIRATORY VIRUS PROTECTION
The importance of proper infection prevention and control is at the forefront for healthcare providers. This document is meant to be a guide for dental practices to consider the elements of a practice respiratory protection program to help prevent transmission in the dental practice environment, with a focus on masks as an element of respiratory virus protection for both Dental Health Care Personnel (DHCP) and patients.
COMPLIANCE: IS YOUR TIME UP?
Face masks have a use-life; best practice dictates changing a mask if the fluid-resistant outer layer becomes wet or soiled with exposure to spatter and bioaerosols and/or the internal lining layer becomes moist from the DHCP’s breath condensation
In an aerosol environment, masks should be changed every 20 minutes and in a non-aerosol environment every 60 minutes during lengthy procedures(6)
COMPLIANCE: CHECK YOURSELF OUT!
COMPLIANCE: ARE YOU FIT FOR SAFETY?
Perform hand hygiene
Inspect PPE prior to donning (e.g., not torn, punctured, ripped)
Confirm the exterior side of the face mask (only side that is fluid resistant)
Prior to placing the mask to the face, create a concave ‘divot’ with your thumb in the aluminium noseband to guide proper placement high on the bridge of the nose
Slightly extend the face mask by pulling the chin-side edge down
Pleat configuration should be open in a downward “waterfall” effect to prevent pooling of condensate or aerosols
Holding mask by the ear loops, orient the noseband divot placement on the face and secure a loop around each ear
Never ‘twist’ the earloop into a figure 8 to gain a closer fit as this will cause the inner lining of the mask material to be in close contact with the DHCP’s mucous membranes (lips/nose)
Never ‘pinch’ the noseband with thumb and index finger as V-notch exposure will remain
Mold the nosepiece with index and middle finger to secure fit across the bridge of the nose and along orbits of the eyes
Fully extend the chin-edge of the mask to cover the mouth and chin
If an additional malleable chin-strip is available, pinch snugly directly under the chin to create a 360° peripheral seal
If using a face shield, put on over the face mask and eyewear
Doffing (removing): With clean hands, on each side of the head grasp the ear-loops of the mask, pull down lifting back and away to remove the mask from the face. Dispose of properly and immediately perform hand hygiene.
REFERENCES
1. Veena, e al. “Dissemination of Aerosol and Splatter during Ultrasonic Scaling: A Pilot Study.” Journal of Infection and Public Health 8, no. 3 (2015): 260-65
2. Harrel, S. “Contaminated Dental Aerosols: Risks and Implications for Dental Hygienists”. Dimensions of Dental Hygiene. October 2003;1(6):16, 18, 20
3. Molinari J, Nelson P, Face Mask Performance: Are You Protected?; Oral Health, March 16, 2016; https://www.oralhealthgroup.com/features/face-mask-performance-protected/
4. Rosen S, Schmakel D, Schoener M. Incidence of respiratory disease in dental hygienists and dietitians. Clin Prevent Dent. 1985; 7:24 -25
5. Grinshpun, S. A., Haruta, H., Eninger, R. M., Reponen, T., McKay, R. T., and Lee, S.-A. (2009). Performance of an N95 Filtering Facepiece Particulate Respirator and a Surgical Mask During Human Breathing: Two Pathways for Particle Penetration. J. Occup. Environ. Hyg., 6:593–603
6. CDC Summary of Infection Prevention Practices in Dental Settings https://www.cdc.gov/oralhealth/infectioncontrol/pdf/safe-care2.pdf
7. Jorgenson G, Palenik C. Selection and use of personal protective equipment. The Dental Assistant 2004; 73;16-19
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Teacher for over 25 years, she is an expert clinician and practices the profession as dental hygienist in different private practices in Northern Italy.
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