The pandemic led to unprecedented adjustments to dentistry, together with the introduction of elevated ranges of non-public protecting tools (PPE). When most consider PPE, masks are the very first thing that involves thoughts. Whereas it’s true that masks have been important in slowing the unfold of COVID-19, for practising dental professionals, face shields are simply as necessary. On this stage of the pandemic, as some dental workplaces loosen PPE necessities, face shields ought to stay an integral a part of our an infection management protocol.
Assembly an amazing want
In response to the extreme scarcity of PPE on the onset of the COVID-19 pandemic, many producers stepped as much as meet the necessity. These corporations weren’t initially within the PPE enterprise, however modified tools to satisfy the wants of frontline employees. Provide hoarding and panic buying left current producers struggling to extend manufacturing. American customers purchased giant provides of PPE because the sheer scale of the disaster and the severity of the illness prompted a surge in shopping for, hoarding, and reselling masks, gloves, and shields. In March 2020, Amazon cancelled greater than half one million presents to promote masks at inflated costs and closed 4,000 accounts for violating honest pricing insurance policies.1 American dental and medical provides have been shortly fortified by corporations who used current tools to develop PPE and promote at honest costs. From sporting items firms to development corporations, automakers, even distilleries, American ingenuity got here by after we wanted it most. One such firm, Burton Snowboards, retooled its 10,000-square-foot snowboard facility in Burlington, Vermont, the place it usually prototypes new board designs, to make face shields for hospitals.2
On the onset of the pandemic, dental workplaces have been determined for steering from the Facilities for Illness Management and Prevention (CDC) and the American Dental Affiliation (ADA) for protocols for preserving sufferers and staff secure. Whereas dental workplaces have been closed, dental hygienists have been busy researching how they might reenter the workplace safely. Hair coverings turned the norm, as did disposable robes and face shields. Whereas medical settings have utilized these things routinely, many hygienists practiced solely in scrubs, lab coats, security glasses/loupes, and masks. Enter COVID, and together with it got here caps, disposable robes, an N95 masks with a level-3 over it, eyewear, and shields. All of us started to appear like aliens within the eyes of our sufferers.
Face shields are supposed to be worn together with different PPE, similar to surgical or N95 masks, and may make them last more by preserving them dry and free from spatter. The general specs to construct face shields usually are not as stringent as with face masks or respirators. Nonetheless, any dental clinician will inform you that face shields that aren’t crystal clear, scratch-resistant, or dent-proof make our job even tougher. Working within the mouth is tough on hygienists’ our bodies below splendid circumstances, however add all this new PPE and it’s significantly strenuous. Many types of mass-produced, low-cost face shields don’t cowl sufficient of the facet or decrease half of the face, fail to accommodate a lightweight, or depart a gap on the highest for aerosols to enter. This drawback exists within the medical group as effectively, notes the American Medical Affiliation (AMA) e-newsletter Delivering Well being: “Drugs itself may be mentally draining as a result of it’s a whole lot of drawback fixing and figuring issues out, however then once you add on these precise bodily layers that you have to put on, and significantly when these bodily layers don’t match effectively, it takes an additional toll since you’re having to carry out on the identical stage of psychological output whereas additionally coping with that bodily drain in your physique.”3
Face shields stay important
After using this set of PPE suggestions for almost two years, there was a calming of their use by dental hygienists. A current ballot of 100 hygienists revealed that some not put on a defend due to the problem accommodating it over a lightweight, heaviness, or getting too heat. Glare or different visibility points have been additionally cited. Excessive-quality shields have been typically not equipped, with workplaces choosing low-cost ($3 vary) shields. These decrease value shields—meant to be disposable, but worn for months—are usually ill-fitting and have extra visibility points. What are the repercussions of eliminating face shields? In accordance with Dr. Tim Landis, a California dentist who designed the primary commercially obtainable dental defend in 1985, the results may be dire. “Due to the trail of air that does move between the fibers of the masks, the air is ‘filtered’ at about three to 5 microns; however viruses are about 100 nanometers. That is about 35 to 50 instances too small to be caught within the paper materials.”4
Have in mind moisture from droplets, spatter, and moisture from your individual face and breath. This renders the filtering potential to a fair decrease fee. Viruses carried in aerosol droplets won’t be filtered in a moist masks. In a perfect world, we’d all put on a brand new N95 masks (correctly fitted to our face) earlier than seeing every affected person. I don’t know any hygienists whose workplace may present this, and I doubt any hospitals may. We’re nonetheless in a state of scarcity relating to good high quality masks. It simply is sensible to cease the onslaught of aerosol droplets, spatter, blood, particles, calculus, and no matter else could fly at us by merely sporting a high-quality defend. Maintain your defend as much as your mild after engaged on a affected person, and also you’ll be satisfied. Simply make sure your defend is sweet high quality, crystal clear, and lengthy sufficient to the touch your chest to maintain something from coming into beneath. Dr. Landis is at present designing an Op-d-op defend that can shut the hole at chin stage for wearers of the brand new forward-view ergonomic loupes. The highest should be closed so aerosols and particles can not enter from above.
We now have skilled a pandemic that shook us to our very core. We now know that an unknown pathogen may be launched at any unexpected time. If our protocols stay at COVID ranges, hygienists will probably be ready. We’ll already be used to the method of doing hygiene in full PPE, and we’ll give our sufferers the sense of well-being that they’ve come to anticipate.
Editor’s notice: This text appeared within the April 2022 print version of RDH journal. Dental hygienists in North America are eligible for a complimentary print subscription. Join right here.
- Cabral L, Xu L. Vendor fame and value gouging: proof from the COVID-19 pandemic. Financial Inquiry. 2021;59(3):867-879. http://leixu.org/xu_price_gouging.pdf
- Cerullo M. How corporations pivoted from making attire, snowboards and whisky to face masks, gloves and sanitizer. CBS Information. March 10, 2021. https://www.cbsnews.com/information/ppe-manufacturing-business-transformations/
- Berg S. He took on state’s high public well being job. Then the pandemic hit. American Medical Affiliation. September 2, 2020. https://www.ama-assn.org/delivering-care/public-health/he-took-state-s-top-public-health-job-then-pandemic-hit
- Tim Landis, DDS, proprietor of Op-d-op. Telephone and e-mail conversations, 2022.