Many state governments and dental associations are discussing how to let dental offices open for routine care during the COVID-19 pandemic. At the same, time dentists and dental groups are also trying to decide if they should, or will, open when they do get the green light. The reality, as of the writing of this article, is that there is not enough PPE available to dentists to open if many offices wanted to.
If you spend a few hours reading articles from the ADA, the CDC, FEMA, KOLs and manufactures, you might be as confused as I am about what masks DHCP (Dental Health Care Personnel) should be wearing to protect themselves and their patients. Every mask in the picture above has an N95 rating, and those masks where lying around in my closet, leftover from the H1N1 scare 10 years ago. You can see why there is confusion, not only is there a question about wearing an N95 versus a surgical mask, there is also the question of which N95 to wear.
Utopia
In a perfect world for the DHCP there would be enough N95 cone shaped respirator masks for the team to use, changing with every patient. There would be unlimited face shields, gowns, booties and even digital thermometers. In dental offices there would be someone that knows how to fit test masks to everyone on the team. There would be a 5-minute test that would show if someone had COVID-19, so the staff and patients would be tested before they entered the office.
Reality
Today, almost all N95s are being sent to hospitals. We have all seen media stories on the news and in the papers about hospital staff wearing PPE much longer than they should — especially masks. With states relaxing regulations on opening businesses, there is suddenly even more demand on masks being worn by everyone in the service industry, as well as consumers walking in to stores.
For the DHCP we need to get creative. Yes, everyone should follow the ADA and CDC guidelines (see ADA guidelines) but for the near future that might not be possible due to the mask shortages.
The first place to look for masks is still your dental supply distributor. There are many sites online that are either selling junk or worse, you pay for masks and they are never delivered. Your distributor will let you know what they have coming in and what amount you are eligible for, as most are being rationed.
We all commend the dental offices that gave their PPE to first responders over the past few months, however many of those offices are now looking to replace their PPE donations. If you can’t get what you need from your distributor, it is time to ask your state and local government if you can acquire some of their new supply. You should also check locally for the entrepreneurial people that are making approved masks and especially printing face shields on 3D printers (as an example, see Kangaroo Smiles).
Another popular workaround, being used in the medical field, is wearing cloth face masks over N95s and surgical masks. The cloth masks can be changed often and washed at the end of the day. In this way the mask under the cloth mask can be worn for more than one patient, without passing on any cotangents that may have come from the aerosolization from a previous patient. These cloth masks are being made by many local sewers; maybe people on your own team can make them with a local flair. If you can access enough of these cloth masks, you can offer them to patients before taking their temperature in their car and have them wear them until they get into the chair. They should then wear the mask and place it in a receptacle on the way out.
We know we are heading into a “new normal” in taking care of our patients and our DHCP. What we don’t know is how long the shortage of PPE will be for this side of the expanded medical field. Until we can get to Utopia of PPE, we need to be creative. The recommendations may also change in the near future, as N95s are made for short time wear. Remember that a product that is filtering most of the air coming through, makes it hard for the wearer to breath, which why they are not traditionally used.
One last note, please order what you believe you may need now and put in orders for future delivery. If people try to over order, the dental profession as a whole will suffer with even more prolonged shortages.
This profession will bounce back.
This article was focused on only one part of PPE. Please take the recommendations for the other parts, there too, as you may have to get more creative than you would probably like.
Stay safe out there!
Special Note: Most of my articles are on management and teamwork. Those articles come from the experience from my career. This article was done from a “reporter” point of view. As noted in the article; please know and understand the recommendations from government agencies and industry organizations.
