The new pandemic legislation has divided society into pro- and anti-maskers, but whilst wearing RPE in public spaces may be a discomfort, a segment of the population has no choice but to wear a heavy-duty mask every day at work. Whilst this has always been the case for workers in the safety and defence industries, COVID-19 has made RPE mandatory for healthcare professionals, including dentists. It is now their responsibility to source a mask that is a perfect fit to their unique facial features, undergo a mask fitting test and care for their mask and filters after each use. These requirements have further complicated the already hectic lives of dentists. It’s understandable that with so many criteria to keep in mind, they would look for a quick and tested solution, turning to colleagues and friends for product recommendations. However, in this unprecedented situation, what is the best facial protection that a dentist can have during the pandemic and beyond?
Design Reality has been improving respirators for the past 20 years and is Fit2Fit certified to perform face-fit tests, so we thought we’d share our expertise. This 10-point guide summarises what to look for in RPE if you are a dental professional, so you can pass your fit test and be your best self, even in a mask.
1. Certified for you
According to COSHH recommendations, dentists and their staff can choose between disposable and reusable RPE. Reusables are widely preferred, as they are more cost-effective in the long run, have a smaller impact on the environment and offer supreme viral protection. Unlike expensive hood respirators that don’t require a fit test, all reusable and disposable mask models have to be fit tested on the wearer and certified for their unique personal use. The myriad of RPE models available for retail and the growing number of trained mask fit testers make this highly individual choice ever more difficult. Whatever you choose, make sure you get fit tested for every single model you try, as each will fit differently to your face. A paid Fit for Use or Pass Certificate is mandated by most dental clinics now, so if you work in more than one practice, wearing multiple masks, you likely will need a different passing certificate for each mask you get.
NHS guidelines recommend FFP3 masks as they offer 99%+ filtration efficiency. Performance isn’t usually tied to brand, but rather to fit – that’s why it’s important to be professionally fitted for your mask and issued with a passing certificate, regardless of the type of F3 filter you choose.
A good RPE mask has to both protect and feel comfortable to wear for extended periods of time. From a design point of view, filtration effectiveness typically comes as the cost of how easily users can breathe through the mask. If there is too much breathing resistance, users will struggle wearing their mask, reducing compliance with legal requirements. That’s why you should aim to find optimal synergy between filtration capabilities, fit and comfort. Our tip: head straps or a one-strap fit mechanism are more secure than over-the-ear straps, and preferable if you wear glasses and a visor.
4. Ease of use
As we know all too well, dental appointments are short and not-so-sweet. If before you see a patient, you have to spend another 10 fiddling with your mask, the appointment will be rushed and your mood will likely not be the best. Not to mention that having to adjust your mask during procedures will likely result in compromised protection. Look for a mask with a simple design that you can don on and off quickly, and that stays in place the whole time. Finally, mask weight is perceived very subjectively, so make sure yours doesn’t slow you down.
A well-fitting mask won’t require further adjustments during use, exposing you to COVID-19 whenever you touch it after touching other surfaces. A good fit also means that your mask should be completely sealed on your face, but not so tight as to leave red marks for hours afterwards. Try on as many models as you must, to find your perfect fit.
6. Easy to clean
You are responsible for cleaning your mask thoroughly after each use. Since masks can’t go in the autoclave, you need a model with an easy-to-clean surface, made from durable, yet smooth material, with filters that are minimally exposed. Design Reality has recently been tasked with designing just the product for our NHS, so watch this space.
If you sometimes wear loops during some procedures, do bring a pair with you for your fit test. The same goes for eyeglasses, which we recommend be tried on with the mask you are planning to buy. Otherwise, you can’t be certain how the mask will sit on your nose together with your spectacles, or they might not stay on your face at all.
You need to be assured that your mask will last you at least as long as its expiration date states. In the case of reusable RPE, this means the shelf-life of the one disposable element of the mask – its filters. Needless to say, the better you care for your mask, the longer it will last. This means thoroughly cleaning it after and checking it before each use.
Although dentists need to wear RPE only during aerosol-generating procedures, the uncertainty of how the pandemic will progress makes it important that they can tolerate wearing a mask for a long time. Light materials such as latex and silicone-free TPE medical grade face seal don’t leave much chemical residue during wear and cleaning and are said to allow users to wear RPE masks for 8+ hours without compromise or discomfort.
When buying an RPE mask, enquire about the available stock of the model’s replaceable filters. You will be surprised how often dentists show up for a fit test with a mask but no filters. Especially if you are ordering bulk quantities for your staff or multiple dental practices, try to find a reliable supplier, who keeps you updated on your order, delivery times, and can guarantee product availability.
And finally, a note to patients. If at some point you stood on your doorstep and clapped for our NHS heroes, you may or may not have included your dentist in your thoughts, depending on your past experiences. Regardless, NHS practices in North Wales stayed open throughout the lockdown, exposing dentists and their families to risk, whilst ensuring that patients received uninterrupted service. COVID-19 has complicated the work of dentists so much, that they deserve some sympathy. Sourcing the best mask for themselves and their team, arranging and attending a fit test with a certified tester, only to discover that they didn’t pass, or that the replaceable mask filters are out of stock – these are just some of the frustrations that dentists have to grapple with because of the pandemic. Add to that the discomfort of having to work in a tight-fitting face cover, removing facial hair daily to ensure a perfect fit and abstaining from make-up; labouring to communicate with patients and colleagues; cleaning and airing out premises and equipment after every patient, and it’s easy to see that the new protective measures dentist have to take before and after seeing us are, in the best-case scenario, a nuisance. And if all that doesn’t convince you to save some love for your dentist, remember that your protection from COVID-19 and other airborne pathogens is primarily in your dentist’s hands. So be nice to them and pay attention to what mask they wear whilst treating you.