Mask Usage: What’s Changed, What Hasn’t & How to Protect Yourself
Dental Practices Must Return to Standard CDC Guidelines
In April 2021 the FDA published a recommendation that health care facilities transition from the “crisis capacity conservation strategies” implemented during the pandemic to CDC standard guidelines. Clinicians and staff now need to use NIOSH-approved, well-fitting face masks and change them between patients, if not more frequently.
It might be easy to argue that we’ve been reusing masks for over a year – why not continue? But recent data has shown that certain masks have a surprisingly short shelf life.
Change Masks Between Patients, If Not More Often
While hygienists and staff don’t touch patients with their masks, they do touch their own faces – to readjust their mask, to scratch an itch, or for some other habitual reason. Then, they touch the patient with their gloved hands.
If their mask has been used for another patient – especially if there were any aerosols around – the risk of cross-contamination is high. We also have to consider how aerosols and simple breathing impact the performance of the mask. If it becomes saturated with moisture, the mask may “wick” – meaning it becomes wet enough to allow microorganisms to penetrate the material.
Industry experts are now recommending that masks should be changed every 20 minutes during procedures with heavy fluid exposure to avoid this wicking process. That means clinicians may need to change their masks during a patient visit.
Which mask should you choose, however?
CDC Guidelines for Mask Choice
When determining which mask to use, it’s important to look at the context. How high is the risk in the community?
In the CDC’s updated Guidance for Dental Settings--Interim Infection Prevention and Control Guidance for Dental Settings During the Coronavirus Disease, mask guidelines were distinguished based on transmission rates – minimal, moderate and substantial.
Minimal Community Transmission: In facilities with minimal community transmission clinicians are required to wear a surgical mask, eye protection, protective clothing and gloves during procedures where there is some splashing or spattering of blood or bodily fluids.
Moderate to Substantial Community Transmission: Facilities with moderate to substantial community transmission present a greater risk and require more precaution because clinicians are more likely to be exposed to asymptomatic or pre-symptomatic patients with SARS-CoV-2 infection. If a patient is not suspected of having SARS-CoV-2 infection, clinicians can follow the standard precautions. However, aerosol generating procedures should be performed with an N95 respirator or equivalent.
This presents another challenge.
N95 respirators require regular fit testing to ensure a proper seal. N95 respirators are typically molded with little give, so they don’t fit every face shape.
In a busy dental practice where clinicians and staff are seeing a record number of patients per day (to make up for the pandemic-related gap in care), finding the time to conduct regular fit testing can be difficult. In addition, dental practices may need to stock multiple brands and styles of N95 respirators to fit clinician’s differing face shapes.
Today’s Masks Are Both Protective and Comfortable
The good news is clinicians have options. Gone are the days of using whatever mask is available: You can choose masks that offer protection and fit.
For any environment that doesn’t explicitly require an N95 respirator, masks that use Secure Fit™ Technology offer better protection – and peace of mind – than a standard surgical mask but without the discomfort and fit testing requirements associated with using an N95 respirator. Next generation masks like those that use Secure Fit™ Technology have been laboratory tested to outperform standard ear loop surgical masks. Secure Fit™ Technology, exclusive to Crosstex ASTM-rated masks, feature flexible aluminum nose and chin strips for a customized fit that eliminates dangerous gaps around any face shape. This is a big differentiator.
Ultimately, the type of mask or respirator needed depends on the length of the procedure, the amount of fluid aerosol, and the level of COVID transmission in the geographic area. They also need to comply with the ASTM International universally recognized filtration scale.
ASTM Level 1 masks, such as the Crosstex™ Isofluid™ Mask, provide light fluid protection with a bacterial and particulate filtration efficiency rating of 95% or greater.
ASTM Level 2 masks, such as the Crosstex™ Procedural line, provide moderate fluid protection with a bacterial and particulate efficiency rating of 98% or greater and fluid resistance of 120 mmHg.
ASTM Level 3 masks, such as the Crosstex™ Ultra Mask, provide high fluid protection.
Crosstex™ Isolator™ Plus N95 Surgical Respirator has demonstrated resistance to penetration by synthetic blood at pressures of 160 mmHg, and the Isolator Plus Respirator offers a particulate filtration efficiency at 0.1 microns of 99.9%.
Next Generation Masks Offer Better Comfort
Another factor that contributes to mask effectiveness is comfort.
When we look at different face shapes and sizes, having a mask that's adjustable helps achieve a better fit and better performance.
To add even more comfort, look for additional features, such as:
FogFree™ Masks include a strip on the inner layer to prevent glasses and eye protection from fogging up and obscuring the vision of hygienists and dentists. Crosstex ASTM Level 1 and 3 masks can be purchased with the FogFree feature.
Sensitive masks that include hypoallergenic inner layers are less likely to cause irritating allergic reactions. This feature helps people who must wear masks for hours at a time but have sensitive skin.
Think about color options as more than fashion. Varying colors can help dental professionals quickly identify the ASTM level for a mask, which reduces time changing masks, increases efficiency and helps ensure compliance. [KE1] This can be a game changer for larger practices.
Dental offices will always have to be vigilant in reducing the risk of cross-contamination and infection, whether it’s COVID, the common cold, the flu or other diseases. By flexing the compliance muscle and reinstituting best practices for infection protection, your practice can be better prepared to keep your patients, colleagues and community safe.
