Not all face masks are created equal what is best for you?Introduction: Not all surgical face masks are created equal. There are many factors to be taken into consideration when choosing the best face mask for your protection. This issue is further complicated by the fact that no one face mask is the best one for everyone in your office. This course will provide you with the important information needed to make informed decisions in this critical health issue for dental professionals. Course Objectives At the completion of this course the dental professional will be able to: * Identify when your surgical face mask should be changed * Demonstrate the proper use of a face mask * Understand the evolution of face mask usage * State the primary principle behind the CDC See Control Data, century date change and Back Orifice. CDC - Control Data Corporation guidelines * Know how to choose the best face mask for you and the entire team Course Outline I. Introduction II. Course Objectives III. Course Outline IV. Glossary V. Dental Treatment Room VI. The Quiz VII. ADA Ada, city, United States Ada (ā`ə), city (1990 pop. 15,820), seat of Pontotoc co., S central Okla.; inc. 1904. It is a large cattle market and the center of a rich oil and ranch area. Policy VIII. CDC Guidelines IX. Function X. Why Change Masks XI. Bacterial Filtration Efficiency XII. PPE PPE (Brit) n abbr (Univ) (= philosophy, politics, and economics) → Studiengang bestehend aus Philosophie, Politologie und Volkswirtschaft PPE n abbr (BRIT ) (SCOL Sequence XIII. Finding the Face Mask for You XIV. Other Areas of Concern XV. Summary XVI. References XVII. Post-test Dental Treatment Room The dental treatment room could be called the perfect incubator. A typical dental treatment room or operatory is usually an area about 10'x10' with lots of moisture from numerous sources. It could be droplets of splatter that include blood and/or other potentially infectious material (OPIM OPIM Other Potentially Infectious Material OPIM Operations and Information Management OPIM Opplevelsesproduksjon Og Interaktive Medier (game design class at Hedmark University College, Norway) OPIM One Point Implementation Methodology ) from handpieces, ultrasonics ultrasonics, study and application of the energy of sound waves vibrating at frequencies greater than 20,000 cycles per second, i.e., beyond the range of human hearing. , air/water syringes, oral evaluators, lab equipment or merely the breath of numerous individuals filling the air throughout the day. The Quiz Ask yourself the following questions related to your face mask-wearing habits. YES NO [] [] 1. Do you wear the same face mask all day? [] [] 2.Do you frequently pull down your face mask away from your nose so you can breathe easier or talk to patients? [] [] 3. Do you leave your face mask on while you leave the treatment room to quickly grab something or to briefly check another patient? [] [] 4. If using aerosol-producing equipment, do you use the same face mask for more than 20 minutes? [] [] 5. During a lengthy procedure, do you use the same face mask for the entire time? [] [] 6. Do you touch your face mask during procedures? Award yourself one point for each "YES" answer. Add up your total score. If you have one point or more, the face mask link in the barrier protection chain has been broken. It is easy to break any area in maintaining your personal protection. The important concept is to identify and eliminate everyday activities that may contribute to breaking any link of infection control. Once the chain is broken, the door for potential risk is open for you, your patients, coworkers, family and community at large. Good News According to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. the American Dental Association's "Policy Statement on Bloodborne Pathogens, Infection Control, and The Practice of Dentistry," the dental office IS a safe place to provide and receive dental care. The policy further states there is no significant risk to the health care professional as long as appropriate infection control guidelines are followed (ADA House of Delegates House of Delegates n. The lower house of the state legislature in Maryland, Virginia, and West Virginia. , October 1999 and amended October 2004). This policy affirms the importance of the chain of infection control procedures. The complete policy statement can be found at www.ada.org. CDC Guidelines The concept of "standard precautions" was introduced by the Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center. (CDC) in 1996. Standard precautions takes universal precautions universal precautions, n.pl 1. approaches to infection control designed to prevent transmission of bloodborne diseases, such as AIDS and hepatitis B in health care settings. a step further and is a standard designed to protect health are workers and patients from pathogens that can be spread by blood or any other body fluid, excretion, or secretion (except sweat) regardless of whether they contain blood; nonintact skin; or mucous membranes Mucous membranes The inner tissue that covers or lines body cavities or canals open to the outside, such as nose and mouth. These membranes secrete mucus and absorb water and salts. Mentioned in: Leprosy, Pulmonary Fibrosis, Topical Anesthesia . In December 2003 "Guidelines for Infection Control in Dental Health-Care Settings" were released by the CDC. These recommended infection control guidelines serve as a source for all health care workers. The CDC enforces the primary principle behind the standards that ALL patients must be treated as potentially infectious. For optimal protection, it is therefore necessary that every link or aspect of infection control be adhered to at all times. A complete copy of these guidelines can be found at http://www.cdc. gov/OralHealth/infectioncontrol/guidelines/index.htm. Each recommendation is categorized on the basis of existing scientific data, theoretical rationale, and applicability. Rankings are based on the system used by CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC HICPAC Hospital Infection Control Practices Advisory Committee ) to categorize recommendations: Category IA. Strongly recommended for implementation and strongly supported by well-designed experimental, clinical, or epidemiologic studies. Category IB. Strongly recommended for implementation and supported by experimental, clinical, or epidemiologic studies and a strong theoretical rationale. Category IC. Required for implementation as mandated by federal or state regulation or standard. When IC is used, a second rating can be included to provide the basis of existing scientific data, theoretical rationale, and applicability. Because of state differences, the reader should not assume that the absence of a IC implies the absence of state regulations. Category II. Suggested for implementation and supported by suggestive clinical or epidemiologic studies or a theoretical rationale. Unresolved issue. No recommendation. Insufficient evidence insufficient evidence n. a finding (decision) by a trial judge or an appeals court that the prosecution in a criminal case or a plaintiff in a lawsuit has not proved the case because the attorney did not present enough convincing evidence. or no consensus regarding efficacy exists. Category IC are OSHA-mandated items that must be followed under penalty of law. Always remember to check with state and local laws that may have mandates more strict than the federal OSHA OSHA n. Occupational Safety and Health Administration, a branch of the US Department of Labor responsible for establishing and enforcing safety and health standards in the workplace. regulations. Following is the part of the guidelines as it applies to masks, protective eyewear protective eyewear, n See eyewear, protective. , and face shields: IV. PPE A. Masks, Protective Eyewear, and Face Shields 1. Wear a surgical mask A surgical mask is intended to be worn by health professionals during surgery and at other times to catch the bacteria shed in liquid droplets and aerosols from the wearer's mouth and nose. and eye protection with solid side shields or a face shield to protect mucous membranes of the eyes, nose, and mouth during procedures likely to generate splashing or spattering of blood or other body fluids (IB, IC) 2. Change masks between patients or during patient treatment if the mask becomes wet (IB) 3. Clean with soap and water, or if visibly soiled, clean and disinfect To remove the virus code that has attached itself to a legitimate file. Sometimes, the antivirus program cannot untangle the code, and the infected file has to be deleted. See quarantine. reusable facial protective equipment (e.g., clinician and patient protective eyewear or face shields) between patients (II) Function Many dental professionals believe face masks are simply to protect oneself from breathing in or inhaling particles in the air. Beyond this basic understanding, the primary function of face masks is to protect the professional from large splatter or droplets that may hit the mucous membranes of the nose and the lip or mouth area. Face masks should cover both your nose and mouth area and be worn whenever splash or splatter is anticipated. Surgical face masks were first used in surgery to ensure protection and healing for the patient. In today's world, facial masks play an important role as a barrier for professional dental health care personnel (DHCP (Dynamic Host Configuration Protocol) Software that automatically assigns temporary IP addresses to client stations logging into an IP network. It eliminates having to manually assign permanent "static" IP addresses. DHCP software runs in servers and routers. ) from potentially dangerous airborne pathogens found in droplets of splatter generated in the treatment room and dental laboratory A dental laboratory is a light manufacturing facility for the production of dental restorations on the order of a dentist. Dental laboratories may make dentures, crowns, or other dental restorations such as implant crowns. . Why Change Masks You should always change your surgical face mask between patients. Moreover, if you are generating high-speed aerosols and/or touching your mask, a generally accepted time frame is to change your face mask after 20 minutes. Even in a dry climate, experts recommend that a face mask be changed after 60 minutes. Once a mask is moistened from either the outside or the inside, there is a wicking wicking Infectious disease Enhanced penetration of liquids, and small pathogens, through minute holes in latex membranes–eg, surgical gloves, which may develop when washed with surfactants, an effect that militates against the re-use of certain materials effect that occurs as moisture is drawn into the material. Also, when a mask becomes wet the resistance to the airflow through the mask increases causing more airflow to pass around the edges of the mask. This weakens the seal between the mask and face. Direct contamination quickly results, making the mask ineffective as a protective barrier. Remembering to change your mask between patients will greatly reduce your potential exposure to hazard at risk; liable to suffer damage or loss. See also: Hazard . This practical step applies to the medical and hospital community as well. According to the standard precaution guidelines from the Healthcare Infection Control Practice Action Committee (HICPAC), coughing and sneezing To verbally tell somebody about a new and interesting Web site. See viral marketing. are examples included in the list of hazardous droplet droplet very small drop of fluid. droplet nuclei the finite particles of matter which are transmitted from animal to animal. transmission sources. Essentially, what may seem like an innocent cough or sneeze sneeze, involuntary violent expiration of air through the nose and mouth. It results from stimulation of the nervous system in the nose, causing sudden contraction of the muscles of expiration. could end up compromising anyone's safety--perhaps in any environment or setting. Bacterial Filtration Efficiency It is recommended that face masks should have at least a 95 percent bacterial filtration efficiency for particles 3-5 microns in diameter. Some experts reveal the recommended particle filtration range may be acceptable from 1 to 6 microns when determining the BFE--bacterial filtration efficiency--a term commonly used for testing facial masks. The American Society for Testing and Materials (ASTM ASTM abbr. American Society for Testing and Materials ) defines BFE BFE Bum Freak Egypt (polite form) BFE Bundesamt für Energie (Switzerland) BFE Base Flood Elevation BFE Battle for Europe (World War II game tournament) as the "effectiveness of medical face mask material in preventing the passage of aerosolized Adj. 1. aerosolized - in the form of ultramicroscopic solid or liquid particles dispersed or suspended in air or gas aerosolised gaseous - existing as or having characteristics of a gas; "steam is water is the gaseous state" bacteria; expressed in the percentage of a known quantity that does not pass the medical face mask material at a given aerosol flow rate." (ASTM Designation: F 2100 - 01) The majority of surgical masks do not offer negligible protection against true aerosols. These small particles may remain suspended in the air for an extended period of time and can be drawn into the lungs. Although there is no evidence that bloodborne pathogens are transmitted by aerosols, this is the manner in which tuberculosis is transmitted. In order to be protected from aerosols and hence tuberculosis, health care workers must wear respirators that have been certified by the National Institute for Occupational Safety and Health National Institute for Occupational Safety and Health, n.pr an institute of the Centers for Disease Control and Prevention that is responsible for assuring safe and healthful working conditions and for developing standards of safety and health. (NIOSH NIOSH National Institute for Occupational Safety & Health, see there NIOSH Recommendations for Safety & Health Standards Agent NIOSH REL*/OSHA PEL† Health effects ). To be effective, these devices need to be tested by a trained technician to ensure proper fit. The level of protection is measured both by the efficiency of the filter material the mask is made of and how well the face piece fits to the face. Most of the material generated in dental procedures is in the form of larger particles including droplets and spatter spatter, n droplets of airborne particulate matter larger than 50 μm that fall to the ground. that tend to drop out of the air over time. These larger particles are not carried into the lungs but can come in contact with the mucous membranes of the eyes, nose or area surrounding the oral cavity oral cavity n. The part of the mouth behind the teeth and gums that is bounded above by the hard and soft palates and below by the tongue and the mucous membrane connecting it with the inner part of the mandible. . Such exposures are capable of transmitting bloodborne pathogens such as hepatitis B Hepatitis B Definition Hepatitis B is a potentially serious form of liver inflammation due to infection by the hepatitis B virus (HBV). It occurs in both rapidly developing (acute) and long-lasting (chronic) forms, and is one of the most common chronic . Even if you are wearing a face shield rather than protective glasses you should also wear a face mask to ensure barrier protection. A surgical face mask acts primarily as a barrier for mucous membrane mucous membrane n. A membrane lining all body passages that communicate with the exterior, such as the respiratory, genitourinary, and alimentary tracts, and having cells and associated glands that secrete mucus. Also called mucosa. exposure by droplets or splatter. In order to provide protection for aerosols, such as those associated with the transmission of tuberculosis, health care workers must wear fit-tested respirators. Surgical facial masks serve to protect in the form of filtration, not like a custom-fit respirator respirator /res·pi·ra·tor/ (res´pi-ra?ter) ventilator (2). cuirass respirator see under ventilator. used by health care workers in highly contagious situations. In order to provide protection for aerosols, such as those associated with tuberculosis, dental health care personnel must wear fit-tested respirators. The employer must provide the DHCP with respirators and establish a written respiratory protection program when applicable. Personal Protective Equipment Sequence To help ensure the chain of infection control is not broken, PPE should always be donned and removed in the following orders. Donning: 1. Gown 2. Surgical face mask or respirator 3. Protective eyewear or face shield 4. Gloves Removing: 1. Gloves 2. Surgical face mask or respirator 3. Protective eyewear or face shield 4. Gown To remove a contaminated contaminated, v 1. made radioactive by the addition of small quantities of radioactive material. 2. made contaminated by adding infective or radiographic materials. 3. an infective surface or object. surgical face mask the DHCP should never touch the front of the mask. The mask should be removed by the ties, ear loops, or where the elastic meets the mask. Wash hands again after removing mask. Finding the Face Mask for You Choosing the correct surgical face mask as part of your Personal Protection Equipment (PPE) is a critical factor in your own goal to eliminate cross-contamination. Finding the face mask that is best for you is extremely important. Masks are available in cloth or cone styles. They come with either ties, earloops, or elastic back. Make sure your mask meets each of the following criteria: * Read the Labels: Make sure your mask meets the requirements for bacterial filtration efficiency. Don't get lost in technical information; try to stick to the basics and recognize the standards that must be followed. * Comfort and Fit: Choose what you feel is right for you! Here are some features to check out: * Make sure it covers the nose and chin. * Look for a comfortable nosepiece nosepiece /nose·piece/ (noz´pes?) the portion of a microscope nearest to the stage, which bears the objective or objectives. nose·piece n. that easily conforms and stays in place. A snug fit over the bridge of the nose will help eliminate fogging of protective eyewear. * Test for earloop bands, ties, or elastic backs that provide a close fit yet do not pull or add pressure. * Test for comfort and fit with protective eyewear in place. * Review the overall mask design. Select a high quality mask construction with LATEX-FREE materials to avoid any allergic reactions. * Breathability: Select a mask that is easy to breathe through, as this will reduce moisture buildup within the mask. * Educate Yourself: Compare the claims of different brands to understand what benefit is provided. Take time to read about how you can increase your personal protection! * Keep Up to Date on new technologies, products and guidelines. * Look for Value: When making your purchasing selection, look for the overall value in terms of comfort, fit, quality, and protection. Other Areas of Concern Maintaining the integrity of the surgical face mask is an important step in any infection control protocol program. However, there are other steps to be taken to alleviate cross-contamination through the face mask. * Keep your mask where it should be--over your mouth and nose! * Avoid pulling your mask down under your chin when leaving the operatory or between patients. * Maintain all personal protection barriers, i.e., glasses or shield, gloves, apparel. * Take time to read the required guidelines! * Ask yourself--would I be comfortable as a patient here at any time, with any staff member? Summary OSHA requires the use of a face mask during procedures likely to generate splashing or spattering of blood or OPIM. Education on infection control procedures (including face masks) must be provided on initial employment, when new tasks affect occupational exposure, or at least a minimum of annually. A postexposure management program should also be in place. The health of yourself, your patients, coworkers, family, and community at large is YOUR responsibility. References ADA--American Dental Association; www.ada.org (Accessed 6/17/05). CDC--Guidelines for Infection Control in Dental Health-Care Settings ... 2003; http://www/cdc/gov/mmwr/preview/mmw rhtml rr5217al.htm (Accessed 6/15/05). OSHA--United States Occupational Safety and Health Administration Occupational Safety and Health Administration (OSHA), U.S. agency established (1970) in the Dept. of Labor (see Labor, United States Department of) to develop and enforce regulations for the safety and health of workers in businesses that are engaged in interstate ; www.osha.gov. Recommendations and Reports, Morbidity and Mortality Weekly Report Morbidity and Mortality Weekly Report (MMWR) is a weekly epidemiological digest for the United States published by the Centers for Disease Control and Prevention. The 5 June 1981 issue of the MMWR published the cases of five men in what turned out to be the first report of AIDS. , Vol.52/RR-17; December 19, 2003. Runge, Pamela, "Bless you! Could you please pass your medical records?," Dental Equipment & Materials. PennWell Publishing, May 2002. Glossary Aerosol--particles less than 10 microns (mist) that can be inhaled in·hale v. in·haled, in·hal·ing, in·hales v.tr. 1. To draw (air or smoke, for example) into the lungs by breathing; inspire. 2. and remain airborne for extended periods of time Airborne pathogens--disease producing microorganisms traveling through air Contagious--transmitted easily from one person to another Cross-contamination--transferring infectious agents from patient to dental team; dental team to patient; patient to patient; dental office to community; or community to patient Droplet--small particles of moisture in the air; may contain infectious microorganisms Microns--unit of measurement equal to .001 millimeter Mucous mucous /mu·cous/ (mu´kus) 1. pertaining to or resembling mucus. 2. covered with mucus. 3. secreting, producing, or containing mucus. mu·cous adj. 1. membranes- soft tissue lining the eyes, mouth and nose Pathogens--disease producing PPE--Personal Protection Equipment as defined by CDC include: gloves, surgical masks, protective eyewear, face shields, and protective clothing Wicking--absorption of a liquid by a capillary action along a thread or through the material Not All Face Masks Are Created Equal What Is Best for You? POST-TEST Choose the one best answer 1. Face masks should be changed A. once a day B. twice a day C. between each patient D. every 20 minutes during aerosol-producing procedures 2. The bacterial filtration efficiency of the face mask should be A. 100% B. 50% C. 75% D. 95% 3. In 2003 the--released "Guidelines for Infection Control in Dental Health-Care Settings." A. ADA B. OSHA C. OSAP OSAP, n.pr an abbreviation for the Organization for Safety and Asepsis Procedures, a nonprofit organization that consists of dental and health care professionals and others interested in promoting infection control and effective health and safety D. CDC 4. All of the following except one are considered improper use of face masks. A. changing mask every 20 minutes during aerosol-producing procedures B. touching mask during procedures C. pulling mask down and away from nose and mouth to talk to patients D. wearing surgical face masks with tuberculosis patients 5. When choosing a face mask you should --. A. use what is in the office inventory B. use the one on sale to save on office overhead C. use one that meets BFE requirements and is comfortable D. use the same type as everyone else in the office 6. Breathability of a mask is important to reduce --. A. respiratory problems in the user B. moisture buildup on the outside of the mask C. transmission of tuberculosis D. moisture buildup within the mask 7. OPIM stands for --. A. other possibly infectious material B. other potentially infectious material C. only potentially infectious matter D. only possibly infectious matter 8. Face shields are a good alternative to uncomfortable masks. A. true B. false 9. The primary function of face masks is protection from --. A. the patient B. inhaling particles in the air C. large splatter or droplets D. solid particles hitting the face 10. A wet face mask --. A. should be changed at the end of the procedure B. allows increased airflow around the mask C. is as effective as a dry mask D. is not as effective as a dry mask, but still considered acceptable Pamela Runge, RDH RDH abbr. Registered Dental Hygienist RDH, n an abbreviation for registered dental hygienist. , MBA MBA abbr. Master of Business Administration Noun 1. MBA - a master's degree in business Master in Business, Master in Business Administration , is the director of marketing and U.S. sales for Medicom, Inc., a manufacturer and distributor of high-quality health care products such as facial masks, gloves, protective garments, and additional disposable products. She may be reached at: 800-361-2862 or prunge@medicom.com. |
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