|Summer 2020 (Volume 9, Issue 3)
During this unprecedented time, we have all instituted countless precautions to keep our team and our patients safe from the coronavirus. One of these is the use of respirator masks, which include N95 and KN95 masks and are designed to filter out aerosolized viruses. In this article I will review the basics of respirators in the dental setting and provide a list of resources including where to acquire masks. This information is primarily directed at dentists in the Seattle / King County area, though may have relevance to dentists from other areas or the general public.
Disclaimer: I am not an expert on respirators or the current requirements. The guidance varies by location and changes constantly. The information presented here is simply my current understanding and I advise you to do your own research and check for the most current requirements of your jurisdiction.
Background about Respirators
The coronavirus has changed the world as we know it and has greatly affected dentistry as well. Respirators have become commonly used in dentistry in order to protect the dental team from this respiratory virus, especially during aerosol generating procedures. Respirators work by filtering the air breathed in by the wearer to remove contaminants including viral particles. Although many types of respirators exist the most common types are N95 and KN95 masks.
With the dramatic increase in demand, numerous companies have started to manufacture respirators. However, not all respirators provide the same protection. N95s, which are regulated in America and have headbands, should be approved by NIOSH. KN95s, which are generally regulated in Asia and usually have earloops, are currently approved for use in the USA under the FDA’s Emergency Use Authorization (EUA) Appendix A.
NIOSH Approved N95 List (Note that the list extends multiple pages, sorted alphabetically):
FDA Approved KN95 List (Note that the list is under Appendix A):
Although the guidance issued by the State has been at times confusing and contradictory, it appears that currently dental offices are being instructed to perform fit testing. Fit testing is used to check that the respirator fits snugly on the face without leaking air in order to ensure that all air inspired by the clinician has passed through the filter. We have performed fit testing on all of our clinical staff because I believe that allows us to be as safe as possible.
Numerous commercial entities can perform fit testing. However, the Seattle King County Dental Society has arranged a program where retired dentists have been trained to perform fit testing and can be scheduled to come to your office to test your staff. Visit https://www.skcds.org/ for more information. I would encourage everyone in the local area to take advantage of this resource.
I feel fortunate that, after a lot of research and uncertainty, I now have a good handle on sources of respirators that I will share with you. Big thanks to the people that have helped me out earlier during my time of need. We will get through this together as profession!
This list contains the type of respirator, the manufacturer and model number, the vendor that I have used, who is eligible to purchase the mask, and relevant notes and link if appropriate. I have personally acquired masks through each of these channels but please do your own research on these products and confirm that is what you want as it is possible they have changed.
At our office, respirators have become part of our new normal. While they are undoubtedly uncomfortable to wear and one could make the argument that their requirement is not evidenced based, we have chosen to use them in hopes that they may provide a little additional protection to us and thus our patients as we continue to provide endodontic care in the midst of this pandemic. I hope this information helps you and your team during this uncertain time. Stay safe!
Endodontic Spotlight is published quarterly by Steven C. Kwan, D.D.S., M.S.D.
KWAN ENDODONTICS is located at 6715 Fort Dent Way, Tukwila WA 98188
206-248-3330; 206-431-1158 (fax); www.seattle-endodontics.com
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