Reopening dental offices post COVID-19 closures has been challenging, with dentists across the country looking for the best ways to protect their team members, their patients and themselves from exposure to the coronavirus.
To help make this a little easier, we asked readers to submit their “back to work” plans so we could share the best ones with the rest of the industry. The submissions we received didn’t disappoint, but one stood out to Dr. Leslie S.T. Fang, the world-renowned clinician who judged the contest.
“At a time when everyone is struggling with PPE shortages, Dr. Robert Shorey decided to make his own N95ish mask,” Dr. Fang said. “The process is not simple, but it takes into account the two elements that are necessary: The mask is form-fitting by design and has the right filter. It remains to be validated with respect to the N95 filtration efficiency, but I think it will pass muster.”
Dr. Shorey detailed the steps to take to create the masks, covered what material to use and included several pictures of the process as well as the final outcome. The masks are meant for dentists who don’t have access to N95s.
“N95 masks are in very short supply,” Dr. Shorey wrote in his submission. “Under emergency circumstances some reasonable alternatives might be used to at least protect an owner doctor not held to OSHA regulation. The attached paper documents a method to create a good fitting mask with 94-99 filtration ability using MERV 13 fibrous filter paper commonly found in hypoallergenic central air systems.”
Dr. Shorey’s submission also included how to improve aerosol prevention in a common 3D printed visor. Many available visor laser shields are very thin, but with the improvements Dr. Shorey detailed, they can be modified to offer better protection.
As the contest winner, Dr. Shorey will receive a dozen face shields from SSI – Face Shield and a donation will be made in his name to the Coronavirus Response Fund for Nurses. You can download his full submission HERE.
We received several other creative ideas we think are worth sharing. Here are the honorable mentions:
Margo Steinmark, Pediatric Dental Associates of Randolph
This practice’s comprehensive plan includes installing storage areas to separate employee belongings, moving workstations so they’re at least six feet apart, propping office doors open so no one touches the handles and requiring patients to fill out paperwork online before their appointment. They’ve purchased two extraoral high evacuation suction units to decrease aerosol droplets as well as ultraviolet lights for HVAC units to reduce virus particles in the air. While everyone now wears N95 masks, it’s still easy for their young patients to see who they are; they all wear selfie iron-on transfers on top of their surgical masks.
Dr. JC Knorr
Dr. Knorr, an oral surgeon, offered a creative solution for fogging. He recently purchased Pure&Clean, HOCL 440 ppm, with a recommended 2:1 dilution for chair and counter tops. The problem? Foggers from GenEon are not available for about eight weeks, and range in price from $700 to $1,000.
His solution? Using the compressed gas outlets already in the wall. The setup cost him $2 for the correct compressed air line connector, $8 for the line pressure gauge, $20 for a sprayer and $6 for a hose, totaling $36.
“Very fine mist covers all the surfaces well,” Dr. Knorr wrote about the results. “Takes about 10 minutes drying time and should reduce the aerosol settling time and disinfection timeline required for room turnover.”
Watch the video of his first fogging:
Dr. Stephen Chow
Dr. Chow outlined the changes he’s made to his practice in seven steps:
1. Fit tested N95 masks and half respirators for the team. Two Optrel Clearmaxx PAPR units.
2. Sneeze guards for the reception desk.
3. Hypochlorous acid maker and ULV fogging unit for waiting room. Hand sanitizer stations throughout the office and at the entrance.
4. Reusable gowns handmade from hair salon capes and full-face shields.
5. Three Surgically Clean Air purifiers and two Germ Guardian air purifiers.
6. The Pura Air System that is a centralized HVAC at source aerosol evacuation system my friend Dr. Wilson Kwong, the chief medical officer at Pura Air, helped develop.
7. Prescreening questionnaire and patients only in the office with the waiting room closed. Patients to wait in their vehicles and will be called into the office when an operatory is ready.