By Lee Slaton, Vice President of Healthcare; Smart Training

Smart Training’s compliance advisors are receiving more and more calls regarding what type of mask to wear in a clinical setting, depending on one’s job description and the type of procedures being performed.

This matters.

First things first. No matter what type of mask you wear, in order to protect yourself, it’s important to do these things.

  • Change your mask after every patient.
  • Change your mask every 20 minutes if you’re working in an environment with high aerosols production.
  • Wear the mask correctly. This is extremely important. There’s a front and back to a mask. One side should go toward your eyes, the other toward your chin. The mask should be pulled fully over the nose, mouth, and chin.

Three Barrier Levels

The American Society for Testing and Materials (ASTM) defines three mask levels (1, 2 and 3) dental professionals should consider when performing different functions or procedures. Level-1 masks are considered low barrier; level-2, moderate barrier; and level-3, high barrier.

OSHA doesn’t dictate which level of mask should be worn during dental procedures; it only states masks should be worn. In some literature, it refers to numbers that would indicate the properties of level-1 masks are sufficient.

But as is sometimes the case, OSHA requirements—and/or CDC and the Organization for Safety, Asepsis and Prevention (OSAP) recommendations—don’t always line up with the latest and best practices.

Which level is appropriate?

Here’s some guidance ASTM provides regarding which mask level would be appropriate in different situations.

Level 1 (low barrier)

ASTM considers this level appropriate for situations including:

  • Exams
  • Prepping operatories
  • Taking impressions
  • Laboratory work
  • Orthodontics

Level 2 (moderate barrier)

ASTM considers this level appropriate for procedures or situations where aerosols and splatter are moderately generated, including:

  • Prophylaxis
  • Non-surgical periodontal therapy
  • Endodontics
  • Sealants
  • Restorative
  • Limited oral surgery

Level 3 (high barrier)

ASTM considers this level appropriate for procedures or situations where heavy amounts of fluid, splatter, and aerosols are produced, including:

  • Ultrasonic scaler is used
  • Air polisher is used
  • Crown preparation
  • Implant placement
  • Periodontal surgery
  • Complex oral surgery

The decision maker needs to choose if he or she wants to purchase multiple levels of masks for the office, or stick to the highest level so the provider is always covered.

It may suit an office to have staff work in level-3 masks during ultrasonic instrumentation, discard them after the procedure; and to put on level-1 masks when returning to the operatory to disinfect.

In most instances, a level-3 mask costs approximately 20% more than a level-1 mask. We see level-1 masks that cost around 8.5 cents/ea (at the low end), and around 10.5 cents/ea for level-3 masks.

With the cost difference being relatively small, consider upping your game to a higher level mask where appropriate, if you haven’t already.

You can write Lee Slaton at Smart Training is in the business of making dental practices safe for staff and patients. If you’re not sure how your practice stacks up in complying with the latest CDC infection-control and OSHA exposure-control protocols, you can contact Smart Training. TDA members receive discounts when they mention “TDA Perks.”