Changing masks

Dec. 1, 2010
I love the song "A Change Would Do You Good." It has helped me stop and evaluate what I'm doing and to think of changes that will "do me good." Simple changes really can do us good.

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I love the song "A Change Would Do You Good." It has helped me stop and evaluate what I'm doing and to think of changes that will "do me good." Simple changes really can do us good.

Face masks are an amazing and simple piece of personal protective equipment to keep you and your clients safe. This simple filtration system prevents the spread of diseases to both patient and clinician. Spray, splashes, and debris that we dental health care professionals (DHCP) are exposed to every day do not reach us if we are wearing a mask properly. Patients will have limited exposure to our sneezes or coughs that create droplets that could contain bacteria and viruses. The Centers for Disease Control (CDC) spelled things out so simply (see box), and yet DHCP do not always understand the use of this simple device, and we need to make some simple changes.

What changes do you need to make in your day-to-day use of masks?

What should the mask cover?
On the cover of a national magazine recently there was a hygienist up to her elbows in plaque serving the oral health needs of a client. She had great posture and the right personal protective equipment, but there was one problem – the mask did not cover her nose. If the mask does not cover the nose and mouth, there is no filtration occurring, and there is no point in wearing it. The mask should protect the nose, mouth, facial hair, and fit snugly on the side of the face and bridge of the nose with no open gaps. The mask must have a tight seal but still allow the DHCP to breathe.

Where do you place your mask after you use it?
If you place it in your pocket, you store debris from the patient, and you can enjoy a great variety of bacteria and viruses throughout the day by simply reaching into your pocket. If you place it on the counter, you are cross contaminating. If you hang it on your neck, you breathe in and have direct contact with patients' bio-burden that ended up on this single-use item. This is a single-use item that is used once and thrown in the trash. If you reuse the mask and accidentally touch it during treatment, you share with that client the previous client's bio-burden.

One size does not fit all.
Masks come in a variety of shapes, sizes, and fits. Try several and see what works for you. In an office with more than one staff member, there should be a variety of masks available.

How are you removing the mask?
You should remove the mask by its straps or elastic band. This will limit your contact with pathogens that are on the front of the mask.

When should it be changed? The CDC is very clear: When a surgical mask is used, it should be changed between patients or during patient treatment if it becomes wet. The Organization for Safety, Asepsis and Prevention reminds us that masks do not filter efficiently. In fact, a wet mask becomes a great wick that draws in moisture and debris. You might be surprised to learn that changing the mask every 20 minutes in a wet environment and every 60 minutes in a nonaerosol environment and between patients is recommended.

As this month progresses, I hope you'll look at what "changes will do you good" in your wearing of a mask. Next month: What to look for when purchasing masks.

Dental health care professionals should wear a surgical mask that covers both their nose and mouth during procedures and patient-care activities that are likely to generate splashes or sprays of blood or body fluids. A surgical mask protects the patient against microorganisms generated by the wearer and also protects dental health care personnel from large-particle droplet spatter that may contain bloodborne pathogens or other infectious microorganisms. It should be changed between patients or during patient treatment if it becomes wet. Source: www.cdc.gov/features/masksrespirators

Noel Brandon Kelsch, RDHAP, is a syndicated columnist, writer, speaker, and cartoonist. She is a member of the Organization for Safety, Asepsis and Prevention, and has received many national awards. Kelsch owns her dental hygiene practice that focuses on access to care for all. She has devoted much of her 35 years in dentistry to educating people about the devastating effects of methamphetamine and drug use. She is immediate past president of the California Dental Hygienists' Association, and is on the board of directors for the Simi Valley Free Clinic.

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