Your most important barrier

May 1, 2002
Face masks are your most important barrier of protection. In their article, Surgical Face Masks: Their Role in Controlling Cross-Contamination in Dentistry, Richard I. Karpay, DDS, and Peggy Gragg, DDS, MPH, wrote, "Both oral and nasal mucous membranes can serve as a portal of entry for bloodborne or other potentially infectious materials.

Face masks are your most important barrier of protection. In their article, Surgical Face Masks: Their Role in Controlling Cross-Contamination in Dentistry, Richard I. Karpay, DDS, and Peggy Gragg, DDS, MPH, wrote, "Both oral and nasal mucous membranes can serve as a portal of entry for bloodborne or other potentially infectious materials.

Face masks are used as filters which protect the oral and nasal mucous membranes of dental health-care workers from exposure to splash and spatter of patient blood ... as mandated by OSHA. The protection provided by a surgical face mask depends upon the amount of aerosol that penetrates through the filter material ... Masks should cover mouth and nose for protection from splash and spatter; should provide a snug fit at the periphery; should be changed frequently during a procedure if subject to heavy fluid exposure; and should be changed for each patient. For suspected or confirmed TB/high-risk patients or for protection from true aerosols, a NIOSH-approved (National Institute for Occupational Safety and Health) N95 particulate respirator should be used."

For the dental health-care worker, there is no more personal or important barrier of protection than the face mask. Yet, as important as the face mask is, the vast majority of wearers know very little about the particular mask they wear other than its color and comfort. This needs to change. Your health and safety could depend on it!

Performance designations

The following are the more basic terms you should be aware of, and should know about the mask you are wearing and face masks in general:

  • What is BFE - Bacterial Filtration Efficiency? BFE measures the filtration efficiency of a mask using viable (live) particles (bacteria) that vary in size from 1 to 5 microns.
  • What is PFE - Particle Filtration Efficiency? PFE measures the filtration efficiency of a mask using nonviable (nonliving) particles that are fixed in size from 0.1 micron to 1 micron. A face mask relies on microfiber filter media technology to capture the submicroscopic particles generated by high-speed handpieces, ultrasonic scalers, and lasers commonly in use. The HIV and TB pathogens are approximately 0.1 micron and 1.0 micron, respectively.
  • Which is better - A higher BFE or PFE rating? Answer: PFE. The micron particle size is no larger than 1.0 micron, thereby providing the wearer with increased protection.
  • Which is more important - BFE/PFE rating or micron particle size? Both. A mask with a BFE rating of 99 percent at 3.0 microns provides less protection than a mask with a PFE of 98 percent at 1.0 micron. Do not be misled by a high BFE/PFE rating without knowing the micron particle size upon which it is based.
  • What is the importance of fluid resistance? In the dental environment, it is very important that the mask you wear is fluid-resistant unless you are only performing an oral exam. A fluid-resistant mask does not permit blood or other potentially infectious materials to pass through to reach the skin, nose, mouth, or other mucous membranes under normal conditions of use.
  • What is Delta P? It measures the breathability of the mask by differential air pressure on both sides of the mask. The lower the number, the better the breathability; the higher the number, the higher the level of filtration efficiency.
  • What is a NIOSH N95 particulate respirator (high-risk) mask? It is a mask that has met the guidelines set by NIOSH for TB exposure control, provided that it is properly fit-tested.
  • My face has broken out in rash. Is it the face mask? If the inside of the mask is colored or has printing, that could be the cause of the irritation. Colors and inks are common irritants to skin. A white, nonimprinted interior is ideal. If the interior is noncolored, and the irritation persists, contact your physician.
  • How often should I change my mask? After 20 minutes of heavy exposure to fluid, one hour of normal use, or with each patient. The filter media of a mask becomes less effective the wetter it becomes.

The importance of a face mask cannot be overstated. Know what you are wearing, and know the level of protection it provides.

At the end of the day, the decision is yours. Make the right one to protect yourself, your team, your patients, and your practice. You'll be glad you did!

Andrew G. Whitehead is a vice president for Crosstex International, manufacturer of infection control and disposable products distributed in 60 countries. He has more than 30 years of experience in the dental industry. He Is a founding member and board member of the Organization for Safety and Asepsis Procedures (OSAP), dentistry's resource for infection control and safety. Whitehead may be reached at (631) 582- 6777, by email at [email protected], or visit www.crosstex.com.

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