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Dental mythbuster 31: Personal protective equipment requirements during coronavirus (COVID-19) within dental practices
Personal Protective Equipment (PPE) can reduce cross contamination and infection for dental staff.
We regard correct use of PPE as an important element of providing safe care. Practices should follow Public Health England (PHE) guidance. If they do not follow national guidance, practices should base decisions on sound reasoning and risk assessments. They will need to justify their decisions if infection is linked to attendance at the practice.
Infection prevention and control recommendations are included in COVID-19 guidance for the remobilisation of services within health and care settings (PHE and NHS).
Donning and doffing PPE
Staff should be trained in donning and doffing PPE. Videos and guidance on donning and doffing PPE are on Gov.uk’s PPE use for aerosol generating procedures page. Videos are also available on PPE for non-aerosol generating procedures.
COVID-19: infection prevention and control (IPC) guidance is published on Gov.uk. Providers should pay particular attention to the COVID-19: infection prevention and control dental appendix. It summarises PPE recommendations for health and social care workers by context. This includes both NHS and independent sectors in secondary care inpatient settings. It also refers to what PHE consider to be aerosol generating procedures (AGP).
Aerosol generating procedures (AGPs)
Risk of transmission of respiratory viruses is higher in treatments with AGP. Health and social care workers who perform or assist in AGPs should use respiratory protective equipment. This is indicated by the Health and Safety Executive (HSE). HSE update their guidance as evidence emerges about COVID-19
During AGPs the following PPE is recommended:
- a long-sleeved disposable fluid repellent gown (covering the arms and body) or
- disposable fluid repellent coveralls
- a filtering face piece class 3 (FFP3) respirator
- a full-face shield or visor
Subject to local risk assessment, the same precautions apply for all patients. This is regardless of case status in sustained COVID-19 transmission. Filtering face piece masks can either be single use or single sessional use. A single session is time a health care worker carries out duties in a specific care setting/exposure environment. Dispose of PPE earlier if damaged, soiled, or uncomfortable.
Fit Testing for FFP type masks
HSE guidance governs respiratory protective equipment. All FFP type masks should be fit tested. They should give the protection they are designed for.
It is important a competent individual does the fit testing. Keep records of fit testing for at least five years. Check masks every time they are donned. This includes ensuring an adequate seal.
If you change the brand or type of FFP mask used, you need to carry out a new fit test.
Filtering face piece class 3 (FFP3) respirators
Respirators prevent inhalation of small airborne particles from AGPs. The Health and Safety Executive (HSE) published guidance on respiratory protective equipment basics. It includes fitting and fit checking of respirators.
It is important to make sure facial hair does not cross the respirator sealing surface. Hair inside the sealed mask area should not touch the exhalation valve. See the Facial hair and FFP3 respirators guide on Gov.uk.
Buy PPE from a reputable supplier. They should provide an audit trail about the suitability of the PPE. If you use a new or unfamiliar supplier, we suggest care to ensure authenticity of the PPE.
We may ask for evidence of face mask fit testing and PPE training, and that PPE is authentic.
- Personal protective equipment at work: A brief guide (HSE)
- Standard operating procedure: Transition to recovery (Office of Chief Dental Officer England/NHS)
- Implications of COVID-19 for the safe management of general dental practice - a practical guide (Faculty of General Dental Practice)
- Guidance for new high volume manufacturers of COVID-19 PPE (Office for Product & Safety Standards)
- Last updated:
- 08 December 2020