As Dental Infection Control Awareness Month (DICAM) draws to a close, the Association for Dental Safety (ADS) is highlighting one of the most visible and vital aspects of infection prevention: Personal Protective Equipment (PPE). PPE is essential for protecting both dental professionals and patients from the risks of infectious disease transmission during dental care.

Why PPE Matters

According to CDC, PPE forms a barrier between dental healthcare personnel and potentially infectious materials, like blood, saliva, and respiratory secretions. Proper selection, use, and maintenance of PPE are critical for ensuring safety in every dental procedure. PPE includes gloves, masks, protective eyewear, face shields, protective clothing, and, when necessary, respirators.

Keys to Effective PPE Use

• Selection: Choose PPE that is appropriate for the specific dental procedure and the type of exposure anticipated. For example, standard surgical masks are designed to protect against large-particle droplets and splatter but do not provide adequate filtration or fit for protection against airborne infectious agents generated during aerosol-producing procedures (such as use of high-speed handpieces, ultrasonic scalers, or air/water syringes). In these cases, use a surgical N95 respirator or equivalent, which is specifically designed to filter airborne particles and provide a tight facial seal. Always select PPE that meets regulatory and manufacturer standards for the intended use.
• Fit: Proper fit is critical for PPE effectiveness. For example, respirators like N95s must form a secure seal against the wearer’s face to ensure that inhaled air passes through the filter material rather than leaking around the edges. Facial hair, such as beards or stubble, can interfere with the seal and significantly reduce the level of protection. Fit testing is required before initial use of a respirator and whenever a different size, style, or model is used, or if there are changes to the wearer’s facial structure. For other PPE, such as gloves and protective clothing, ensure the correct size is selected to provide full coverage and comfort without compromising dexterity or barrier integrity.
• Donning and Doffing: Follow established protocols for putting on (donning) and removing (doffing) PPE to minimize the risk of self-contamination. For example, always perform hand hygiene before donning PPE. When removing PPE, avoid touching contaminated surfaces and remove items in the correct sequence (e.g., gloves first, then gown, then eye protection, then mask or respirator). Handle PPE by the straps, ties, or clean areas, and perform hand hygiene immediately after removal. Visual guides and training videos, such as those provided by the CDC, can help reinforce correct technique.
• Maintenance: Reusable PPE, such as protective eyewear and face shields, must be cleaned and disinfected between uses according to the manufacturer’s instructions and established infection control protocols. Inspect PPE regularly for signs of damage, wear, or contamination. Discard and replace any PPE that is visibly soiled, damaged, or no longer provides an effective barrier. Store clean PPE in a designated, clean area to prevent contamination.
• Training: All dental team members must receive comprehensive training on the selection, use, and limitations of PPE. Training should be provided initially upon hire and updated regularly, especially when new equipment is introduced or guidelines are revised. Training should cover the rationale for PPE use, correct donning and doffing procedures, fit testing (for respirators), maintenance and storage, and recognition of when PPE is compromised or needs to be replaced. Ongoing education and competency assessments help ensure consistent and effective PPE use across the dental team. [1,2]

Common PPE Questions

Q: What's the difference between a surgical mask and an N95 respirator?
A: Surgical masks provide barrier protection against splashes and large droplets but don’t filter small airborne particles or provide a tight facial seal. N95 respirators are designed to filter at least 95% of airborne particles and must fit snugly to the face to be effective. [1]

Q: When should I wear an N95 respirator?
A: N95 respirators should be worn during aerosol-generating procedures, especially when treating patients with known or suspected airborne infectious diseases.

Q: Why do I need to wear eye protection?
A: Dental procedures often generate sprays, spatter, and aerosols containing blood, saliva, and other potentially infectious materials. These can expose your eyes and mucous membranes to infectious agents and physical hazards, like tooth fragments or restorative material. Eye protection is essential to prevent infection and injury during dental care. [2]

Q: Can I wear a face shield instead of protective eyewear?
A: No. Face shields can provide additional protection, but they aren’t a substitute for protective eyewear. Face shields should be chin-length, provide top and side protection, and be curved. They may not offer adequate protection against high-velocity particles, so they should be used along with protective eyewear. [2]

Q: Do my patients need to wear eye protection during treatment?
A: Yes! Patients should be offered eye protection during treatment to prevent injury from projectiles or splashes. They can keep prescription glasses on, but you should still provide them with protective eyewear if possible. [2]

Q: How do I handle reusable PPE?
A: Reusable PPE, like protective eyewear and face shields, should be cleaned and disinfected between patients according to manufacturer instructions and office protocols.

Recommended PPE Resources:

• Ask ADS
• CDC – Best Practices for Personal Protective Equipment
• CDC Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care
• CE Center – Eye Safety Courses
• CE Center – PPE Courses
• CE Center – Respiratory Protection Courses
• DICAM Infection Prevention and Safety Resource Toolkit
• If Saliva Were Red
• Infection Control and Management of Hazardous Materials for the Dental Team, 7th Edition
• Infection Control in Practice (ICIP), Volume 21, Issue 2
• Infection Control in Practice (ICIP), Volume 22, Issue 3

Get Involved!

DICAM is the perfect time to review PPE protocols, educate your team, and share your commitment to patient safety. For more information, resources, and ways to participate, click here.

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