Report of a Powered Air-Purifying Respirator and Its Use in the Dental Setting

Med J (Ft Sam Houst Tex). 2021 Jan-Mar:(PB 8-21-01/02/03):97-103.

Abstract

Background: Respirators have received much attention since the outbreak of the COVID-19 pandemic. Due to a substantial shortage of the most commonly used respirator, the N95 Filtering Facepiece Respirator (N95), as well as the desire to have added protection while performing aerosol generating procedures (AGPs), dental healthcare personnel (DHCP) have considered alternative respirator options. It is well documented in the medical literature that the Powered Air-Purifying Respirator (PAPR) provides better protection against respiratory pathogens; however, there are no reported cases that describe the use of PAPRs in the dental setting. This survey report evaluates the use of a loose-fitting full facepiece PAPR by different dental providers.

Objective: To determine if a PAPR can be used in the dental setting and identify any potential barriers to use.

Methods: Eleven DHCP representing general dentistry, dental hygiene, pediatric dentistry, endodontics, orthodontics, oral and maxillofacial surgery and maxillofacial prosthodontics at Walter Reed National Military Medical Center (WRNMMC) and Naval Postgraduate Dental School (NPDS) were asked to wear the MAXAIR PAPR while performing an AGP. They then completed a 14-question survey.

Results: There was a 100% response rate. All DHCP with the exception of the endodontist were able to successfully wear the MAXAIR PAPR for the duration of their procedure. All DHCP reported that the PAPR was more comfortable than expected. There were no reports of fogging or hindrance to visibility, breathing was unaffected or enhanced, and the noise level was tolerable. Average time to don and doff the PAPR was 5 minutes. All DHCP were able to wear loupes; some were not able to wear a headlight. Two DHCP reported a history of mild claustrophobia, and both were able to tolerate the PAPR without any issue. 44% preferred the PAPR over the N95.

Conclusion: This preliminary survey of a loose-fitting PAPR in the dental setting suggests there is a place for PAPRs in the dental community.

MeSH terms

  • Aerosols
  • COVID-19 / prevention & control*
  • COVID-19 / transmission
  • Dentistry*
  • Humans
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control*
  • Military Medicine*
  • Occupational Exposure / prevention & control*
  • Respiratory Protective Devices*

Substances

  • Aerosols