Three things. The first is to divulge a financial interest in Dental Aerosol Safety Hood or D.A.S.H. I invented it and then developed it with a national manufacturer.
The second is a link. Some of you know that I can write books. So for the short version, here is a link to the video on it: https://www.youtube.com/watch?v=FWUcPFqWXkk Additional links are at the bottom of this post.
The third is a story. This all started at the beginning of our shutdown because I wanted to find a way that I could still use my high and low speed handpieces and my Air/Water syringe whenever I wanted, wherever I wanted, and to still feel safe doing this. A negative pressure room was not an option for me as it does not protect the occupants. Unfortunately, all other current options leave aerosols in the air. Many of us rely on our side unit high speed evacuators. However, the best of these only get 90% of aerosols. The video shows how much that 10% left over is and how much a standard dental suction misses.
My original intention was to make something just for myself. My wife is a Medical Technologist and works under negative pressure hoods in a lab. My thinking was to try and design something like this for patients. My requirements were that it would have to remove aerosols, patients would have to be comfortable under it, and I would have to be able to work on them in it. While investigating other similar inventions by both individual doctors and corporations, I developed the biased opinion that my invention is currently the best option on the market.
D.A.S.H. is a negative pressure hood that goes over the patient. I am not legally allowed to say that it gets all of the aerosols generated. However, in my heart I believe that it does. This can be seen in the YouTube videos with a fog machine. I use handpieces and the A/W syringe whenever I want with no special scheduling or chair selection. I personally do not wear a face shield or safety glasses while using D.A.S.H. as I believe that it’s Plexiglass barrier is a safe substitute for these.
As to how it is used; patients sit in the chair with their facemask on and D.A.S.H. not over them. It is then rolled into place, tilted over them, and the height adjusted only when needed. Once set, the height rarely needs adjusted. Patients then remove their mask. When the appointment is over, they replace it before D.A.S.H.is tilted and rolled away. D.A.S.H. tilts, raises and lowers, and rolls closer or further away as needed. Tilting also makes disinfecting the underside easy. We tilt the bottom up 90 degrees and then spray and wipe the underside.
To this point in time I have not had a single patient report that they were uncomfortable being treated with D.A.S.H. We currently use D.A.S.H. on all patients except quick wire clips, separator placements, and scanning. The vacuum is only on during aerosol generating procedures. At other times it just acts as a splash guard. At first I thought that patients would not like the sound of the vacuum. Interestingly, many report that they like it. We forget how many patients do not like the sound of the “drill”.
D.A.S.H. does not include the actual vacuum. However, there is one that I personally use and think is the best. It is the Festool CT 15. It “has been tested in accordance with EPA RRP. This HEPA filtered vacuum is tested and certified in accordance with IEST RP-CC-001, to filter and exhaust air particles to 0.3 microns with at least 99.97 % efficiency with no bypass leakage”. It draws 130 CFM and is priced at only $349. It is not just a wet/dry vacuum as it is HEPA certified (the certification is key) and has far greater CFMs. Many of the extra-oral dental suction elephant looking things being sold right now are not HEPA certified and are not certified to have no bypass leakage. Also, most of the other dust extractors (they call these ultra-high end wet/dry vacuums Dust Extractors) are double or more the price of the Festool CT 15.
I found the Festool CT 15 and ultra-high end Dust Extractors in my investigations after discovering that we are not the only ones to have aerosol issues. The average woodworker loses 1% of their lung function every year. These dust extractors have been around for years to deal with this issue. Woodworkers, Painters, and the people who sand drywall use them regularly. HEPA certified particle removal is important to them.
I strongly believe that D.A.S.H. in combination with the Festool CT 15, or similar HEPA certified vacuum is far superior to those elephant looking extra-oral suctions. While these are on the right track, they lack in 3 important ways. The 1st is that they do not act like a medical hood. As they do not surround the working area, they cannot get all of the aerosol generated. The second is that many of these units are not HEPA certified and also not certified to have no blow around of the filter. The third is that they do not act as splatter guards. You still are getting hit in the face with large particles of plaque, saliva, and blood with them. We all have had this happen.
In my opinion, the D.A.S.H. solves all 3 problems. It surrounds the patient to create a negative pressure environment. It is powered by a suction capable of evacuating dental aerosols. It is a HEPA certified vacuum source with no bypass leakage. It also acts as a splatter guard. It certainly beats what many of us are doing now, leaving the aerosol go into the room air.
Whether a bunch of these are sold or none at all, having these in my personal practice is already a win for me. I have to keep reminding myself that I have already won the game. I wanted to feel safe using a high speed and low speed handpiece and an A/W syringe whenever I wanted. I currently have that and do that.
A link to the YouTube playlist with a patient testimonial and a testimonial of a GD friend using Loupes with it are at https://www.youtube.com/playlist?list=PL5PZGTFOy-2a5_0Be2-0jkWLUMaFypOoc
A link to the page with further information, a FAQ, and the ability to purchase is at www.DentalAerosolSafetyHood.com
Thanks for reading all of this. Questions and suggestions are always welcome.
