April 21, 2020
Last week, the title of this column was a Jon Bon Jovi reference from the 80’s hit Livin’ on a Prayer, hoping that “We’re Halfway There” when it comes to getting back to ‘normal’. As I was thinking of a title this week, the first thing that jumped into my mind was a story I remember about “the boy in the bubble”.
When David Vetter was born in 1971 with severe combined immunodeficiency (SCID), an experiment to keep him alive made him famous. Vetter became known as “The Bubble Boy” after he was placed in a germ-free plastic bubble that he lived in for 12 years.
David was protected during that period of time from all the bad things in the air by this plastic enclosure. The air within the bubble was kept clean so that his severely immunocompromised system could survive. Sadly, David died from an unsuccessful bone marrow transplant. Children born today with this disease have better treatments available in helping them to lead more normal and productive lives.
The dental operatory is a bubble. It is a small, crowded space. Add to that a high-speed turbine in a person’s mouth, creating an aerosol that is spraying all over the room. This is nothing new.
In the 1970’s and 80’s, dentists were not wearing gloves, masks or eye protection, and many were smoking cigarettes during procedures. Since then, the dental office has become a much safer place for both patients and dental personnel.
Has the coronavirus changed that? Are we doing enough? What more can we do? Can we really create a ‘bubble dentist’? Who and when is someone going to tell dental offices what to do? What are the financial implications? These, and many more questions, are at the forefront of many conversations going on in the dental community.
I listened to a webinar this week presented to a group of dentists by a company called Surgically Clean Air. They have been around for about 10 years, starting in the dental field, but have branched out into other industries including professional sports and retail.
With their system, they claim to filter and ‘sterilize’ the air within a dental operatory every 5-8 minutes. I thought the presentation was very good and convincing. However, these are units that sit on the floor in the dental operatory and filter the air in the room. The critics would question the effectiveness of protecting the patient, dentist and dental assistant from the immediate aerosol being produced during a procedure. They also come with a very high price tag.
I also did some google research on capture systems for dental aerosols. These types of systems claim to effectively capture airborne contaminants via a 5-foot evacuation hose that is positioned 6-12” from the patient’s mouth during a procedure. The air is cleaned in a 3-stage process including HEPA filtration. These units can also be set up to be exhausted outside to create a negative pressure within the room……closer to being in a bubble.
It will be interesting to see what happens. I will report what I learn along the way. It is a topic that should not and cannot be ignored. And, until we have a vaccine, I think careful consideration needs to be given to allow dentists to provide the 5-minute COVID-19 tests available to keep people safer.
Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at firstname.lastname@example.org. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.
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