You probably haven’t given much thought to the mask you don before dental procedures. However, it’s quite important to have the facts when choosing products designed to keep you safe when exposed to pathogenic viruses and bacteria. Let’s explore the what, when, where, why, and how to choose and properly use a surgical dental mask.

What is a surgical mask?

A dental surgical mask is a barrier that protects the clinician from potential respiratory disease agents and is an FDA regulated medical device. Masks are composed of several layers of synthetic microfiber materials created to trap microscopic matter and are manufactured in a variety of sizes and shapes.

When is a surgical mask worn?

The Centers for Disease Control (CDC) recommends that a surgical mask be worn during procedures which produce aerosols, spattering, or splashing of blood or other bodily fluids. The mask must be disposed of after each patient, following one hour of continuous treatment, or every twenty minutes during a procedure producing a high level of aerosols.

The American Society for Testing and Materials (ASTM) specifies the performance of face masks and certifies the levels of mask type to be worn based on the procedure.

ASTM low barrier level 1 is used during procedures where there is a low concentration of aerosols, spatter, or fluids being produced. Examples are: patient exams, lab work, taking x-rays, applying fluoride, and disinfecting the operatory.

ATSM moderate barrier level 2 should be donned when there is a moderate concentration of aerosols, spatter, or fluids being produced. Examples include: Use of the ultrasonic scaler, hand scaling, rubber cup polishing, air polishing, use of a slow speed handpiece, placing a filling or sealant, placing a permanent or temporary crown, placing an inlay or onlay, taking impressions, and any other procedure which would produce moderate aerosols, spatter, or fluids.

ATSM high barrier level 3 masks should be worn where there is a high probability of concentration of aerosols, spatter, or fluids being produced. Examples include: ultrasonic scaling, air polishing, use of a high-speed handpiece, extractions, implant placement, any surgical procedure, and any other procedure which would produce a high-level concentration of aerosols, spatter, or fluids.

Where is a surgical mask worn?

A mask is worn on the face of the clinician and must cover the nose and mouth without actually touching the nostrils or the mouth. It’s attached to the head securely so that the clinician is comfortable and able to work effectively and safely. 

Why wear a surgical mask?

Dental aerosols are produced in the highest concentration within two feet of the patient being treated. Furthermore, the clinician is usually within this two feet and is exposed to the larger droplets and the remaining smaller nuclei droplets. These smaller droplets remain airborne for extended periods and can contain pathogenic viruses and bacteria.

How is a surgical mask used properly?

1. Wash hands before touching a clean mask.
2. Handle the mask for proper placement- the side of the mask which is facing up in the box is always the front of the mask. The pleats of the mask should be facing down when opened. The metal noseband is bent to the contour of the nose.
3. Hold the mask by the ear loops and place the loops around each ear.
4. Form the malleable metal strip to the shape of the nose.
5. Extend the bottom of the mask over the mouth and chin.

Some other factors to consider when choosing a mask include confirming that it has a high bacterial filtration efficiency (BFE), it doesn’t cause fogging of eyewear, and it’s made of a material that doesn’t irritate the skin or cause an allergic reaction. While it may take some time to find a mask which suits you and your team, most manufacturers offer samples so everyone can try different types and make an informed decision.