Sir, I write with my thoughts on three recent items published in the BDJ.1,2,3 in relation to fit testing for FFP3 respirators,1 an additional consideration is that the Occupational Safety and Health Administration have advised that prescription glasses, or where required safety goggles, must be worn during the fit test.4 The author cited reasons for undergoing a fit test, one of which was facial change since the previous test. It would be interesting to note that major dental work such as new dentures would fall under this category.
Secondly, in relation to thermal screening2 the CDC in its guidelines for dental settings recommends that a patient should not be deferred treatment for the sole reason of being febrile ie a clinical correlation of the fever must be made.5 The same guidelines recommend that the definition of fever be updated to either a measured reading of ≥100.0°F or subjective fever. If a patient is found to be febrile with a strongly associated diagnosis of dental origin such as the presence of intra-oral swelling and pulpal/periapical dental pain with the absence of symptoms suggestive of COVID-19, dental care may be provided following routine protocol.
Finally, in relation to orthodontic treatment3 this author mentions the use of self-etch primers (SEP) to avoid an AGP, however the technique of applying SEP involves gentle air drying according to some manufacturers, making it a potential AGP. There is also a mention of utilising light cured resin modified GIC, but this material does not require a dry field and in fact, the surface of the enamel should be moist during bonding to ensure success.6 The author suggests hand trimming of excess composite/flash with a scalpel. An alternative to this would be to utilise either: band removing pliers (posterior teeth), hand scalers/Mitchell's trimmers (incisors) or adhesive removing pliers.6 Minimal remnants of residual material on the enamel surface can be lost with time as a result of toothbrushing.6
Rollings L. FFP3 respirator face fit testing - what is it all about? Br Dent J 2020; 229: 112-114.
Kumar U, Parmar P, Kaur C K, Yadav S, Rajpu A. Thermal screening. Br Dent J 2020; 229: 148.
Marya A. AGPs and orthodontics. Br Dent J 2020; 229: 208.
Occupational Safety and Health Administration. Transcript for the OSHA Training Video Entitled Respirator Fit Testing. Available at: https://www.osha.gov/video/respiratory_protection/fittesting_transcript.html (accessed 17 August 2020).
Centers for Disease Control and Prevention. Dental Settings. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html#section-2 (accessed 18 August 2020).
British Orthodontic Society. The AGP Question: Implications for Orthodontics. 6 May 2020. Available at: https://www.bos.org.uk/Portals/0/Public/docs/Advice%20Sheets/COVID19%20FACTSHEETS/Recovery%20Phase%20Advice/AGP/AGP%20BOS%20guide%20Version%20May%206th%202020%2016.30aw.pdf (accessed 28 August 2020).