Sir, in order to provide safe dental services, the NHS recommends strict personal protective equipment (PPE) which includes N95 (FFP2) respirator, impermeable full sleeved gown and face shield.1 Recently, additional literature has suggested that these strict PPE requirements impair the technical and non-technical skills of health professionals.2
We completed a questionnaire-based study at our dental clinics in the Aga Khan University with oxygen saturation and pulse rates assessed in 35 staff members. The results were in line with the study conducted by Yánez et al.2who suggested impaired visibility and communication, increased fatigue, headache and dissatisfaction with work. Furthermore, there was a statistically significant drop in oxygen saturation and increase in pulse rate after wearing PPE for four hours as compared to baseline.
Another finding was that most of the participants tended to adjust their N95 mask intermittently for breathing issues which raised the risk of self-contamination.3 How long this pandemic may last is anybody's guess and therefore the strict PPE requirements are unlikely to change soon. Consequently, we recommend further studies are required to observe the long-term effect of PPE on the general health of the wearer.
References
Press release. New personal protective equipment (PPE) guidance for NHS teams. 2 April 2020. Available at: https://www.gov.uk/government/news/new-personal-protective-equipment-ppe-guidance-for-nhs-teams (accessed August 2020).
Yánez BenÃtez C, Güemes A, Aranda J et al. Impact of personal protective equipment on surgical performance during the COVID-19 pandemic. World J Surg 2020; 44: 2842-2847.
Umer F, Haji Z, Zafar K. Role of respirators in controlling the spread of novel coronavirus (COVID-19) amongst dental healthcare providers: a review. Int Endod J 2020; 53: 1062-1067.
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Umer, F., Devi, K. & Jamal, S. PPE: a coin with two sides. Br Dent J 229, 210 (2020). https://doi.org/10.1038/s41415-020-2078-5
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DOI: https://doi.org/10.1038/s41415-020-2078-5