Why I Use The D.A.S.H. - Moorestown Orthodontics: Robert Kazmierski DMD, MS
Why use the D.A.S.H.?
First and foremost is safety. The CDC considers aerosols to be the primary means of transmitting the COVID-19. As they also believe it is spread before patients are symptomatic, that means that the spread is by aerosols generated during speech and speaking. While dental aerosols have unknown infectivity, they are a definite source of aerosols containing viruses and bacteria.
In my opinion there are 3 current options that we have with regard to dental aerosols.
The 1st is that we can ignore dental aerosols. That means that we either believe that they are non-infectious or that we rely 100% on our PPE to protect us from them. In my opinion, PPE should be the last defense not the first.
The second is that we can use our side unit high speed suctions. However, the best of these captures 90% of aerosols. The video shows how much that 10% left over is and how much a standard dental suction misses. Our testing shows that, adding a funnel to a dental delivery unit high speed evacuator makes the aerosol removal even worse. The fog evacuation videos show this. Given the current situation, any solution that relies exclusively on dental side unit high speed suction does not feel safe to me.
The third is that we can buy one of those high powered extra-oral dental suctions that look like an elephant with their trunk. While these are on the right track, they lack in 2 important ways. The 1st is that they do not act like a medical hood. As they do not surround the working area, there is still a lot of aerosol that they miss. The second is that almost all of these units are not HEPA certified and they are not certified to have no blow around of the filter.
In my opinion, the D.A.S.H. solves all 3 problems. The videos show how much of the fog aerosol that the D.A.S.H. collects. In my opinion, the D.A.S.H. beats dental side unit high speed suctions by light years. The ability to surround the patient with the D.A.S.H. hood, blows the elephant like units out of the water as well. As a vacuum source, I use a real, and relatively inexpensive ($350) powerful external suction unit that is EPA and HEPA certified and certified to have no blow around of the filter.
With regards to our procedures, patients do not remove their masks until they are under the hood and they place them back before the hood is removed. Suction is on only during aerosol producing procedures. Adult patients actually report that they like the vacuum sound. We forget how much patients hate the sound of the “drill”. The D.A.S.H. still acts as a splatter barrier when the suction is not on.
Having these in my personal practice is already a win for me. I wanted to use both a high speed and low speed handpiece and A/W syringe whenever I wanted while still feeling safe and having my staff feel safe. I currently have that and do that.