As the novel coronavirus reaches more countries and U.S. cities, infecting over 90,000 people, killing at least 3,100 and prompting the governors of Washington, Florida and, most recently, California to declare states of emergency, the general public is scrambling to purchase masks in hopes of protecting themselves from infection ― an effort that health officials say is misguided and could lead to critical shortages for the health care providers who are required to wear them when caring for or transporting patients.

Many large manufacturers in China, where a majority of face masks are produced, are operating at a fraction of normal capacity and are reportedly restricting exports to protect their supply for the more than 80,000 people infected in that country.

With medical and dental suppliers racing to keep up with the spike in demand, dentists are reporting that they are running low on masks and are contacting CDA with questions about their options to ensure they can continue to protect themselves and their patients and comply with infection control regulations.

Mask supply and purchasing

Online dental supply companies, including The Dentists Supply Company and Henry Schein, have taken measures in recent days to address the growing demand for masks.

In a notice on its website, TDSC stated that it is closely monitoring all orders that include masks and has implemented some restrictions in response to demand and to “minimize disruption within daily practice operations.” Those restrictions include (1) stopping the sale of masks to dental students, (2) limiting order quantities of masks to 20 boxes per week for existing customers and five boxes per week for new customers, and (3) adding an extra layer of validation to ensure the company is only fulfilling orders for licensed member dentists who are having mask orders shipped to their practice. Given the volatile situation, these restrictions could change as supply warrants.

Additionally, as some manufacturers have raised their prices on masks, TDSC has passed those increases along to purchasers. TDSC stated it is “working closely with our manufacturer and supplier partners to secure inventory to meet our customers’ needs” and will revert to regular operations as soon as the market allows.

Henry Schein Dental, in a notice posted on its website, said, “Given this situation and acute market needs, we anticipate disruptions to orders for certain infection products in various markets.” The notice requests that purchasers contact their local Henry Schein consultant for specific inventory quantities.

In a March 2 news release, the U.S. Food and Drug Administration, which regulates face masks and other personal protective equipment, announced a joint effort with the Centers for Disease Control and Prevention to make more respirators available “to meet the needs of the U.S. health care system” noting the “increased demand and supply challenges.” The masks will not be available to the public.

Also, Gov. Gavin Newsom on March 4 declared a state of emergency in California “to make additional resources available” to help the state prepare for broader spread of COVID-19.

CDA is working with the CDC and state government to minimize the impact of limited face masks and other PPE for dental practitioners. In the meantime, health care facilities can continue to report any supply disruptions to deviceshortages@fda.hhs.gov.

Use of disposable and cloth masks, face shields

Currently, Dental Board of California regulation states that all dental health care personnel “shall wear surgical facemasks in combination with either chin length plastic face shields or protective eyewear whenever there is potential for aerosol spray, splashing or spattering of the following: droplet nuclei, blood, chemical or germicidal agents or OPIM” – other potentially infectious material. The combination of face wear is intended to securely close the gap between the shield and the provider’s jacket or gown.

The dental board regulation is consistent with the CDC’s guidelines on the use of face masks by health care personnel.

Masks labeled for single use are regulated by the FDA and considered disposable devices and should not be washed or sterilized for the purpose of reusing with patients. Also, cloth masks were shown to be not as effective as regular masks worn by health care workers, according to a study published in the British Medical Journal in 2015.

In the interest of patient and employee safety, CDA Practice Support recommends that dental practices with a low supply of masks reschedule their patients to a time when they are resupplied with masks.

Watch for important updates on CDA’s new COVID-19 information and resource page.

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