A scoping review of surgical masks and N95 filtering facepiece respirators: Learning from the past to guide the future of dentistry

Highlights

• •

  N95 respirators are equivalent to type 3 face masks in preventing infection transmission.

• •

  Proper donning and doffing is critical for safe use of PPE.

• •

  Face shields should be used only in combination with lower face protection.

• •

  High volume evacuation helps to limit the production of aerosolized particles at the source.

Abstract

With the 2019 emergence of coronavirus disease 19 (colloquially called COVID-19) came renewed public concern about airborne and aerosolized virus transmission. Accompanying this concern were many conflicting dialogues about which forms of personal protective equipment best protect dental health care practitioners and their patients from viral exposure. In this comprehensive review we provide a thorough and critical assessment of face masks and face shields, some of the most frequently recommended personal safeguards against viral infection.

We begin by describing the function and practicality of the most common mask types used in dentistry: procedural masks, surgical masks, and filtering respirator facemasks (also called N95s). This is followed by a critical assessment of mask use based on a review of published evidence in three key domains: the degree to which each mask type is shown to protect against airborne and aerosolized disease, the reported likelihood for non-compliance among mask users, and risk factors associated with both proper and improper mask use. We use this information to conclude our review with several practical, evidence-based recommendations for mask use in dental and dental educational clinics.