Frequently Asked Questions

Clean Air

Why do I even need clean air in my dental office?

Is the dental profession a high health risk profession?

Yes, the dental profession is one of the highest health risk professions there is.

According to the CDC, dental professionals are 23 times more likely to die from Idiopathic Pulmonary Fibrosis, a progressive fatal lung disease. Learn More

Hygienists, general dentists, dental assistants, and dental lab technicians occupied 4 of the
top 5 spots out of a ranking of 974 job occupations for health risks. Learn More

Do my dental procedures substantially increase the risk for spreading contagious viruses like COVID19, bacteria, and other harmful pollutants?

Yes, dental procedures that use high-speed turbine handpieces, ultrasonic scalers, and other similar equipment that create aerosols. Aerosols are airborne particles that can be laden with COVID 19, viruses, bacteria, and other pollutants. These aerosols can remain in the air and active for hours and even travel long distances.

Consequently, if these dangerous aerosols are not controlled, they can quickly travel throughout a dental office potentially infecting many. What makes aerosols so dangerous is their ability to stay in the air for long periods of time and travel great distances. It is the dental procedures that create the aerosols and why dental offices are an extremely high risk occupation for dental professionals as well as high risk for patients.

Is there still a risk of spreading COVID 19, other viruses and bacteria when there are no dental procedures occurring?

Yes. There is still a risk of aerosols spreading throughout the office, but the risk is lower than when dental procedures are taking place. Catching COVID 19 in the dental office without dental procedures is similar to catching COVID 19 in any office or indoor environment. Although, a lower risk, safety measures still need to be employed.

What methods are available to capture aerosols/pollutants during dental procedures?

What is an extra-oral vacuum system and how effective is it?

An extra-oral vacuum system is one that collects aerosol pollutants after they leave a patient’s mouth.

It has an air inlet placed near a patient’s face which is connected to an air filter via a flexible hose. Aerosol pollutants as they exit a patient’s mouth during dental procedures are drawn into the air inlet and go into the hose and down through an air filter. The air filter cleans the air of aerosol pollutants before releasing the cleaned air back into the operatory.

An extra-oral vacuum system such as Dental Safety First, Inc’s “Dental Aerosol Extractor (DAX)” can be highly effective at cleaning the air of aerosols making a much safer operatory. It can capture virtually all the aerosols exiting the mouth at a high 200 cubic feet per minute of air flow traveling at the rate of 50 mile per hour. It then cleans the air to 99.99% particles during dental procedures.

What is an intra-oral vacuum system and how effective is it?

An intra-oral vacuum system is one that tries to collect primarily water being generated by a dental procedure. They capture a small amount of the aerosol before it exits the patient’s mouth. They can be either a saliva ejector or a high-volume evacuation tip.

They have suction tips that fit inside of the patient’s mouth. The suction tip is connected to a small diameter hose with very low air flow (i.e. 6 cubic feet minute). Some aerosols are drawn out of the mouth into the tube which is then released to the outside air

These intra-oral vacuums were first designed to evacuate water out the mouth to provide moisture isolation during dental procedures. Lately they are touted to remove aerosols although they never make a claim to remove them all. Their effectiveness depends to some extent on what region of the mouth is being worked on. The procedures on the posterior teeth are easier to remove aerosols while the anterior teeth may be more problematic. In addition, the air flow rate is so low that there is little assurance that most aerosols will be removed.

What technologies are available to keep my airspace clean and how effective is each one?

• HVAC

Every dental office already has a HVAC system whose function is to heat and cool to keep comfortable temperatures. They change air 6 to 10 times per hour of which some is new fresh outside air and some recycled. The fresh air is needed to flush out the CO2 buildup from human breathing.

With significant amounts of new fresh outside air, it would seem that my dental office air is being continually cleaned. However, that is not the case. A recent study showed that less than 10% of COVID 19 virus particles were flushed out of classrooms by an HAVC system. They found that poor circulation created hot spots, safe zones, and vortexes. It left COVID 19 on surfaces. Also, air filters in HVAC systems do not effectively trap the small virus and bacteria particles.

Instead of helping, HVAC systems make it worse. They quickly pick up the dangerous virus, bacteria, etc. laden aerosols and distribute them throughout the dental office when they recycle a portion of the air. HVAC systems are clearly not the final answer to having safe, clean air in a dental office.

• Air filters

Air filters can be extremely effective at providing safe, clean air in the dental office. That is why NASA uses them in their space programs. However, it depends on the design. An air filter system properly designed is the gold standard.

The design needs to incorporate a HEPA filter. To be a HEPA filter, it must remove 99.97% of the most difficult size particles to remove down to 0.3 microns in size. Some HEPA filters are even better, but many air filters do not meet this standard. For example, a MERV 14 rated air filter removes only 75% of 0.3 micron size particles. And more challenging is that virus particles are generally smaller than 0.3 microns.

It does no good to have an excellent HEPA filter if the virus and bacteria laden aerosols are not captured well and continue to pass on through it. That is where a well-designed extra-oral vacuum system comes in to play. It vacuums the virus laden aerosols right as they exist the mouth of patients and pushes them through a HEPA filter for the air to be cleaned. When procedures are not being performed it can be cleaning the whole dental office air.

Dental Safety First, Inc’s “Dental Aerosol Extractor (DAX)” is well designed and meets the gold standard for clean safe air in dental offices.

• UV - ultraviolet light

Ultraviolet light can deactivate viruses and bacteria. However, there are many issues in using it to disinfect air in dental offices. Ultraviolet light is hazardous to health and can seriously damage eyes if viewed. With the right application, it can still be used safely in two ways.

In the first application, the UV light is only turned on safely when the dental office is closed and no one is there. It is limited in its disinfection in that in only disinfects objects that the UV light shines directly on. Surfaces like under the countertops are not addressed with overhead UV lights. Of course, there is no protection during office hours when most of virus laden aerosols are being produced. It’s simply too late to be effective.

The 2nd application is to pass air through an UV light that is enclosed, so that none of the UV lights rays escape to damage people’s eyes. The issue here is that it takes several minutes of light exposure to deactivate the viruses. If operated in this way it takes a long time if truly deactivating, whereas an HEPA air filter can trap the versus with a high rate of air volume. UV lights operated properly are simply are too slow to be effective. In many cases, air flow is increased with UV lights but when done, they become ineffective in deactivating viruses.

There is another problem, as some of the viruses can become active again in the presence of florescent lights. In addition, they do not clean the air, they only deactivate living viruses and bacteria. One still breathes them as well as enamel dust, pollen, and etc. particles. A good HEPA filter like Dental Safety First, Inc’s DAX unit traps 99.99% of all viruses, bacteria, and all other particles in the air, and most importantly keeps them all out of your lungs.

• Plasma – negative ions

Negative ions work because their negative charge attracts the positive charge of viruses and bacteria making them heavy. They fall to surfaces that still need to be cleaned and disinfected.

The jury is out on just how effective they are in deactivating viruses and bacterial. There is enough uncertainly to warrant pausing before relying on negative ions when HEPA air filters, the proven gold standard for making air safe is available.

Negative ion generators always produce some level of ozone which is also a health hazard. They never trap anything; they simply move from air to surfaces and maybe provides some unknown level of deactivation. A good HEPA filter like Dental Safety First, Inc’s DAX unit traps 99.99% of all viruses, bacteria, and all other particles in the air and keeps them all out of your lungs.

Which is Best?

How do I know which extra-oral vacuum system is best?

• High air flow in cfm
The higher the air flow measured in cubic feet per minute (cfm) generally is better extra-oral vacuum system but not always. Balance in the system vacuum is the key.

If a larger diameter hose is used, you can get a higher cfm but the air speed goes down. Also, a HEPA filter can be compromised for trapping small viruses with too much air flow. DAX not only has high 200 cfm air flow, but it is balanced for maximum air speed at the air inlet and slow speeds at the HEPA filter to trap the small viruses.

• High air flow in miles/hour at mouth
The higher the air speed measured in miles per hour (mph) at the air inlet is generally a better extra-oral vacuum system but not always. Balance is the key.

If a smaller diameter hose is used, you can get a higher mph air velocity, but then the cfm air flow volume goes down. Also, a HEPA filter can be compromised for trapping small viruses with too much air velocity. The key is generating high air velocity at the air inlet to capture the fast-moving aerosol, and then slowing the air down to very minimal speed over the filter media to actually capture the virus particles out of the air. DAX not only has high 50 mph air speed, but it is balanced for cfm air at the air inlet and extremely slow speeds at the HEPA filter to trap the small viruses.

• Ease of positioning in front of mouth
It is important that the extra-oral vacuum system is easily positioned a few inches from a patient’s mouth. The DAX unit is on casters that allow for quick general positioning. Then it’s stay in place hose/air inlet can be fine-tuned into position. Once in position it stays that way without any additional support.
• Good capture of aerosols coming from mouth – the shape is important

Any standard shaped air inlet can be used, but DAX’s patent pending air inlet is uniquely designed to provide ergonomics and the air velocity required to capture the aerosol.

The DAX unit has a removable clear shield attached to the air inlet that directs the aerosols into the air inlet and through the HEPA air filter. The patent pending removable shield improves the ability to capture the aerosol and direct it away from the professional’s face and breathing zone.

The shields are to be removed between patents, cleaned and sanitized. When scratched and worn they would be replaced.

• HEPA filter with 99.9+% particle removal
At a bare minimum an air filter needs to be a certified HEPA filter that removes 99.97% of the hardest to get 0.3 micron size particles. Each individual DAX unit HEPA filter is tested and certified to deliver 99.99% 0.3 micron particle removal.
• Low air speed through HEPA filter to capture tiny viruses

Viruses are tiny compared to bacteria and many other air pollutants. They are generally smaller than 0.3 microns and they are very hard to capture.

Tiny virus sized particles can be captured in a HEPA filter by a process of diffusion. Diffusion occurs by a combination of Brownian Motion and Van Der Waal forces which require extremely low air speed through the HEPA filter at less than 5 feet per minute, or 0.06 mph. Unless the extra-oral vacuum system slows down the air moving through the HEPA filter they will not capture all of the tiny viruses like COVID 19.

The patent pending Dax units are designed to have high 200 cfm air flow and 50 mph air speed at the ergonomic air inlet. This captures the aerosol exiting the patient’s mouth. The air is then slowed down to cross the HEPA filter at less than 5 feet per minute, or 0.06 mph in order to capture tiny COVID 19 size virus particles by diffusion. It is this superior balance, based on NASA science that make DAX truly an effective extra-oral vacuum system.

• Carbon filter for gas removal
All good extra-oral vacuum systems should have a carbon filter in addition to the HEPA filter to clean the air of off-gases. The patent pending DAX has an activated carbon prefilter.
• Mobile and easy to position in operatory
An extra-oral vacuum system should be mobile and easy to move for positioning. DAX is on deluxe casters and rolls into position easily.
• Air speed controls
An extra-oral vacuum system should have speed controls for various levels of air flow. The choice for air flow can then be better matched with the requirements of each procedure. The patent pending DAX has 4 speed settings as well as on/off positions that can be adjusted via remote control.
• Filter replacement indicator
An extra-oral vacuum system should have an indicator light to tell when it is time to replace the HEPA/carbon filters. The patent pending DAX system has a light that indicates s when to change the filter.

Day-to-Day Operations

How do I setup and maintain my DAX unit and what can I do if I have other issues?

Are there instructions for assembly and use of DAX when I first get it?

Yes, follow this link (PDF COMING SOON) to find instructions for assembly and use.

Are there Instructions for installing replacement HEPA/carbon filter?

Yes, follow this link (PDF COMING SOON) to find instructions for installing the replacement HEPA/carbon filter.

Is there someone I can call for operating/maintenance issues?

Yes, call the hot line (541-371-2760 and use prompt 3) for unresolved operating and maintenance issues.

Questions about day to day operation of DAX?

How close to the patient do I need to position the air inlet?
The closer the better but of course allowing for ample space for vision and work.
Will the air inlet obstruct my view or get in the way of doing my job?
No, there is a clear, see through shield that allows for excellent vision for work.
How easy is it to position the air inlet for each patient?
It is very easy to position the air inlet into position for work. The DAX unit is on casters that roll it into general position. Then the hose is a stay-in-place hose that is easy to position properly and stays where you put it. The unique ergonomic air inlet even has handles to make it easier to fine tune the position.
What do we do with the DAX when we don’t have a patient in the chair?
The best thing to do is to turn the DAX unit to its lowest speed setting. Push the stay in place hose toward the ceiling and let it clean the air of 99.99% particles thereby keeping the operatory air squeaky clean.
What speed should I set DAX to?
It depends what you are doing. If you are performing intense aerosol producing procedures such as using your high-speed turbine hand piece or the hygienist using an ultrasonic scaler, then the high-speed setting might be best for you. Other less intense procedures might warrant using a lower setting. Each person will find the settings that work the best for them.
How do we clean the DAX unit?
Areas that are handled often such as the air inlet and the remote control should be cleaned between patients. All other exterior surfaces can be cleaned less frequently. Avoid liquid cleaners on the remote control and the control panel of the main unit. A damp cleaning cloth is recommended.
Can we re-use the shields? Or do we need to replace them after each patient?
Yes, the shields can be reused. However, it is recommended that a freshly cleaned and disinfected shield be used for each new patient. When they become scratched and show wear they should be replaced.
How much do the shields cost?

The DAX replacement shields cost $29 for a 5 pack. They can be purchased at the Shop tab on the website dentalsafetyfirst.com/shop

Other

Questions a hygienist might ask?

I’m a hygienist and the doctor is not using an extra-oral vacuum system, why do I need it?
If you want to use your ultrasonic scaler and meet ADA and ADHA guidelines, you must use an extra-oral vacuum system like DAX.
I’m a hygienist, if I have a DAX unit, can I use my ultrasonic scaler again?
Yes, if you use a DAX unit you can use your ultrasonic scaler and meet ADA and ADHA guidelines.

Questions about extra-oral vacuum systems in general?

Is the DAX unit only needed because of the COVID 19 pandemic?

No, COVID 19 is only one of many dangerous pollutants in a dental office. Click here to see just how dangerous a dental office can be.

If they find a vaccine, will I still have a use for this equipment?

Yes, a vaccine for COVID 19 only solves one the many dangerous biological contaminants and pathogens in a dental office. Click here to see just how dangerous a dental office can be.

Does the DAX unit capture Coronavirus?

Yes, studies show that a HEPA filter calibrated to the NASA recommended air velocity of 0.06 mph, the HEPA filter captures the coronavirus by diffusion.

How does the DAX filtration compare to the N95 mask I’m wearing?

The DAX system captures 99.99% of particles whereas a N95 mask only captures 95%. Also, although the N95 masks captures 95% of particles for the wearer, the rest of the people in the dental office not wearing an N95 or equivalent mask may be exposed to the aerosol and are not protected.

Furthermore, when you take off your mask in your office you are no longer protected. You have to wear it 100% of the time and remove it outside unless you have an extra oral vacuum system like DAX. With DAX running, the aerosol is captured, contained and all the air is safely cleaned. Wearing a N95 mask simply gives you an additional level of protection with DAX.

Our doctor and staff are wearing N95 masks during procedures. So why do we need the DAX unit if the virus can’t get through our mask?

The DAX system captures 99.99% of particles whereas a N95 mask only captures 95%. Why wouldn’t you want maximum protection to protect your health? Again, although the N95 masks captures 95% of particles for the wearer, any other person in the dental office not wearing one, they are not protected.  

Furthermore, when you take it off your mask in your office you are no longer protected. You have to wear it 100% of the time and remove it outside unless you have an extra oral vacuum system like DAX. With DAX running, the aerosol is captured, contained and all the air is safely cleaned. Wearing a N95 mask simply gives you an additional level of protection with DAX.

Does the DAX unit have any benefits to my patient in the chair? What about patients waiting in the lobby?

Yes, not only does DAX contain and capture the contagious aerosols in its HEPA air filter from dental procedures, it does the same for the dental office environment. This keeps the whole office including patients and office personal safer.

Does the DAX unit mean I do not have to wear an N95 mask?

No, in order to meet ADA and ADHA guidelines you need to continue to wear N95 masks. Also, why not have extra protection by wearing a N95 mask along with using a DAX unit.

Do I still need to pre-screen my patients in their cars? Do I need to still take their temperature?

Yes, in order to meet ADA and ADHA guidelines you need to continue to pre-screen patients and take their temperature. These procedures simply add a higher level of protection against contagious diseases like COVID 19.

Questions about buying and owning a DAX?

Is there a warranty?

Yes, one year from date of invoice.

Do you offer a payment plan for DAX units?

No, not at this time.

Is the DAX unit upgradable over time?

Yes. We have built the DAX unit with sound technology and design today, but we are always looking to the future. As new technologies become available such as more efficient filters, software upgrades etc., Dental Safety First will be ready and able to support you for the life of the unit.