Experts Weigh in On Air Quality, Equipment and Office Design
July 16, 2020
Recorded in June 2020.
Want to know what you’ll learn before watching?
When COVID hit, Benco created a future of dentistry task force because we wanted to be at the forefront of solutions. We also wanted to ensure practitioners were excited to get handpieces back in their hands while keeping patients and staff safe.
In this educational webinar, you’ll learn:
The various techniques to improve air quality in your practice
About the benefits and the technology behind extraoral suction
How the design of your practice should respond to need infection control needs
Read the full webinar transcription below.
Kay Huff [00:00:06] Welcome, everyone. We’re excited to share some great information with you, and I’m very excited to introduce Julie. Julie, can you tell me a little bit more about this Future of Dentistry course?
Julie [00:00:25] Sure. First, good afternoon everyone. So, when COVID initially hit back in late March, Benco created a future of dentistry task force because we wanted to be at the forefront of solutions, and we wanted to apply the protocols that came from the FDA, ADA, CDC and other state regulators. But we also wanted to ensure practitioners were excited to get handpieces back in their hand and let patients feel safe. So, the task force came together to look at the following initiatives. We looked at PPE that could be from masks to gloves to gowns, COVID testing, air quality that looks at ambient air as well as aerosol air and design of the future. We focus on all the protocols and recommendations that come through from all those federal and state agencies. We wanted to look at education options as well as any clinical practice or enhancements that hygienists or practitioners would need to make in this post-COVID world.
Kay Huff [00:01:37] Wow, that sounds fantastic. I would imagine that once you get that many experts together, you get a lot of great feedback, right?
Julie [00:01:44] You get a lot of feedback and the team did a fantastic job. Just vetting through hundreds and I mean hundreds of companies through all those different initiatives because we wanted to make sure that we brought the best of the class to the Benco customers and practitioners in general. We wanted to do the research just because the way COVID hit, we were all unprepared. And then we were all inundated with all these different options. And we wanted to be able to create a team that created the recommendations for practitioners. We wanted to get dentistry back. But more importantly, we wanted to get it back safely.
Kay Huff [00:02:28] I’m super excited about today. I really want to get this started because we have a lot of great information to give out today. If for any reason we don’t get to your question today, don’t worry. We are going to answer all the questions and send out every single one of those Q&As to everyone who is on today. With that being said, this is my favorite part. I get to introduce the person who puts everyone together to make sure all these teams are put together correctly, and all the hiring and everything that happens behind the scenes. We can’t do it without him. I would like to introduce the managing director of Benco Dental, Chuck Cohen.
Chuck Cohen [00:03:30] Kay, that’s great. Thank you very much for having me. And your introduction for me gets better and better all the time. It just feeds my ego more and more. So, I appreciate that. Truly, this is one of my favorite webinars that we do because the future of dentistry is where we should be. Our mission statement at Benco is “We drive dentistry forward through our innovative solutions and our caring family culture”. And this webinar really brings all of that together. We’ve got five Benco experts who are going to talk to you today about where dentistry is going in a post-COVID-19 world. Paul Jackson, Principal Researcher and all-around dental guy. Melissa Sprau, who heads our Design Department and comes from a very strong background of overall health care design and how it applies to dentistry. Sue Evans, who has been with Benco for over three decades and understands more about equipment than probably anyone else out there and has been researching and studying air quality issues. And then Julie Radzyminski, who you heard from before. I’m going to turn over to this expert team. You are in for a treat today. And our job is to predict where the puck is going. And to help you get there before it gets there. So, welcome everybody, and thank you. I think the first speaker will be Melissa, correct?
Melissa Sprau [00:04:44] So, as Chuck mentioned I’m Melissa Sprau and I manage our design department here at Benco Dental. Before I came on board at Benco, I designed hospitals. When the COVID crisis hit, it put us in a unique position because a lot of the issues that we’re seeing around air quality, infection control and the interim recommendations of the CDC, are very much aligned with what has been happening in the hospital world for decades. I’ll also share with you that my husband is a dentist and has an independent dental practice. I’ve been looking at this COVID crisis not only with my designer hat on, but also, as a practice owner. He and I have spent the last several weeks huddling at the beginning of the day and the end of the day trying to figure out what’s next and what’s best. Having this personal connection helps our design department position needs that are spot on with what dentists need to get back to work and get patients back in the chair. The COVID crisis is unlike anything that we’ve seen in the dental design world so far. It has changed the needs of the dental office. It changed the physical needs and the safety needs of the practitioners and patients. And design is really a response to the needs of the people using a space. We’ve really taken this opportunity at Benco to examine what these needs are so we can position a multitude of solutions to our customers to walk away with. Now, of course, the ADA and the CDC have put out some interim guidance. It’s evolving. It’s changed a few times since we’ve been involved in this process and it doesn’t answer everything. There’s still a lot of unknowns. But the challenge is, we need solutions now because we have customers who are back to work and who want to get back to work. We have customers with design projects on the horizon, so we’re using this opportunity to do our best thinking and share it with all of you. We encourage you to keep up to date with the protocols and recommendations from the ADA and CDC. As we walk through some of these solutions, there is no one-size-fits-all solution that will work for all practices. There’s a spectrum of safety, infection control and comfort that is on the horizon for many practices. We always like to present choice to lead with choice and there might be a combination of solutions that may work best for you. It’s about addressing the physical space, how you furnish and outfit the space, what equipment you use and of course air quality is a huge factor that weighs in as well. Whether it’s built directly into the design and the HVAC system or if it’s addressed in other ways, like extra oral suction and air purification, which we’ll talk about in just a little bit. But let’s start by reviewing some of the new needs that have come out of this pandemic. When you look at functional space needs – needs that require a designated space in your office, whether that be an existing space that changes, a repurposed space, or something new. We have patient screening that now has to take place. I think the important takeaway is to put some thought into what your patient screening protocol is going to be. Make sure that you have the required tools where you need them so that that process run smoothly.
Melissa Sprau [00:08:32] We’re also seeing additional clean storage needs. We have loads of extra PPE that we haven’t had to deal with before. So, where do we store these things? And furthermore, where do we put these things on? Where do we take them off? How do we deal with soiled linens? How do we deal with all this increased extra storage? The other thing that we are recommending in response to COVID, is closed sterilization areas that are separate from clean supply. Again, this isn’t coming from the ADA or the CDC. This is coming from what hospitals have been doing for decades. We’ll talk a little bit more about that. But in a hospital environment, it’s very important to keep clean and dirty spaces separate. So, we’ll talk about how that can apply to dentistry.
Melissa Sprau [00:09:20] Then when we think about safety and comfort needs, there are some design responses that we need just to make people feel better and feel more comfortable. There’s increased emphasis on hand hygiene and respiratory etiquette. You may have noticed in the ADA’s recommendations for practices reopening, to have supplies for hygiene visible throughout your practice. We’ll talk more about how to place those. Personal distancing is, of course, recommended by the CDC. We’ll talk about how that overlays when you look at your reception space.
Melissa Sprau [00:09:56] There’s additional needs for privacy as well. Sometimes just having a screen or a barrier gives you the sense or perception of privacy. And we’re also seeing a greater need for materials that are cleanable and durable.
Melissa Sprau [00:10:23] I thought that it would be best to tell a story of our solutions using images. You’ll see some of the sketches here that our design team put together. And we’ll start in reception.
Melissa Sprau [00:10:34] One of the biggest things we’re seeing as practices reopen is “What do I do with my reception space”? “Do I take every other chair away”? “Do I take all of the seats out of my reception space”? Over the last several weeks, we’ve been studying how to make reception spaces inviting. You want them to be reflective of your values and set the tone for the rest of the patient’s experience at your practice. It’s so important. So, how do we incorporate these new COVID needs like personal distancing, and still make the reception space feel the way we want it to feel? You can see we’ve been doing some research about what it looks like as we start incorporating screens and partitions. What does it look like as we space our seating apart? We can incorporate different seating types, different groupings and variety. As you can see, they add a lot of visual interest to the space if they comply with the needs to remain a little bit farther apart. Privacy screens are a big one. We’re recommending screens that are movable. I think we want as much flexibility with a lot of these COVID recommendations as possible because our environment is changing so much. The ADA is saying you need a box of tissues, alcohol-based hand sanitizer, a trash can and any signs that instruct patients about new protocols or respiratory etiquette. One of my favorite design tips is to utilize trays. You can also place signage in a nice frame, which creates a simple and clean way for incorporating these recommendations.
Melissa Sprau [00:12:46] Again here’s another example of utilizing screens and different groupings and types of seedings to address reception spaces. So, by varying the seating, it’s going to add some interest. It’s also important during this time to make sure that the seating and the furnishings within your reception space are durable and cleanable. Many of our customers want to go to Wayfair, OfficeMax or T.J. Maxx and find a stylish waiting room seat, but it doesn’t mean that it’s going to withstand the CDC recommended cleaning protocols. Here at Benco, we’re a Herman Miller dealer. But any commercial furniture manufacturer that’s designated to the healthcare market, is going to build furniture with materials that are designed to withstand heavy use. So, they’re going to be much more durable. They’re going to look better longer, and all of the materials are going to be able to withstand the heavy cleaning protocols. And again, we want to keep screens and partitions movable and flexible.
Melissa Sprau [00:13:50] We also have design customers all across the country. But not a lot of places have the luxury of a large reception space. I was on a call with our sales region in Manhattan and they said, “What do our customers do”? Here in the city, you don’t have the luxury of being able to wait in your car. I think just simple screens in between the seats, as you can see in the rendering on the left-hand side. Screens are appropriate at reception desks as well. I think you want to weigh the pros and cons. What’s interesting is there’s very little research about the effectiveness of screens in terms of containing error. Hopefully, we’re looking at the pandemic as a reason to really spark some additional research around this area. But we know that a screen is certainly something that can cue a behavior or make people feel a little bit safer. So that said, our recommendation – if you’re looking to incorporate screens in your practice, whether in reception or at the front desk, make them movable and make them flexible. I don’t think there’s any reason to make a large investment. Spending ten or fifteen thousand dollars to close your reception space in glass or plexiglass may not be a good idea when our needs could very well evolve six months or a year from now. The other thing that’s interesting about screens is there’s an acoustic change that will happen from one side of the desk to the other. So, our recommendation is keep it movable and keep it flexible.
Melissa Sprau [00:15:36] So, let’s talk about operatories. What we are seeing and promoting at Benco is the move back to closed operatories. We think that it’s a great solution for a number of reasons. I think it’s a myth that open operatories save space. Coming from a department that plans about a thousand offices a year, I can tell you that open bay operatories don’t really save a lot of space, if any at all.
Melissa Sprau [00:16:10] Center islands are big. There are clearances required all around, especially when you’re sharing the sink in between. Don’t let space savings deter you from looking at a closed operatory versus an open operatory. We also have a lot of customers who say, “Oh, I like the openness and the lightness that you can achieve with open bays”. There are actually ways to do that with closed operatories. You can incorporate what we call clear story windows. If you were to take the top 18 inches or two feet of your operatory walls, you can insert things like glass, Plexiglas panels or decorative resins to create a feeling of lightness and share some lightness between the rooms, but still allowing for privacy. You’ll see in the rendering on the left-hand side, we’re showing a dual entry operatory which is very common, and there’s ways to add doors to make these private that are minimally invasive. We’re showing a pocket door on the left-hand side and on the right, which is the assistant entrance, is a barn door that opens on the corridor side. These are great ways to add doors to your practices without taking up a lot of swing space with doors that open and close in traditional ways. Another exciting thing that we’re studying here at Benco is the concept of distributed waiting or decentralized waiting. We can make the reception space of a dental practice smaller and incorporate a small vestibule at the outside of each operatory. You can see it on the right-hand side of the rendering that has a couple of seats. This is an interesting concept and it’s something that hospitals across the country are doing, especially when it comes to emergency rooms. Let’s get patients out of the waiting room and triaged right away to a sub waiting space. In dentistry, this space could be used for a variety of things. You’ll see a screen that’s mounted there on the back of the 12 o’clock wall that can be used for patient education or patient engagement. They can pick their favorite Netflix channel while they wait. This can also be used for patient intake. It can be used for billing. And it’s a great space to be used for consultation. So, a little bit of a different concept, but that’s one of our favorite things that we like to do here in our design department, is approach these new problems in creative ways. And this is one that we haven’t seen before and demonstrate that we’re happy to explore.
Melissa Sprau [00:18:38] I also get asked very often, “What do I do if I have existing open bays”? “How can I close these off or create a sense of privacy”? There are a lot of awesome screen vendors that have come to the market. Now, a screen doesn’t necessarily mean that contaminated air can’t travel or circulate around. There’s really no foolproof way of closing off operatories. However, if it creates that sense of security, or safety, in my opinion, it’s a win. There are different mounting styles. There are screens that can hang from the ceiling. There are screens that have a magnet at the top and can attach right to your ceiling grid. These screens also have an acoustic property, which I think is very valuable. Open bays can be a little loud just by design. Acoustic materials might seem soft when you look at them, right? When they’re soft they can absorb sound. But believe it or not, the image that you see here is made of PET, which is basically a fiber that’s made of plastic. Even though this is soft looking, sound absorbing material, you can spray it with an EPA registered disinfectant, and it will hold up beautifully. This style has perforations. They’re available both with and without. But we think that screens are a great solution for open bays.
Melissa Sprau [00:20:13] The other thing that you can do if you’re looking to close your open bays is simple hospital grade privacy curtains. It’s not ideal, but if done well, it can be just fine from an aesthetic standpoint. I think the important thing to do if you are looking at curtains to separate your bays, is to find a local hospital linen company. They’re going to do a couple of things. First, they’re very good at how they can design and manipulate the overhead track. It can make tight curves. It can fit around very specific spaces, if done well. A hospital linen company is also going to look at healthcare grade curtains. They’re easy to clean and some of them even have anti-microbial coatings over top for an extra layer of protection. The other thing to be mindful of as you separate open bays is the sprinklers that are overhead. There’s a lot of things overhead in a dental office. You’ve got ceiling lights. You’ve got X-rays mounted on the wall – a lot of things that can clash and interfere. But I think most folks don’t register that there’s sprinklers up there as well and those sprinklers have a very important life safety component and a code component to the design of your practice. The code states that you need to have 18 inches of clearance between your ceiling and any obstruction to allow the sprinklers to spray with the appropriate span to protect in the event of a fire. So, a hospital grade privacy curtain will have 18 inches of mesh up at the top for just that reason.
Melissa Sprau [00:21:52] Another thing that we’re studying at Benco, as I alluded to in the beginning of the presentation, was separation of sterilization and clean supply. Again, this is not a mandate by the CDC or the ADA, but as we’re doing our best thinking in response to the pandemic, we know that hospitals have been separating clean and dirty spaces for quite some time. Sterilization or dirty spaces are designed with negative air pressure and clean supply spaces are designed with positive air pressure. Negative air keeps the contaminants in that room from going out and contaminating other areas of the practice. It’s ideally exhaustive, directly outdoors, whereas positive air pressure is going to have a constant intake of fresh air to keep the clean supplies clean. When you think about the dental sterilization process, it’s really been the same for quite a long time. And the COVID crisis is a great opportunity to look at how can we make this better. A couple of things that we’re looking at is – what if a sterilization space, in addition to being a closed designated room, had a drop off window for cassettes. We know that sterilization is like the kitchen island of a dental practice. It’s very busy. There’s a lot of in and out. But imagine how we can affect infection control if we can drop off dirty materials without having to enter the dirty space. There’s a great benefit there. You’ll also see in this plan that there’s a pass-through window up at the top between sterilization and clean. The thought here is that after you have your cassettes wrapped and everything is clean, you place them in that window and they can be accessed from the clean side. It gives you the ability to grab clean supplies from a clean room and bring them out to where they need to go without having to enter a dirty space.
Melissa Sprau [00:24:01] You’ll also notice in clean supply and even in sterilization, a lot of storage. I think storage is often overlooked in a practice. But as we are looking at increased PPE, it’s so important. And I’ll give you a couple of tips on incorporating it. One is to close off. Say you have an existing sterilization center that’s galley style. We love the use of barn doors. We find that they’re very versatile and they’re space saving. So, it gives you the ability to close a room without having a door swing take up valuable square footage.
Melissa Sprau [00:24:40] Just a couple of thoughts around clean supply storage, especially as we deal with all this increased PPE. You should not be storing your boxes of PPE down on the floor. Everything should be elevated. Even some simple designated wire shelving is an inexpensive way to give you some extra square footage. Of course, we love tip out bins in our design department. We think that it’s just a powerhouse way to add organized, concise storage that doesn’t take up a lot of square footage.
Melissa Sprau [00:25:15] When you look at the design of a hospital space, they have what are called designated donning rooms. This might be something for you to consider if you’re renovating a practice or if you’re building new. Of course, existing practices don’t typically have the luxury of adding a new space with a completely new function. But as we look at the future of practice design, I think it’s important to consider a designated donning and PPE storage spaces. As you look at this rendering, this is what it would look like in a hospital space. It could be very appropriate for dental as well. The important things are we want to keep this separate from sterilization. Sterilization is considered a dirty space and we want to make sure that there’s adequate storage for that PPE.
Melissa Sprau [00:26:00] This also brings us to “What do we do with all of the soiled materials that we are taking off”? Hospitals have designated duffing spaces where let’s say somebody comes out of surgery and before they leave the surgery suite they have a room where they can take off all of their contaminated PPE, put it in a bin, and then they’re able to leave the room without taking any of that dirty stuff with them. Now, I know that CDC recommendations are saying to doff your disposable gown within the room, but there are still a couple of things to think through. For example, if you’re utilizing a laundry service to deal with lab coats, we must think through where you’re going to store dirty scrubs or dirty lab coats. Hospitals have what they call soiled folding spaces. It’s basically a room where you can keep all the soiled material. It’s closed off. It’s designated. It’s not going to contaminate anything. And then you have safe keeping for the soiled material until they can be removed by your linen company or even by your own staff if you’re doing your own laundry. It’s just kind of a nice place to store in the interim.
Melissa Sprau [00:27:14] On-site laundry is also something to consider in dental practices moving forward. A lot of practices have them. We do have customers who recommend them. But I think asking customers who are undergoing renovations or new builds is important. For practices who are doing laundry onsite, these are just a couple of different ways that we have approached it. In the past we would often incorporate it into a team space. What’s not shown in this rendering is it’s nice to have a wall of lockers in between to separate these two functions. And of course, stackable units are a nice space saving way to deal with onsite laundry as well.
Melissa Sprau [00:28:05] While we’re on the topic of team spaces, I think the pandemic has caused us to think about people returning to work. They’re returning to a very different environment. We have a lot of unknowns. There are staff members who might have anxiety or concern about their safety. You want to make sure that you are nurturing your staff in a way that allows them to bring their best selves to work every day. And I think a simple way to accomplish this through design is to give a little bit of love to your team space or your break room. Often these are afterthoughts, but I think it’s important that every team member have a place to hang your hat by simply having a designated locker, cubby or a hook. It just builds a sense of comfort and a sense of camaraderie, and it makes your staff feel important that they have this little space. Also, think of your team space as an area of respite. It’s important for our mental health and for our well-being to have that space where you can turn it off for a little bit, have some lunch, or a cup of coffee. This is a great time to really upgrade your team space in that regard.
Melissa Sprau [00:29:33] I’ll leave you with just a couple of additional resources. We’re constantly asking why and how to bring better solutions to our customers as our post-COVID world evolves. On our website underneath the COVID-19 header, we did a whole hour on practice design for post-COVID. So, please check that out. I talk a little bit deeper about each of these spaces and the functional and psychological needs that have stemmed from the pandemic and how they affect design. We are also working through a white paper strategy. We have a series of white papers focused specifically on dental design that are in editing as we speak. So, keep an eye out for those. It was really exciting to do our best thinking there and really put it out for our customers to use. And you also may be familiar with our Build Your Future workshops. Traditionally these are two-day CE events at our CenterPoint locations. We talk all about everything you need to know to design or renovate a practice. We’re in the process of moving this online and we’re excited about it. It’s going to be a master class format. So, please keep an eye out for that and we hope to see you there. With that I’m going to pass it over to Paul Jackson, our Principal Researcher. He is going to share some information with you on the latest CDC and ADA guidance. Paul.
Paul Jackson [00:31:22] Thank you, Melissa. We take a lot of guidance from the CDC and the ADA, as well as other research that we do and other sources. But with that said, I do want to cover a couple of things and make some recommendations. The ADA has a tool kit you can download for free. It’s a step-by-step guide for starting your practice up and ideas for keeping your patients, yourself and your staff safe. They’re science-based recommendations, not regulations. They give you guidance on how to incorporate these safety ideas and safety recommendations into your practice.
Paul Jackson [00:33:15] The CDC updated their recommendations on June 17th. There were three things that they specifically covered. They recommended to let your room rest for 15 minutes before you cleaned and disinfected it after the patient left. They have since changed it, by removing the wait time. The ADA did say that they recommend keeping the wait time. The second recommendation is on patients. If they were in your office and ended up getting infected or becoming sick, they should contact you within two days of being in the practice. The third is air quality which has been a subject for more than 20 years in dental offices. Specifically, they talk a lot about ventilation systems. Sue’s going to talk about how to reduce aerosols at their source. A lot of people are talking about UV, but they’re talking about it up in the filtration in the HVAC or in a separate unit, not UVC for running a light around the room. There’s a lot of discussion on foggers and what goes into them. And then it does have ideas around barriers that Melissa talked a lot about. You can use them to separate patients, but you can also use them for separating the airflow. If you have a filter unit, it can be more efficient for this space and you can design it with the air turn over for another space. So, with that, I’d like to pass to Sue Evans and she’s going to talk about air quality.
Sue Evans [00:37:57] Hello everyone. My name is Susan Evans. As Chuck had mentioned, I have been here a long time and I’m proud to work with a team that has been working behind the scenes to bring you products that are going to provide a safer environment for you, your staff and your patients. I just wanted to say thank you for letting us be a confidant in talking to you about these products, because we feel that working with Benco or any good dealer, they’re going to ensure that you’re getting a product from a reputable manufacturer and that Benco and the manufacturer will stand behind the product. I just wanted to take a few minutes to review some of the various products that we can help you with. We have various solutions with central evacuation systems, portable chair side evacuation systems, central air, as well as portable air and a little new and innovative product that Paul will talk about a little bit later. These products can be implemented immediately, such as the mobile systems or systems that are longer term that can be installed in the ceiling or self-contained in your HVAC systems.
Sue Evans [00:39:28] Let’s talk about the centralized system. Nederman is a centralized system that literally can mount above your ceiling. What’s nice about the Nederman system is that it takes away the concern about space on the floor in the area where the hygienist and doctor have to be working. But there are multiple solutions. The most convenient would be above the ceiling, but there are multiple solutions to be able to mount that. They have these three really neat, innovative solutions around the arms that you are able to move these 360 to get as close to the oral cavity as possible, utilizes HEPA filtration, which is what we’ve been talking about that there are various levels of HEPA filtration. But what’s most important is the medical HEPA filtration that is incorporated. And this system vents outdoors. And what’s cool about it is if you can implement this long term into your practice, it really is around the same cost as what you would be investing in in a mobile system.
Sue Evans [00:40:49] You’ll see here that these are examples of extraoral mobile suction systems that we carry here at Benco. They vary based on different levels of filtration. As mentioned, they provide additional safety measures that include UVC lighting that is effective at killing the bacteria or virus. And these are mobile and go right into the operatories and can get close to the oral cavity to capture additional bacteria that is airborne. These systems will also vary by decibel levels, but not much over what you would find in a normal conversation in an operatory.
Sue Evans [00:41:38] I’d like to go over what is a little test that we learned about with one of the systems that we carry called the ADS, and this test was done at Temple University. As you can see, there’s pictures here that show that they used paper filters and dye to try to capture aerosol as it lands during an aerosol producing procedure.
Sue Evans [00:42:11] The question that was posed is “What is the value of the aerosol that is generated from using a hand piece and real-life clinical settings”? The Dean at Temple University volunteered as a patient. They had two fully PPE dentists and operated a handpiece close to his teeth for five minutes using regular saliva injectors and HVE suction. They used red dye and white filter papers. The results surprised us. The aerosol cumulated on his chest and on the side of the dental assistant where you see the papers using regular suction.
Sue Evans [00:43:36] Here we’re showing a few air purification systems that can be mobile or implemented into your ceiling grids. Vida Shield, which is a unit that we just implemented into our offering, is a 24/7 active air purification system. It is a patented device that combines ultraviolet germicidal irrigation chamber and circulating fans with an overhead ceiling light to reduce the germs in the air. The innovative design helps treat the air and allows for ambient lighting and UVC to help kill. It’s certainly a space saver because it can be installed in a standard two by four drop ceiling. They have different options that you can get. One could be just a total duration and one can be with UV as well as the ambient lighting.
Sue Evans [00:44:52] This is where I’m going to hand it back to Paul because it’s a cool innovative product that we learned about recently and we’re in the testing phase and we’ve gotten some feedback that seems to be very promising.
Paul Jackson [00:45:05] Thank you Sue. If you think of a PAPR, it’s like we’re talking about air quality so, it’s between PPE and air quality that’s in the operatory. It’s personal airspace. It’s a positive pressure device. There’s a filtered fan that pushes air into the space around your face and it’s sealed but not completely sealed because it’s positive pressure. If there are any leaks, the leaks just go outside. It’s all filtered and there’s a small HEPA filter that’s built into the unit. This one is made by Gentex. They’re a company that has been making PAPRS for a while – more than 10 years and mostly for other industries. You probably have seen some of these PAPRS where it’s like a hood. But this is not invasive. It’s less invasive. It’s light and weighs a little less than three pounds. It is a little heavier than some other PAPRS because the fan and the filter are built into the headpiece. It has an advantage because it’s less pieces. If you have four-handed dentistry, the aerosol is reduced by 80 or 90 percent. But as we said, there’s not one solution for all. This PAPR could be a real answer for hygiene. We’re still evaluating to make sure that it’s practical for dental. But this is a very popular unit that’s used, as I mentioned, in other non-health care industries. But it’s also very popular in hospitals.
Sue Evans [00:48:20] I just wanted to have one last take away. We do have a brochure that can be electronically sent to you. But it’s a brochure that really gives more information and allows you to compare all the different products that I had mentioned and even more.