Tufts Dentist Had a Clear Vision for Protecting Health Care Workers

Years of research and advocacy pay off with approval of new safety standards
A dentist wearing a face shield prepares to work on a patient.
Face shields, adopted by dentists for COVID protection, also meet the new national eye-safety standards for health care workers. Photo: Shutterstock
September 23, 2021

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A new national safety standard intended to prevent eye injuries to dentists and other health care workers stems directly from the research and advocacy of a professor at Tufts University School of Dental Medicine.

“This has raised the bar to protect all health care workers from potential infection and injury,” says Peter Arsenault, D94, professor of comprehensive care. “I’m very proud,” he adds, noting how great it feels “to say you’ve done something that when you’re long gone will still be helping other health care providers, improving lives, and saving vision.”

The issue at hand is what is known as the “bottom gap”—the space between the lower edge of safety glasses and the wearer’s cheek. Debris, blood, saliva, aerosols and other hazardous materials can shoot though that sliver of space. It’s estimated that 70 percent of dentists have something fly into their eyes at some point in their career, and the bottom gap is at fault in most of those cases, Arsenault says. In fact, it was after he needed a trip to the ER when a shard of a silver filling injured his eye that Arsenault began exploring the problem.

Arsenault and an engineer friend—Arsenault himself trained as an engineer before going to dental school—conducted research documenting the bottom gap phenomenon. That data, in turn, was replicated by the National Institute for Occupational Safety and Health (NIOSH), and then used by the American National Standards Institute (ANSI), the nonprofit that oversees protective products for U.S. industries, as the basis for updated eye protection regulations. The federal Occupational Safety and Health Administration (OSHA) relies on ANSI standards.

The new standard, adopted this past July, requires employers to provide eye protection that obstructs the bottom gap, either through specially designed masks, face shields, or other means. Of course, many health care providers have already adopted face shields as part of their COVID-era PPE, but the new standard means the shields may likely outlive the current crisis. “It’s so relevant in light of this pandemic,” Arsenault says. “With COVID, everybody has upped the game on PPE.”

Aside from dental offices, the new standard will also apply to clinical employees at any kind of medical or veterinary facility, clinical researchers, and first responders, Arsenault says.

With colleagues from NIOSH, Arsenault is now researching potential bottom-gap hazards of the protective eyewear many patients wear while in the dental chair. The work is conducted using mannequin heads and specific spray flow simulations to map dental debris or fluids coming from the patient’s own mouth. “We need to make sure our patients are protected,” he says.

Helene Ragovin can be reached at helene.ragovin@tufts.edu.