How to Reduce Fallow Time in Dentistry
To minimise aerosol transmission of Covid-19, England’s CDO introduced the concept of fallow time – downtime in the surgery following an aerosol generating procedure (AGP) taking place.
Room ventilation
This is the number one factor in the ability to reduce fallow time. Most dental surgeries are neutral pressure rooms (i.e. there is no pressure difference between the surgery itself and the communal areas). The 60 minute recommendation is based on a single room with 6 air changes per hour (ACH). Opening windows and using air conditioning (with recirculation turned off) can increase ACH, and decrease the fallow time needed. The manufacturer of your ventilation systems can advise on the ACH capacity of your equipment, based on the room size.
High volume suction
High volume evacuation is used by 94% of surgeries (Source: BDA) and offers the best solution for removing potentially infectious aerosol particles before they leave the mouth. The best systems have exhaust air filters in place. This avoid directing unfiltered exhaust air outside the practice building. SDCEP suggest that the use of high volume suction should reduce the fallow time needed by 10 minutes.
Rubber Dam
By isolating the work area from saliva and blood in the mouth, rubber dam can help reduce the amount of aerosol generated. SDCEP believe that the use of rubber dam can reduce the fallow time needed by 5 minutes.
Extra-Oral Suction
Stand-alone units such as the high power BA Optima EOS-350 can help efficiently purify air and capture airborne aerosols. Medical grade triple layer HEPA filters are combined with UV-C lamps to trap then sterilise viruses and bacteria. The units are mobile, lightweight and can easily be moved between surgeries.
Cold Fogging
Some practices have introduced cold fogging: a technique that normally involves releasing a solution containing Hypochlorous acid (LOCl). Sometimes a combination of silver ions and hydrogen peroxide is used instead. The droplets are in the form of a mist of particles with less than 20 micrometres diameter.
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