As more businesses reopen amid the coronavirus pandemic, dental practices are considering enhanced measures to clean their facilities and equipment, as well as protect their patients and staff.
One of these tactics involves the use of ultraviolet light to sanitize the air, surfaces and equipment in dental offices. Disinfecting with UV light products is widely used in hospitals and larger medical facilities, but now small practices are looking into adopting the technology as well.
“We’re getting calls, emails, hundreds and hundreds, if not thousands of requests on a daily basis,” said Brett Messina, vice president of sales and marketing at Medical Illumination, which makes VidaShield, an air purifier that disinfects using UV light.
In mid-May, Messina estimated that 80% to 90% of the company’s new requests were coming from dental offices.
However, before committing to purchasing a product that may cost $2,000 per unit, dentists should understand the advantages and drawbacks of UV technology and know their options. This investment could be particularly costly at a time when practices may be trying to recoup profits after closing operations during the Covid-19 pandemic.
Dentists in particular may be considering new sanitizing technology in reopening their business because they use procedures where people can easily transmit the virus to one another through droplets in the air, according to Ann Marie Pettis, president-elect of the Association for Professionals in Infection Control and Epidemiology.
However, she said basic hygiene practices and protective gear should be dentists’ first step in preventing disease transmission.
“Much of what they need to do is what they probably and hopefully were already doing,” Pettis said.
They can also implement new measures such as spacing people 6 feet apart in the waiting room, staggering appointments, practicing “telephone triage” where patients are asked questions to ensure they are not sick prior to dental treatment and even temperature-screening visitors, according to Pettis.
The American Dental Association gives similar recommendations in its “Return to Work Interim Guidance Toolkit” for dentists, which does not mention UV light decontamination. In response to being asked about UV sanitizing in dental offices, ADA told CNBC it “is researching many strategies to mitigate possible routes of infection.”
“We will continue to evaluate the validity of emerging evidence and research to support any future recommendations supporting the safety and health of the public and profession,” the association said in a statement.
If dentists are interested in purchasing sanitizing equipment in addition to following ADA hygiene practices, UV light products may be a viable option. Pettis said UV sanitizing has been used in large health care facilities for years and is “very effective” in killing germs and bacteria.
UV light is also particularly useful against coronaviruses, according to Dr. Richard Martinello, an associate professor at Yale School of Medicine and medical director of the Department of Infection Prevention at Yale New Haven Hospital. Martinello is also on the board of the International Ultraviolet Association, which promotes the use of ultraviolet light in sanitizing practices.
“One good thing about the coronavirus is that it is a very fragile virus,” Martinello said. “What makes it fragile is that it has a layer of lipids, a fatty layer that coats the virus itself, and that layer is very easily disrupted.”
UV light as well as cleaning products like soap and disinfectants can destroy this layer, causing the virus to degrade and die, according to Martinello.
He said IUVA has seen an increasing interest in UV light applications since the onset of the pandemic. However, just because UV light is effective in decontaminating surfaces does not mean it’s effective for treating the virus in humans, which was an idea President Donald Trump pitched at a press briefing in April.
“There’s just absolutely no plausibility for the use of ultraviolet light to treat people with coronavirus,” Martinello said. “There should be no research in this area because it would just be an incredible waste of money.”
In addition to understanding how UV light decontaminates, dentists should also learn about the different UV sanitizing products available, which include disinfecting towers for rooms, chambers for sterilizing equipment and air purifiers.
Disinfecting towers, which are portable columns that beam UV light into a room in order to decontaminate the area, are traditionally found in hospital settings. These devices use UV-C, which is ultraviolet light with a shorter wavelength, for sanitizing.
However, staff need to take special precautions in order to use this equipment properly, including not being in the room when it is in operation, according to Nicole Greeson, director of the Occupational Hygiene and Safety Division at Duke University and a board officer of the American Industrial Hygiene Association.
“It can cause burns to the skin and to the eyes if the person was not covered with appropriate personal protective equipment, so the best means of protection is to actually have them leave the room so that they wouldn’t have exposure,” Greeson said.
She said this kind of large equipment may not be the best fit for small medical or dental practices, and that other options are available, especially when it comes sanitizing dental tools.
“UV is typically not used for equipment because there are definitely materials for which it’s not compatible,” Greeson said, citing plastic as an example.
Instead, dentists can rely on autoclaves, which are chambers that can come in small sizes and use heat to sterilize tools, according to Greeson.
However, that’s not to say there aren’t UV sterilizing chambers available.
Online dental supplies retailer Treedental has seen an increase in demand for its UV Dental Disinfection Cabinet, according to Jenny Pan, an advertising and marketing planner at the China-based company. The unit has a list price of $145 and a disinfection time of 15 minutes, and is supposed to be able to eliminate germs on glass, metal and plastic tools.
The company has been careful in mentioning UV light as being effective against the coronavirus in marketing its products, as research into this is “ongoing,” according to Pan.
“There is not enough data to say that UV lights can inactivate Covid-19,” she said.
Instead, Treedental only mentions products’ ability to “protect” against the coronavirus when advertising items like masks and gloves.
Located in San Fernando, California, Medical Illumination has taken a similar tactic in promoting its VidaShield UV light air purifier, though Messina said the product has been effective in eliminating different coronaviruses, as well as other germs and bacteria, including MRSA, tuberculosis and influenza.
“The interest in the VidaShield product has gone up significantly with the pandemic that we’re going through now,” he said. “The air is where a lot of stuff lives.”
In eliminating germs in the air, the product keeps them from settling on surfaces, according to Messina. He said the product is commonly used in hospitals, but that dental offices are becoming interested too.
Installed in the ceiling, VidaShield uses fans to draw in air from the surrounding environment and purifies it using UV-C light. It also contains either fluorescent or LED tubing allowing it double as a ceiling light panel.
VidaShield also doesn’t have the same risks as a disinfecting tower does in exposing people to UV light, as it is self-contained within the product, according to Messina.
“No UV escapes out of this unit, so it’s safe to use in an occupied space, meaning this can be on 24 hours a day, seven days a week, continually cleaning the air,” he said.
VidaShield costs anywhere from $1,400 to $2,000 per unit, depending on the model, according to Messina. Comparatively, UV light towers typically used by hospitals and other medical facilities can range in price from $25,000 to $100,000 per unit.
However, any extra cost could be a burden for businesses reopening after weeks of lost income. Messina said that in addition to dental practices, offices, daycare centers and restaurants are also making inquiries into VidaShield, and considering whether to make the investment as they reopen.
UV Resources, another manufacturer of UV light sanitizing devices, has seen a ten-fold increase in business inquiries, including from dental offices and other businesses.
“It’s been pretty crazy,” said Daniel Jones, president of UV Resources. “For the UV companies, the surge has been incredible.”
Currently facing back orders, the Santa Clarita, California-based company has been struggling to meet demand as there are a limited number of manufacturers that make the UV lamps the company needs for its products, according to Jones.
UV Resources makes Upper-Room UV-C fixtures, which are mounted on the wall in order to treat air in the environment and costs around $1,000 per unit. Unlike the VidaShield, the UV light is not contained within the unit. Instead, it emits UV light at an upward angle, creating a “kill zone” for microbes that rise in the air near the ceiling, according to Jones.
“The key is we don’t want UV to be in the lower space where people are working or walking around,” he said.
With the kill zone limited to this upper portion of the room, Jones said the product is safe to keep on 24/7 and when people are in the room. He even has one in his own home.
While UV light has been proven effective against SARS and MERS, as well as other kinds of coronaviruses, Jones said there have been limited studies looking at how it interacts with the novel virus that caused the pandemic.
“That’s why I’m really emphasizing that we are not putting out anything that says, ‘it kills Covid-19,'” Jones said regarding the marketing of his company’s products.
However, even without specific mention of the coronavirus in its marketing, UV Resources has faced a rush of inquiries from various businesses consider installing air purifiers in their offices and break rooms.
In the past, it’s been a struggle to get people to spend money on UV technology, but all that changed with the pandemic, according to Jones.
“Knowing what we know and what the entire world is having to put up with … it’s just brought UV to the top,” he said.