Hands-Free HVE

Protecting patients and staff used to be a matter of following guidelines and wearing proper personal protective equipment. But heightened awareness around aerosol reduction makes creating a safe operatory environment a bit more challenging. Here, Mary Govoni, MBA, BS, weighs in on the challenges of high-volume evacuation in the dental practice and a hands-free solution that can work for virtually any office.

Protecting patients and staff, the goal of all dental practices, comes with challenges. Whether it’s having enough personal protective equipment on hand or using evidence based protocols and tools, meeting safety requirements sometimes means learning new skills and integrating specialized equipment into your daily routine.

For instance, consider aerosol reduction. The COVID-19 pandemic brought this issue to the forefront, but it’s something dental practices always should have been focused on. So many of the procedures we perform throughout the day generate aerosols (including SARS-CoV-2, influenza, measles, and chicken pox) that can potentially jeopardize the health of patients and team members.

HVE Research

Intraoral suction (such as low-volume evacuation [LVE] and saliva ejectors) is designed to remove pooled fluids and isn't highly effective at reducing aerosols. In addition, a study by Harrel and Molinari noted that the size of the device opening plays a role in efficacy. Openings on HVE devices typically are 8 mm or larger, making them more efficient than saliva ejectors, which have much smaller openings.

A more recent study by Suprono and colleagues highlighted the effectiveness of using both HVE and LVE. The study found that the highest microbial counts appeared on agar plates placed closest to the operating zone in the treatment room. When HVE and LVE were used in combination, the lowest microbial counts were found on these agar plates.

HVE Challenge

Integrating HVE into a dental office can help achieve enhanced safety, but the larger, self-contained units can be cost-prohibitive for some practices and may require operatory changes to accommodate their installation. In addition, using HVE at chairside can be cumbersome and necessitate additional staff to hold the device while the clinician performs procedures.

HVE Solution

To address the challenges associated with HVE, Forest/DentalEZ introduced the Hands-Free HVE Holder. This device provides continuing HVE suction during aerosol-generating procedures and the holder’s flexible design means clinicians can easily position it as needed for optimal efficacy, without having to hold the device themselves or request an extra pair of hands for assistance.

The Hands-Free HVE Holder is compatible with most patient chairs and is easy to clean using common disinfectants. The kit includes the flexible HVE holder, which is preassembled with an HVE valve and tubing that connects to existing vacuum systems. The quick installation doesn’t require any tools. Anyone in the practice can tighten the holder in place, connect the tubing, and position the extraoral HVE.

Several of my clients who are using the Hands-Free HVE device say that it’s helped eliminate the struggle they previously experienced when trying to hold an HVE tip and a scaler at the same time. Now, they can position the device where they need it and use their nondominate hand for holding a mouth mirror to reflect light to the area or to retract tissue for improved visibility.

References

1. Harrel SK, Molinari J. Aerosols and splatter in dentistry. J Am Dent Assoc. 2004;135(4):429-37.

2. Suprono MS, Won J, Savignano R, et al. A clinical investigation of dental evacuation systems in reducing aerosols. J Am Dent Assoc. 2021;152(6):455-62.