The New Rubber Dam?

The New Rubber Dam?
A patient undergoing a dental procedure using NoPaS

A team have invented & produced a new device to help dental practices in their safe management of the risks from aerosol borne infections.

The multidisciplinary group is from the University of Bristol and University Hospitals Bristol and Weston NHS Foundation Trust.

They claim that the new environment-friendly shield could offer better protection during dental surgery and it has been named the NoPaS (Novel Patient Shield)

Dr Mojtaba Dorri, a consultant in restorative dentistry, led the development project.  Dr Dorri explained, “During the COVID-19 pandemic the development of innovative environmentally-friendly solutions have been much needed to allow routine dental care to be delivered in a safe environment without risking virus transmission. With the virus still circulating and the chance of future pandemics, it is important routine dental care continues to ensure public oral health is not affected”.

NoPaS is now being promoted as a solution to the challenges of safe working in the age of COVID. Apart from protecting both patients and dental teams it could greatly cut down on clinical waste, including environmentally damaging single use PPE. The developers hope that the shield could also increase the number of patients seen by dentists and help reduce procedure wait times. The device could also have uses beyond dentistry, and according to Dr Dorri, “With minor modification, NoPaS can be used for medical procedures on the head and neck, including endoscopy, anaesthetics and ear, nose and throat.”

A key benefit of the NoPas device is that it is claimed to meet the requirements of  HTM03-01.

It is accepted that the decontamination document HTM 01-05 was originally designed around larger institutions, and its imposition upon dental practices created many challenges. The official designation is that of a Health Technical Memorandum, however compliance is in the ‘must’ rather than ‘should’ category.

A similar document, HTM03-01 relates to specialised ventilation to healthcare buildings. Following the onslaught of COVID the document was updated in June 2021. It was taken into account when the various SOP’s were drawn up, including the controversial fallow time recommendations.

Reponses to a picture posted on dental twitter of NoPaS in use were mixed. Comments were made questioning patient acceptance, in particular by those living with claustrophobia.  However Dr Dorri reports that the device has been tested on claustrophobics who had been happy to have treatment with it, and that more severe cases could be helped by fitting a mirror inside or using AR goggles during treatment. He added that decontamination after use was similar to that required for work surfaces, and that all parts can be wiped down.

With support from the Elizabeth Blackwell Institute, MRC Confidence in Concept and Bristol and Weston Hospitals Charity grants, the NoPaS prototype has now been fully tested. The device is patented, with its developers seeking partnerships to take NoPaS into mass production.

Events of the last 2 years have shown that the general publics response to the risks of COVID have varied widely. There is still a section of the population avoiding contact with others, including their healthcare providers. For this anxious group, seeing precautions such as NoPaS could give them added confidence and encourage them to make an appointment.

Dentists in general practice may well be dubious about the device. Against that many will have been pleasantly surprised by the positive reception the introduction, or increased use, of rubber dam has received from patients. The team behind NoPaS will be hoping for a slightly faster acceptance of their invention, across the profession.


Image Credit:University of Bristol Dental School


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