When you’re in dentistry, it’s important that you wear the right protective gear. With over 20 million bacteria living in one’s mouth, you should not be light with protection. You need a good pair of gloves, a coat, glasses, and of course, a mask.

However, you may not know which mask is right for the job. Masks have three levels of protection, and it’s important you pick the level that is appropriate for your situation. You don’t want to go into a long operation wearing a mask that’s only intended for general use. You could end up sick, and it’s not sanitary at all. Admittedly, the masks can be a little confusing, with newcomers not knowing which mask rating to get. That’s why we’re here to help. We’ll explain the levels and talk about what procedures a level 3 mask is appropriate for.


So, without further ado, let’s look at masks and what procedures you should use a level 3 mask for.

What Are These Levels?

If you’re a little confused about what the difference between a level 3 mask and other masks, you’ve come to the right place. If you’ve looked at a mask, you may notice that it has an ASTM rating of level 1, 2, or 3. Before we explain the differences, it’s important you know what the ASTM rating even is.

ASTM stands for American Society for Testing and Materials. They have defined how much protection these masks offer. Obviously, not all masks have this rating, especially if you don’t live in America. However, if you are American, it’s worth it to search for masks that have these ratings in order to make things easier. That’s the best way to assure that you have the right mask.

There are three levels the ASTM has rated these masks. Let’s explain them.

Levels 1, 2, and 3

Level 1

This mask has the lowest barrier with protecting you against fluids, aerosols, and bacteria. This mask should be worn for general use when there are little to no fluids coming your way.

Level 1 masks are the most affordable, and that’s why they tend to be favored when there’s nothing going on. However, if you are performing a procedure, it may not offer you the protection you want.

Level 2

Level 2 masks have a moderate barrier against aerosols, sprays, and bacteria. If you are performing minor procedures like sealing, short oral surgery, or a prophylaxis, the level 2 mask will work splendidly for this. They are a little more expensive than level 1, but less than 3. Because of this, they are flexible. However, there are some procedures where a level 2 may not provide enough protection.

Level 3

This is the mask that gives you the highest barrier of protection. When you are performing a procedure where you expect there to be aerosols, fluids, and bacteria in the air, it’s important to put on this mask.

Level 3 masks tend to be worn when the dentist needs them the most because these masks cost more than the other two. If someone has a lower budget, they may want to use a level 3 sparingly and save the level 1 and 2 masks for less severe procedures and situations. With that said, if you feel like you need a level 3 mask, you shouldn’t cheapen out on something of a lower level.

Some Procedures You’ll Need a Level 3 Mask For

When deciding if a level 3 mask is for you, the procedure you’re performing can be a good indication that you’ll need it. Let’s look at some procedures that definitely require you to have a level 3 mask.

Air Polishing

This is a procedure where you clean stains from the teeth of the patient by using air, water, and glycine powder. It can take a while for you to polish one’s teeth, and as you’re doing so, aerosols are going to be flying from your patient’s mouth. Stay protected through a level 3 mask.

Complex Surgery

When you are performing oral surgery, you can get by with a level 2 mask if it’s a simple little surgery. However, if you are performing any surgery that’s a little more complex, it’s important you have the most powerful mask around.

Crown Preparation

This restorative procedure does require you to be exposed to fluids quite a bit, so it’s important you have a level 3 mask handy when you do this.

Implant Placement

Putting an implant in one’s mouth can take quite a while, so it’s important that you have a level 3 mask handy when you do this. Never put in someone’s implants without implanting a mask on your face first.

Periodontal Surgery

This restorative surgery helps someone feel more confident by restoring periodontal structures. It’s definitely a surgery where you want to have a level 3 mask.

Anything Else?

There may be other procedures where putting on a level 3 mask is important. If you are in a situation where you expect to have high amounts of splatter or fluids, it’s better safe than sorry to put it on.

What About Vapor Protection?

A level 3 mask is not meant for protecting against vapors and airborne illnesses. While it can protect against bacteria, it’s important that you have an N95 respirator if you want to protect yourself against any of that.

ASTM Level 3 vs N95

Let’s briefly discuss what the differences between these two masks are. The main difference between these masks is that the ASTM level 3 mask is designed to repel fluids and aerosols, as well as keep your germs from reaching the patient.

Meanwhile, a respirator is to help prevent you from inhaling dangerous particles or airborne viruses. Respirators are in short supply, so it’s important that you only use them when it’s appropriate for you to do so.

ASTM Level 1 Vs. Level 3

If you’re someone who is unsure of the main differences between an ASTM level 1 vs. 3, let’s take a look at them for clarification.


  • First, let’s look at the fluid resistance. If you are in an area where you expect little fluids, then a level 1’s 80 mmHG protection can work. However, a level 3 is double that at 160 mmHG. When you are in an operation where you expect to be hit with fluids, a level 3 is the clear winner. 
  • A level 3 mask is much more breathable, having a <5 mm H20 as opposed to the <4 that a level 1 provides. If you are in a long operation, being comfortable is important, and a level 3 can help with that. 
  • For aerosol filtration, a level 1 mask filters around 95 percent of particles at 0.1 microns. Meanwhile, a level 3 filters 98 percent. That three percent difference doesn’t seem to be too huge, but when you are in a long-term operation, it helps.

We hope this has made the differences a little easier to understand.

Why a Level 3 Mask Works

You may wonder what goes into a level 3 mask to make it offer the highest level of protection. Let’s look at some ways it’s tested.

Tested to Resist Fluids

When people test a level 3 mask, they throw high amounts of synthetic blood at the mask quickly. When it comes to fluid resistance, a level 3 mask has 160 mmHG of it. This is double of what a level 1 has.

Breathability

The more breathable a mask is, the more comfortable it will be to wear. A good level 3 mask should be breathable so it feels good for long periods. In order to test for breathability, professionals will test it through testing the air pressure of the mask before and after it’s applied. A level 3 mask should have a breathability level of <5 mmH20, which is one more than a level 1 mask.

Particle Filtration

Professionals will use synthetic aerosol and bacteria to test how well a mask filters. If a mask is unable to filter these particles, then they are quite useless. For aerosol particles, a level 3 is designed to filter 98 percent of them at 0.1 micron. Level 1 masks, on the other hand, only filter out 95 percent. That’s a bit of a difference.

With bacteria, it’s the same thing, only 0.3 microns is used instead of 0.1.

Tested for Flammability

All three levels of masks have equal flammability, which is about the same as your clothes. Being thin, it’s important that your mask doesn’t burst into flames should it accidentally touch any fire. A mask’s materials are held to a flame and then the flammability is determined by how long it takes until it catches fire.

How to Use Your Level 3 Mask

If 2020 taught us anything, it’s that many people do not know how to use a facemask properly. Being a dentist, we know you’re probably the exception, but just in case, let’s talk about some things to remember.

Double Check the Rating

It’s wise for you to double check the case and make sure that it is indeed a level 3. Even if the packaging looks similar to a level 3 mask, it doesn’t hurt to double check in case if you are unsure. People make mistakes and sometimes grab the wrong kind of mask for the job.

Check for Holes

Before putting on the mask, it’s important that you check it for any holes or flaws. Look carefully on both sides. Should you see anything defective, throw away the mask. Having a mask with a hole in it defeats the purpose of wearing them and it’s not something you should do under any circumstances.

Put it On Correctly

First, it’s important to put the mask on correctly. The darker side tends to be the front, while the lighter side is what touches your face. There should be an area specifically crafted to be put over your nose as well. Make sure the mask is on the right side.

When you do put it on, another thing you need to be sure of is wearing the mask so it covers your nose and chin. There’s little point in wearing a mask if it doesn’t cover your nose. When putting it on, it should fit snugly over your face and not budge.

You Need to Change Masks

These masks are meant to be disposable, but some people use them longer than they should. Here are some instances when you should be changing your mask.


  • Change it whenever you’re seeing a new patient. After you’re done seeing them, dispose of your mask and put on a new one. 
  • For instances where aerosols are in the air in high amounts, changing it every 20 minutes or so is ideal. 
  • In addition, do not touch the mask whenever you do take it off, and wash your hands after you dispose of it. 

Always Verify You Have An Authentic Mask

You can get an ASTM level 3 mask online, but there are many shams out there. If you’re purchasing an ASTM level 3 mask, Amazon and other retailers should tell you what company the mask is manufactured by. You can also read the reviews and make sure you’re purchasing a mask that is ideal for your situation.

Conclusion

Putting on a mask when you are about to perform a procedure is always important, but it’s also important for you to pick the right kind of mask. An ASTM level 3 mask can help you with any demanding procedure or any situation where you expect to have plenty of aerosols invading your face.

An ASTM level 3 face mask provides you with the highest protection. While they do cost more, they are worth it depending on the procedure. When you are purchasing an ASTM level 3 surgical mask, you are guaranteeing the most protection, as long as you follow the instructions and change frequently.