Periodontist invents aerosol dome to protect patients, team

Restless nights became a common occurrence for periodontist Dr. Lara Ryan during the COVID-19 shutdown. As a dental professional, she knew she was trained to deal with airborne pathogens, but she wanted to provide her patients and team with more protection.

After a sleepless night, some computer research, and an article about an anesthesiologist in Taiwan, Ryan found herself on the path to better protection from potentially harmful aerosols that occur during many dental procedures. She created the Perio Dome, an aerosol hood with an attached vacuum that captures aerosols and splatters that may contain pathogens such as SARS-CoV-2.

"I knew that this could be something, and actually be a very viable device that could help our profession and the future generations of dentists and professionals," said Ryan, the owner of Johnson County Periodontics, Dental Implants, and Laser Surgery in Overland Park, KS. "I never looked back."

The product is being manufactured and a patent is pending. Ryan expects it to be available for sale in June.

The Perio Dome, an aerosol-reduction device and vacuum that trap potential germ-containing aerosols and droplets. All images courtesy of Dr. Lara Ryan.

The aha moment

Ryan initially researched possible ways to protect her dental team and her patients from disease-containing aerosols.

She stumbled upon an "aerosol box" -- a plastic box that fits over a patient's head and neck and was created by an anesthesiologist in Taiwan. One side of the box has small holes that allow for a doctor's hands, and it was designed to protect clinicians while they placed patients with severe respiratory complications associated with COVID-19 on ventilators.

"I remember trying to draw the box and somehow take it to dentistry," Ryan said. "I could not find a way to get the box to fit around a dental chair, and the cut-out arm holes were too restrictive to do any sort of dentistry."

She started drawing different shapes and designs, and she settled on a dome shape that would allow clinicians to work under it with enough freedom to move their arms and hands, she said.

"The clear dome also would act as a shield to protect us from pathogenic aerosols, blood, saliva, and dental splatter," she added.

She recognized that the design was her "outside of the box" moment and the key to resolving her aerosolization concerns.

From there, she bought some clear plastic salad bowls from an online restaurant supply store. She cut a hole in the bottom of a salad bowl, slipped it onto a gooseneck arm that had a halogen bulb, and added caster wheels to the base.

"We didn't use the light because it would have melted the plastic bowl," Ryan said. "They were very wobbly and looked handmade for sure."

Not perfect, but appreciated

When Ryan reopened her practice on May 6, 2020, following a nearly two-month shutdown during the pandemic, she and her eight-person dental team were nervous despite implementing new safety protocols and training.

Dr. Lara Ryan.

"Everyone was paranoid, and [with] any little sniffle we thought we may have contracted COVID-19," she said.

Fortunately, she was able to use her salad bowl prototypes during that first week, and it did put some at ease.

"This did help relieve some of our anxiety," Ryan explained. "Patients really thought it was something new for COVID-19 and did appreciate the extra steps we were taking."

Ryan was experimenting with the Perio Dome's design, using self-fasteners and magnets to attach the salad bowl to the gooseneck, which resulted in a few embarrassing moments. One time, a dental assistant knocked into the dome accidentally, and it landed in a patient's lap.

"Luckily, everyone thought it was funny," she added.

After she determined that working under the dome was possible, she took her invention to the next level. She connected with a patent attorney and several plastics companies, and she was referred to mechanical and electrical engineers. Together, they, along with optical experts, have finalized the Perio Dome.

The features

The dome is a transparent plastic aerosol hood that is placed over a patient during dental procedures. An attached vacuum and a dual-layer high-efficiency particulate air (HEPA) filtration system capture 99.9% of potentially harmful aerosols and splatter, measuring 0.06 µm, Ryan said.

"The visual clarity is a huge part of the dome, and obviously we need to be able to see undistorted and without glare from overhead dental lights and loupes," she said.

The Perio Dome is rechargeable and can run for six hours, and the fan has a life of about 50,000 hours. Also, the dome is easy to detach, and the unit is adjustable and can pivot much like a dental light.

The device allows for at least 13 inches of space between the dome and a patient's face. The width of the dome is 21 inches, providing ample space for an assistant, hygienist, and dentist to work without restrictions, Ryan added.

She has been using some form of the Perio Dome in her practice for months, and some patients have remarked that they feel "naked" without it.

"It really has added a layer of protection that is undeniable," Ryan said.

Always in the cards

Though she never thought of herself as an inventor, she did learn the value of building things from her father while she was growing up. Her dad, an operating engineer, taught her how to use different tools, and she would help him change spark plugs and the oil in their cars. She said she gets her entrepreneurial spirit from her mother, who was a business owner and had a strong influence on her. Ryan remembers one of the last conversations she had with her mother before she died in January 2021.

"I was telling her about my progress on my invention, and she said, 'I just knew you were going to be more than a periodontist someday,' " Ryan recalled. "I just laughed and said, 'Mom, I have always wanted to make you proud and hope I always do.' "

Ryan admits that she is pleased with herself.

"To be honest, I think I am most proud of the courage and perseverance it has taken me to turn this idea into reality," she said. "One of my motivators was the fear of not being able to practice dentistry and losing my livelihood to this pandemic. This process has not been an easy endeavor, and I am fortunate."

Ryan hopes to see the Perio Dome continue to evolve and become a new standard of care for aerosol protection.

"For now, I will keep doing my day job and keep trying to make my mom proud," she said. "Regardless, I know that aerosols are not going away, and the threats of airborne pathogens are something we face every day.