Bridging a gap

Photo of Dental College of Georgia team
Team: Dental College of Georgia residents who 3-D printed nasal swabs used by the state of Georgia to test for COVID-19 pose for a photo at Augusta University’s print lab. From left, Drs. Jeffrey James, Jasmine Salis, Bryan Benton, Alex Faigen, Christian Dahl, David Pearson, Michael Thompson, Matthew Yeung and Will Baldock. Not pictured: Dr. Kyle Frazier.

Augusta, Ga.
— When Augusta University’s medical center began running low of nasal swabs for COVID-19 testing, a group of dental residents at its Dental College of Georgia assembled to help.
Their goal: utilize 3-D printing technology at the school’s printing labs to produce and supply 300 swabs a day for the hospital.
It didn’t take long for Gov. Brian Kemp’s office to learn of their effort, and asked Dr. Jeffrey N. James, program director of the department of oral and maxillofacial surgery, in a late April meeting to increase his team’s output to 5,000 swabs a day to test Georgians across the state.
Image of 3-D printed swabs
Design: Dental College of Georgia modified a nasal swab print design from the University of South Florida to construct a swab more appropriate for COVID-19 testing.
“It’s in our nature as oral surgeons to get the job done, so I said, ‘No problem,’” Dr. James said. “Then I left the room and basically had a panic attack.”
Nonetheless, his team was up for the challenge.
From April 24 to May 8, the team of dental residents printed over 70,000 swabs that would be used throughout the state — bridging a gap until the state acquired more testing swabs just as it became one of the first states to reopen amid the pandemic. Georgia’s shelter-at-home order had expired May 1.
“We did it, and I couldn’t be prouder of the team who worked the print lab 24 hours a day,” Dr. James said.
From jaw surgeries to cranial reconstructions, 3-D printing has been instrumental in the maxillofacial world.
“We use it every day,” Dr. James said. “We’d fix a problem on the computer first, then go to the operation room.”
So when he learned of the limited supply of nasal swabs at the medical center, which houses the department of oral and maxillofacial surgery, two of his residents — Drs. Alex Faigan and Kyle Frazier — had an idea: take that 3-D technology and apply it to printing swabs.
In mid-April, Dr. Faigan found a file from the University of South Florida designed by Dr. Summer Decker for printing nasal swabs. And on April 17, Dr. James reached out to different program directors at the dental school and formed what he called the “DCG Print Team.” It consisted of dental residents, including Drs. Faigan, Frazier and Bryan Benton from the oral and maxillofacial department; Dr. William Baldock, periodontics; Dr. Matthew Yeung, advanced education in general dentistry; Dr. Christian Dahl, endodontics; Dr. David Pearson, orthodontics; Dr. Michael Thompson, pediatric dentistry; and Dr. Jasmine Silas, prosthodontics.
“Everyone was cautiously optimistic about 3-D printing swabs,” Dr. James said. “When we printed the exact file from [the University of South Florida], it was a little bulky, and we still didn’t have verification it would work.”
The team of residents began modifying the design, making adjustments to construct a swab more appropriate for the COVID-19 test. They shrunk the diameter, extended its length and added hash marks to let health care providers conducting the tests the swab has been inserted far enough.
Allison McMullen, Ph.D., a medical director of microbiology at the department of pathology, tested the 3-D printed swabs to ensure they worked.
“I can’t even tell you how many man hours it took to perfect it,” Dr. James said. “These guys deserve all the credit. They learned and knew everything about the materials, the physics of the acrylics, testing the swabs and calibrations.”
On April 24, Dr. James brought the second prototype to a meeting that included a liaison to the governor. By the end of the meeting, the team, with the assistance of the National Guard, was tasked with printing 5,000 a day.
It took another week before the print team reached the daily goal of 5,000 swabs. Using seven printers, the team of residents rotated between two daily 12-hour shifts.
“Our swabs have been used from the southeast to the northwest corner of our state,” Dr. James said.  “It wasn’t a perfect solution, but it was a solution. Of all places, the Dental College of Georgia was there to help because a group of dentists from every specialty pulled together to accomplish this.”