Patients are beginning to return to their dentist for regularly scheduled cleanings and procedures. As dental offices begin to resume care as normal, it’s important to remember these workplaces warrant specific infection control considerations.
While generally considered an essential business, rules for dental offices differ greatly from state to state and at the peak of stay-at-home and shelter-in-place orders, most dental offices around the country were closed except for emergencies. However, according to a poll conducted by the ADA Health Policy Institute (HPI) on June 1, 90% of dental practices are open for elective care—a dramatic increase from the 3% of dental offices open in early April.
However, experts still say warn dentist offices are high-risk areas for spreading COVID-19. This virus is known to spread through respiratory droplets and as most people know, even a simple cleaning can be messy. Because dentists are using high-speed instruments in patients’ mouths, often causing sprays or aerosols of water, saliva, blood, and microorganisms, dental staff are at an even greater risk of contracting the coronavirus.
Preparing for Procedures & Appointments
The Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA) have both published interim guidance for dental offices operating amid the COVID-19 outbreak—detailing patient management and facility consideration information for before, during, and after appointments.
“Oral health is an important part of overall health,” according to ADA President Chad Gehani, D.D.S. “Resuming regular dental visits are important because treatment, as well as prevention of dental disease, helps keep people healthy. The guidances from the ADA and the CDC give dental professionals the information they need to practice as safely as possible.”
It’s critical to encourage patients and personnel to stay home if they are feeling sick; make sure your office has flexible policies in place so employees feel comfortable taking time off. Have dental staff call patients before scheduled appointments to ask questions about their current health status and ensure they feel comfortable coming in. Additionally, your office may want to conduct temperature checks for people entering the office, and assess all patients upon arrival
Maintaining Healthy Distances for Dental Care
Outside of the work dental hygienists and dentists does with patients, it’s important to enforce social distancing in other areas of the office.
- Limit the number of people who people allowed to accompany the patient, and encourage patients to come in alone.
- Remove toys, reading materials, and other high-touch items to reduce the likelihood of transmission.
- Remove chairs in the waiting room to limit the number of people in the space and place chairs six feet apart.
- Use floor tape or floor signs to mark off six-foot distances at check-in desks or the reception area.
- Install a clear barrier at the front desk or in office spaces when social distancing may not be feasible.
Personal Protective Equipment (PPE)
Although many medical professionals face PPE shortage, PPE stockpiles have increased significantly in dental offices, according to HPI poll data. Employers should provide staff with additional PPE, such as surgical masks, N95 masks, face shields, goggles, etc., and direct staff to wear additional protection when appropriate to keep the office as safe and healthy as possible for patients and employees. Patients should also be advised to wear their own PPE, a CDC-recommended face covering, when coming in for their appointment and in areas like the waiting room.
Dental offices can take several measures to reduce the likelihood of transmission of the COVID-19 virus. Make sure to place hand sanitizers or hand sanitizer stations in multiple locations around the facility for both staff and patients. Provide tissues, soap at sinks, and trash cans in waiting rooms, bathrooms, and patient consultation rooms. In the ADA’s Hand Hygiene for the Dental Team, staff should be washing their hands when entering the workplace, before and after any contact with patients, after contact with contaminated surfaces or equipment, and after removing PPE.
If your office hasn’t done so already, implement a protocol for sanitizing surfaces regularly throughout the day, and equipment is thoroughly disinfected before and after each use. There should be a schedule for all tables, chair arms, doorknobs, light switches, and anything else people come in contact with, to be wiped down with an approved surface cleaner.
Because coronavirus is known to be a respiratory virus, ADA guidance also suggests taking steps to reduce aerosols, such as:
- Hand scaling when cleaning teeth rather than ultrasonic scaling,
- Using high velocity suction whenever possible, and
- Using rubber dental dams whenever possible.
COVID-19 continues to impact how we go about our daily lives, but as patients begin to return for their scheduled cleanings, dental environments play an important role in protecting public health.
Check out regulations, mandates, and recommendations by state with this interactive map from the American Dental Association.
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