Dentistry Returns to a New Normal

With the exception of emergency procedures, dental practices across the nation have been closed for business ever since the COVID-19 pandemic began to take hold in the U.S. Now that stay-at-home orders are lifting in many states and all kinds of businesses are reopening their doors, dentists and their patients are wondering: What does this mean for the field of dentistry?

Let’s take a look at the processes and procedures that dentists must follow to ensure a safe reopening.

 

CDC and ADA Guidelines

Based on guidance from the Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA), dentists and their office employees should adhere to the following protocol:

 

Pre-Appointment: Patients should be screened prior to coming in for any appointment or procedure. Office personnel should ask about specific health symptoms like fever, cough, shortness of breath, and flu-like symptoms, as well as travel and any contact with COVID-19 patients. Ask them to limit the number of companions they bring to the appointment, and let them know that you will be taking their temperature and repeating the same questionnaire once they arrive at the office.

 

Patient Reception: Be sure to have hand sanitizer and masks available at your front desk for patients to use upon arrival. Take your patients’ temperature, and inform the dentist immediately if it is elevated (above 100.4 degrees). Screen each patient once again with the same set of questions you used over the phone. After each patient interaction, disinfect all surfaces and points of contact. Arrange chairs in the waiting room to be at least six feet apart or have patients wait in their car until appointment time.

 

During Examinations/Procedures: Experts are recommending that dental practices limit chair-side paperwork and other documentation that’s normally presented in the examination room. Find safer alternatives for obtaining relevant documents and information. In addition, it’s important to keep clinical staff to a minimum in each exam/procedure.

 

PPE: Personal protective equipment (PPE) requirements are the most common inquiry among dental care providers. PPE requirements break down into two categories:

1. Non-Aerosol Procedures (exams, orthodontic checks, simple extractions, crown cementation, etc.) require:

• • Level II or III masks
  • Gloves
  • Regular Infection prevention and control sterilization and operatory procedures
  • Eye protection OR face shield

2. Aerosol Generated Procedures (any procedure that uses air-water syringes, ultrasonics, or hand pieces; the vast majority of dental procedures fall into this category) require:

• • National Institute for Occupational Safety and Health (NIOSH)-approved N95/K95 mask or Level 3 surgical mask
  • Gloves that cover cuffs
  • Head cap
  • Goggles OR face shield
  • Gown for barrier

PPE is only effective when worn properly. Experts strongly urge that dentists utilize a top-to-bottom application and a bottom-to-top removal.

 

Additional Tips/General Guidelines

More than ever before, your patients will be concerned about infection control and what your office is doing to prevent the spread of COVID-19. Sending a letter or email to your patients will ease any anxiety they may have about coming in to your office. Inform them about all safety procedures you are following, including prescreening and temperature checks of all staff members, and reassure them about your Safety First commitment to protecting the health of patients and providers alike. 

Follow the saying that “what happens at the office stays at the office” – have employees wear their street clothes into the office, then change into clinical attire after arriving. In the same vein, ask them to change out of clinical attire and back into their street clothes before leaving at the end of the day. Use a laundry service or your office’s own appliances to keep clinical attire clean. Anyone handling exposed clothing should be protected with PPE.

Finally, disinfect anything that is delivered to your office before unpacking or using it.

 

Closing Thoughts

It’s hard for everyone right now.  Dental clinics are among many businesses devastated by the COVID-19 pandemic. It’s definitely time for a new normal to emerge, where dental office teams and patients alike can return to the clinic for all manner of non-emergency procedures. The longer patients have to wait for dental care, the greater the likelihood of long-term issues in individual patients and from a public health perspective. 

Going forward, have your sanitation team lead the charge to ensure all safety protocols are being followed. These individuals should communicate openly and frequently with all other team members with a goal of keeping everyone safe and healthy. It’s not going to be easy, but together we can do better.