COVID-19 Safety Precautions
Recommendations for practicing during the pandemic
Derek Giddon, DDS
If you run a dental practice, you probably still have a lot of questions about how to keep yourself, your employees, and your patients safe from COVID-19. Maybe you've read the guidelines from the American Dental Association, the US Centers for Disease Control and Prevention (CDC), and other agencies, but you're having a hard time pinpointing the important takeaways in the long, jargon-filled documents. Or maybe you're just wondering how what you're doing at your practice compares to what other dentists are doing at theirs. To help dentists practice safely, a review of the most up-to-date guidelines and extensive conversations with practicing dentists were distilled into the following list of important COVID-19 precautions.
Before the Appointment
Safety precautions should begin long before you get close to a patient's pearly whites. Start by screening all patients for COVID-19 symptoms in the days prior to their appointments. If you use a patient portal or other online booking system, you can require patients to answer screening questions before allowing them to confirm their appointments. A checklist provided by the American Medical Association offers suggested questions to include and guidance on what actions to take based on patients' responses.1
Another important element is reducing the number of appointments that you schedule in a day and making an effort to stagger the times so that, when patients aren't waiting in their cars, no more than two are ever in the waiting room at the same time. To further limit the number of people in the building, let your patients know that they can only bring one person with them, if necessary (some practices make exceptions for patients with children).
Lastly, for those individuals who may have forgotten that they aren't at home, CDC recommends putting up signs in the hallways and doorways leading to your practice to remind patients that masks are required.
In the Waiting Room
During the pandemic, your waiting room should look very different. First, rearrange the furniture so that social distancing is mandatory and put up physical barriers to separate groups wherever possible. Second, remove any magazines, toys, or other communal items that people put their hands on.
It is also important to ensure that there is hand sanitizer readily available and that the front desk staff are instructing patients to use it before their appointments. Speaking of the front desk, you should consider it your first line of defense against COVID-19. Staff at the front desk should be trained to properly check each patient's temperature before his or her appointment and to be able to spot any relevant symptoms.
Remember Your Staff
Before coming to work every day, staff should be screened in a manner similar to your patients. They should be advised to wear their masks at all times, including in break rooms where they may come in contact with their coworkers. Everyone in the office should be given access to N95 masks and gloves, which should be changed in between handling patients.
It's crucial that every staff member in your office is given unlimited sick days for the foreseeable future and instructed not to risk coming into work if they exhibit any signs of illness. You may want to change the practice's schedule to ensure that there is appropriate coverage if one employee has to be out.
During Procedures
Dental care is associated with a lot of COVID-specific fears because of all of the open mouths involved. Therefore, there are certain recommendations for dental practices that may not be as important to other medical professions.
It's important to think about air flow. Many dentists are keeping all of their interior doors open and positioning their dental chairs to face the open operatory doors to improve the air circulation. Even though this might have seemed weird in the "before times," patients will become used to it. Medical grade air filtration systems are great options for keeping the air flowing. If you want to maximize safety, it's also a good idea to consult an air flow expert and your building manager regarding your options.
Before each appointment, consider having patients rinse with a 1.5% hydrogen peroxide solution. This reduces the salivary load of oral microbes, and it could be helpful in reducing the risk of COVID-19 transmission because the virus is vulnerable to oxidation.
In addition to masks, you and your team members should wear eye protection when dealing closely with patients, especially during any procedures that may cause saliva or blood to spatter. If you're performing an aerosol-generating procedure, it's recommended to use a portable high-efficiency particulate air (HEPA) filtration unit during and immediately after.
Ongoing Compliance
Well, there you have it. Remember that every state has different and changing recommendations regarding COVID-19. To see if there's anything else that you should be doing, be sure to check your local government's guidelines, and it's prudent to keep in mind your community's rate of infection when considering adopting precautions.
References
1. Robeznieks A. Use this COVID-19 screening script when reopening your practice. AMA website. https://www.ama-assn.org/practice-management/sustainability/use-covid-19-screening-script-when-reopening-your-practice. May 15, 2020. Accessed February 9, 2021.
About the Author
Derek Giddon, DDS is the founder & chief executive officer of Smylen, a first-of-its-kind platform for dentists to get new patients on their own terms.
