As states across the country continue to relax stay-at-home orders, many dental offices are reopening for routine services under new and stricter protocols.¹
For many years, dental practices have worked under standard precautions developed by the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) to protect their patients and staff from blood and airborne diseases, such as HIV, hepatitis, strep, and staph infections. With COVID-19, dental offices will be taking even greater steps to keep you, staff, and dentists safe.
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Let’s first look at procedures already commonly used in dental offices to ensure patient and staff safety from infectious diseases.
1. Hand hygiene
Dentists and their staff are required to clean their hands frequently either by hand washing with soap and water, using antiseptic hand washes, antiseptic rubs such as alcohol-based sanitizers, or surgical antiseptic scrubs. Hands must be washed both before and after procedures, prior to and after gloving, and anytime during a procedure when gloves must be changed.
2. Use of protective equipment
Personal protective equipment (PPE) for dentistry includes gloves, masks, gowns, and eye protection. These must be worn during all dental care, removed, and discarded when the dental care is over.
3. Sterilization of equipment and instruments
Reusable items must be sterilized after each use and stored in a way that maintains sterilization until the package is opened again for patient use. Sterilization means that all contaminants, bacteria, and spores are killed during the process.
4. Disinfection of surfaces
Disposable plastic barriers cover most surfaces in a dental care area. The dental staff throws away the barriers after each patient. The plastic covers on the patient chair, countertops, trays, drill handles, computer keyboards, and other surfaces keep airborne pathogens from accumulating. After removal of the plastic barriers, those surfaces are wiped down with disinfectant before new plastic barriers are reapplied.
Dental offices across the United States have used these and other complex precautions to protect patients from diseases for nearly four decades. Now, with COVID-19 as the new concern, more precautions will most likely be put in place to keep you safe. Here are some new procedures you may notice when you go back to your dental office.
New ways to keep you safe
Across the United States, dental regulatory boards and professional associations, such as the ADA, are developing new guidelines for dental offices to follow that will keep patients and staff members safe from exposure to COVID-19. Although these may vary from office to office, here are some guidelines that most states are recommending their dentists follow for a safe reopening.
1. Phone screenings
You may find that the dental staff calls more often and, when they do, they want more information than a simple confirmation that you plan to come to the appointment. Many may ask about symptoms and travel as well as your specific dental needs. This telephone screening might allow the dentist to supply advice and treatment over the phone to save you a trip to the office.
Questionnaires to asses risk factors for COVID-19 will be common. Questions about symptoms, fever, coughs, shortness of breath, contact with known COVID-19 patients, travel, and testing status will be common. These might be a repeat from the questions they asked you over the phone.
3. Fewer appointment times
Rather than scheduling multiple patients for treatment at the same time, dental offices may stagger appointment times to minimize patient-to-patient contact. Many will only allow one patient per dentist or dental hygienist to be treated simultaneously. Some will not use all their dental chairs but will stagger room usage to allow for proper disinfection between patients.
4. Social distancing
To keep patients and staff safe, waiting areas may no longer be filled with patients and their friends or family. Some guidelines are asking dentists to eliminate waiting room items, replace upholstered chairs with ones that can be disinfected, and have patients wait in their cars until a treatment room is ready. Chairs, when they are still used, are placed at least six feet apart. You might see clear plexiglass barriers in front of the reception desk, much like at the grocery store checkout.
Limiting the number of patients inside the office at any given time will help ensure that patients and staff can maintain social distancing except during procedures when PPEs are worn.
5. No visitors
Patients should come alone to their appointments. Only in cases where parents or interpreters are needed will anyone other than patients be allowed inside the office.
6. Checking in
Depending on the layout of the office or building where the dental office is located, you may be asked to text or call when you arrive and wait in your car rather than coming directly inside. Someone will either come to the parking lot to get you when it is time to come inside, or they might text or call for you to come in. When you come into the office, you will be asked to use hand sanitizer and possibly don PPEs such as masks (if you don’t bring your own), and a disposable gown to protect your clothing.
7. Temperature checks
Dental offices may be equipped with touchless thermometers to take patient’s temperatures prior to treatment. Each staff member and dentist will also have their temperature taken each day prior to seeing patients.
8. No-frills waiting rooms but less waiting
Magazines, toys, TV remotes, and other unnecessary items may be removed from waiting rooms. This cuts down on the possibility of surface contamination and helps keep everyone safe.
Even pens and clipboards may be gone. You may be asked to use your personal pen or pencil to answer questionnaires. Some offices might supply complimentary pens for you to use and take home to avoid the need to disinfect them after each use.
Do not expect to spend much, if any, time in a dental office waiting room. Most offices may escort you directly to the treatment room once you complete the check-in process.
9. COVID-19 testing
Staff members and dentists may have COVID-19 tests prior to delivering any dental care to the public. Whenever possible, patients should supply the dental office with their COVID-19 test results.
Currently, no plans are in place for dentists to test their patients for the virus. This may be a possibility in the future when more testing supplies become available.
10. Treatment rooms
You may no longer see items and decorations such as magazines, educational pamphlets, tooth models, and posters on the walls of the treatment rooms. These can become contaminated and, rather than having to disinfect these items after each patient, it can be more effective to remove them all. If your dentist or hygienist needs to use visual aids or written materials to explain your treatment needs, they will bring those items out on an as-needed basis.
11. Pre-procedure rinses
Patients will be asked to use a mouth rinse prior to starting treatment. This helps cut down on contamination in air droplets during dental procedures.
Although your dentist and hygienist have likely always worn masks during procedures, you will notice that they are now wearing the higher level N95 or similar masks. These provide the dentist, staff, and patients with better protection from germs that exit through the mouth and nose. Front desk and other administrative staff may wear simple cloth masks.
Plan to bring a mask with you. But, if you show up without one, the office may provide one for you before you enter the building.
13. Face shields
While some dentists and hygienists have use face shields in the past, you will be seeing a lot more in the future. These protect the worker from aerosols that might contaminate the mask and eyewear, making those PPEs last longer. Face shields supply an extra layer of safety for both you and the dental workers.
14. Hand sanitizer stations
Do not be surprised to find several hand sanitizing stations around the office. Entryways, bathrooms, hallways, and treatment rooms will have hand sanitizers so that both patients and staff have easy access to this important tool for avoiding COVID-19 infections. The staff will ask you to use hand sanitizers when entering the office and before you leave to return home.
15. No hand shaking
This social practice is probably a thing of the past. If your dentist or hygienist has always shaken your hand, do not expect that to happen anymore.
16. After you leave
The dental staff may decontaminate the room where you received treatment. They throw away all plastic barriers and wipe down all surfaces with a hospital-grade surface disinfectant. Each person who took part in your treatment removes their PPEs and cleans their hands with sanitizer or soap and water.
The room where you received treatment may have to sit for 30 minutes to one hour to allow the disinfectants time to work before the staff can replace the barriers for another patient.
Before your next dental appointment
For many years, your dental office has been one of the cleanest, safest places to be. Long-standing practices to avoid cross-contamination between patients and staff are second nature to many dentists and their staff.
In many cases, your dentist may have sent you a notice regarding their office reopening and their infection control procedures. If you haven’t heard from your dentist, now may be a good time to contact them about your next appointment.
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This is not dental care advice and should not be substituted for regular consultation with your dentist. If you have any concerns about your dental health, please contact your dentist's office.
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