I recently wrote about how dental professionals should protect themselves and the patients against the coronavirus at dental practice. Things have rapidly escalated since and the coronavirus is beyond stopping. It is now question of slowing the spread of the virus so that the health care wouldn’t become overwhelmed with patients needing an intensive care and that all the people needing intensive care will get it all throughout the pandemic.
Drastic and Immediate Measures
All the non-urgent treatments should be postponed until the coronavirus epidemic has settled. And I mean all! Only urgent treatments should be performed. Find out if your country has centralised place for people who need urgent dental treatment and has signs of influenza (cough, runny nose, sore throat). Some countries do. If your country does, accept only healthy patients to be given urgent dental care at your practice. Also patients that have returned from abroad in the past 14 days, patients that has had contact to a quarantined person or contact to a person with confirmed COVID-19 should not be allowed to have treatment in the surgery.
This measure is necessary for many reasons. First, you will guarantee that you will not run out of the face masks. Second, you will slow down the spread of the virus. Third, you protect your own employees and patients and by doing that your practice might be able to stay open all throughout the pandemic. Fourth, you will guarantee that you will be able to provide urgent dental care in the next months to come when availability of face masks, disposable gloves and hand sanitiser is uncertain.
Limit the Contamination Area
If your surgery has many treatment rooms, use only one or two of them – the same ones every day. This is easy if you have followed my first advice as not as many patients are coming in as normally. Also choose the ones closest to the waiting room.
This measure is for the likely event of COVID-19 positive person visiting your practice. You would need to perform extensive cleaning and sanitising only to those rooms where you treat patients.
Minimalism at the Waiting Room
Remove newspapers and magazines from the waiting room. Also a remote control for TV if you have one. Remove some of the chairs and leave rest of them 2 meters (78 inches) apart. Also like I said on my previous post – provide hand sanitiser at the waiting room but do not trust the patients know how to use it (do you?). You can always ask patients to wash hands when they arrive at the treatment room. Most likely they don’t know how to do this properly either and you can be a role model (remember to follow the 20 second guideline plus correct way of closing the tap. If unsure, check this)
If you haven’t already read my previous post, now is the time as there is more information about face masks etc. All those advises are still applicable.
What About Profit?
We all know that most of dental practices make huge profits. It is now time to forget the money and do the right thing for common good. Imagine how restaurants, shops, hotels, musicians (just to mention few of them) are doing now when everything is cancelled. We dental professionals need to do our part in slowing down the spread of the virus.
And surely, you wouldn’t want you surgery to be put on lockdown if a positive COVID-19 patient visits your practice. In the worst case scenario, you might not have a business to run after things have settled.
Please help slowing down the virus and share this post to you friends and colleagues to raise awareness.
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Like doctors and nurses in hospital, the dental professionals are more at risk of contracting viruses. Dental offices can also be a place where the viruses, such as corona can spread if the cross infection control is not up to the standards.
I have gathered the most important things here for dental professionals to check to make sure you are protecting yourself, the staff and the patients. I have not gone into things like instrument disinfection because that should be organised regardless the coronavirus. If in doubt, read this.
Something we should remember when using hand sanitiser is that it does not kill all the viruses like norovirus (the one causing the winter womiting disease). Therefore it is advisable (also advised by the World Health Organization, WHO) for all of us to wash hands 20 seconds with soap even though it is pain in the backside to wait for the hands to dry so that you can pull on the examination gloves. Remember to use disposable hand towels to dry your hands and close the tap either with your elbow or with the hand towel to prevent re-contamination of your hands from the tap.
In the normal situation where we treat healthy patients, a lower fluid resistance and filtration efficiency are acceptable (personally I use either ASTM Level 2 or Level 3 masks). But when we are at greater risk of treating a patient who might carry airborne diseases like coronavirus, TB and influenza, we should use masks that have the maximum filtration. These face masks you recognise from the markings FFP2.
It is even better if the face mask has a visor attached to the mask. But even if it has the visor, use also safety glasses/your normal glasses under the visor. If the face mask doesn’t have a visor, use safety glasses or separate visor – also on top of your normal glasses.
Now, I would use also disposable hats like they do when performing oral surgery because people (me too) have these mannerisms of touching our head, scratching our head etc. for example on a lunch break. And do we always notice we do that? If we don’t, then how do we know to wash our hands straight after before we take another bite from the sandwich.
Check Your Surface Disinfection Liquid
Today is the day to look deeper into the small print of your practice’s disinfection liquid. I did some research some time ago because I wanted to find out if the liquid we were using was killing everything it was meant to. I found out that not all of them kill for example norovirus. And if they don’t kill norovirus, I doubt that they kill coronavirus.
I cannot tell you which one to use, but the bottle should have all the information needed. If not, contact the supplier or the manufacturer. One thing I noticed when I did my research that the disinfection wipes and liquids for sensitive surfaces are the ones that do not kill viruses.
It is good idea to wipe the door and chair handles (the unit’s of course but also the regular chairs) with disinfection wipes. Also it is good idea to go through the other handles of the practice many times a day – even the ones outdoor.
Provide Hand Sanitiser for Patients
Place a bottle of hand sanitiser in the waiting room. I saw my physiotherapist yesterday and first thing I did was to wash my hands. Common people do not realise to do this so could you perhaps ask your patients to wash their hands (for 20 seconds) when they arrive to the surgery?Continue reading “Coronavirus in Dentistry and How to Protect Yourself”