Dentists! It Is Time to Raise Stakes with Coronavirus

person washing his hand
Photo by Burst on

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.

You might also like

Coronavirus in Dentistry and How to Protect Yourself

Are Your Dentist’s Tools Clean?

How Clean Are Your Hands?

It’s ok to swallow, it’s only water… Or is it?

Are Your Dentist’s Tools Clean?

It is extremely unlikely that you get HIV from a dentist appointment. Tomah VA dentist accused of using improperly cleaned tools resigns

I shouldn’t read news as I always have something to say about them. This news above reminded me about working in the UK and how the instruments were cleaned there.

This Thomas VA dentist is not the only dentist that is underperforming in the instrument cleaning. There are dentists who have read this news and have wiped sweat from their foreheads and thanked their lucky stars it wasn’t their name on the headlines. Honestly!

Let me tell you how things were done in six of the practices I used to work in the UK. I will first go through the correct way of cleaning the instruments.

This I How It Should Be Done

1. Disinfect the contaminated instruments preferably in a washer disinfector like Miele Dental Disinfector

With this washer disinfector the cleaning job is half done. You just put used instruments within 4 hours of using them to the washing cycle and you get disinfected instruments in less than an hour (no need to soak them in anything prior the cycle).

No scrubbing is needed which will minimise the accidents of nurses cutting themselves.

2. Dry the instruments thoroughly. Use pressurised air on all the hard-to-reach areas like matrix retainers, sonic scaler tips, forceps.

3. Place the instruments that  don’t need to be sterile on the metallic tray to be autoclaved. Put the instruments that need to be sterile in pouches and close the pouches.

4. Put all the instruments in an up-to-date vacuum autoclave and run the cycle. Once they are cooked, put them in cupboards or drawers to be picked to the surgeries.

Simple and pathogen-free tools.

This Is How It Should Not Be Done

None of the surgeries I worked at in the UK had washer disinfector. Instead there was a dish brush and Hibiscrub. Yes, you read it correctly. Hibiscrub was used like washing up liquid on dish brush and the instruments were washed over a sink in the surgery. But this was done only up until health and safety regulations stated that using dish brush was a health hazard – there was too big risk of an injury from sharp instruments.

Once the instruments were brushed with Hibiscrub and rinsed with water, the instruments were placed on metallic trays (no drying) and put in the Instaclave, the simplest of the simplest model (non-vacuum). If there were surgical instruments, they were either put on the pouches and put on trays without closing the pouch. The pouch was closed after the cycle in the Instaclave. Sometimes the surgical instruments were put on the trays without pouches and once they had gone through the cycle, the nurse put them in the pouches that were taken straight from the package. This of course meant that the pouch was non-sterile as it had not gone through the cycle in the autoclave. Non-sterile pouch equals non-sterile instrument – no matter if the instrument has gone through the cycle.

So needless to say that many things went wrong. And let me clarify that all the above was done in the surgery. Every surgery had their own autoclave – just about five feet away from the patient.

This was the typical setup in the dental surgery in the UK for cleaning tools used on patient

The Question: Did I Do It Too?

Well, as much as I think that you live by the rules of the country you are in, I did not follow this questionable way of cleaning instruments. I did inventory on surgery’s storage room and found a container with a lid. I asked the practice manager to order me instrument disinfection liquid. I had to do some convincing before the liquid was ordered – understandably of course as no-one else was using one. So why should I?

So all my instruments were brushed with dish brush under running water and then placed into this container which had disinfection liquid in it. The instruments were kept in there for the recommended time, rinsed with water, dried and then put in the Instaclave.

Not perfect, but enough for me to have a clean conscience.

If you liked this post, you might also like:

It’s ok to swallow, it’s only water… Or is it?

Welcome to My Surgery – Waterline Cleaning Video

Thank you for visiting my surgery! Please note that I do not get any financial benefit of introducing certain brands (although I am starting to feel I should – this blogging is hard work I don’t get paid for!).

Now it might be time to read two of my posts regarding the waterline cleaning so you understand why I posted this video:

It’s ok to swallow, it’s only water… Or is it?

Told You So, Part III