Reopening the Dental Office
The COVID-19 pandemic stormed the world, and affected everybody. For all of us it changed our lives, for some it affected their health, while others lost their lives fighting this virus.
All over the country most of the businesses had to shut-down in an effort to fight the spread of the pandemic. We agreed with that decision, and on March 16th we closed the office in order to protect both our patients and out team.
Even if we were closed we worked behind the scenes to make our office even a safer place than before. I need to make a small parenthesis here. The dental offices were extremely safe from a patient point of view even before the pandemic. We strictly applied Universal Precaution for more than 30 years. In my research of dental articles I was able to find that dental office visits “does not frequently result in infections in the patients or dental healthcare providers. Therefore, the actual risk for cross-infection is low, as far as we know from studies in developed countries” (Volgenant, C.M.C., de Soet, J.J. Cross-transmission in the Dental Office, Curr Oral Health Rep 5, 221–228 (2018). Also “reports of transmission of infectious agents between patients and dental healthcare personnel in dental settings are rare” (CDC Expert Commentary, Preventing Disease Transmission in Dental Settings, CDC Division of Oral Health, January 30, 2017)
Nevertheless we changed, and we will continue to adapt a number of protocols in our office.
First of all, the time to reopen the office depends on a number of factors:
- State and county regulations
- American and California Dental Academy recommendations
- Our dental team health and availability
- Not in the least, our clinical judgement that it is safe to open the office
Behind the Scenes
We have been using this downtime to upgrade our sterilization and disinfection methods to address the COVID concerns:
You will notice that we installed sneeze-guards at the front office. We strongly believe in open spaces, where we can communicate with no barriers between us. However, it was necessary to install the sneeze guards in order to offer an extra-layer of protection to our team. Another change is that the front desk employees will wear face-masks, face-shields, disposable gowns, and bonnets.
We have removed all the magazines and remotes from our lobby. As usually we will have our Keurig machine, but it will be behind the sneeze-guard. If you want a tea, coffee, or water before the appointment please let us know and we will help you
We are installing several extra HEPA filtration units throughout the office, including in every operating room, and in the lobby. We are already using high MREV filters for our AC unit. We are upgrading our exhaust fans in the office with high CFM units in order to create a high volume of air evacuation from the office.
In the back office we upgraded our aerosol evacuation systems to help with minimizing the aerosol formation during the dental and hygiene procedures
Before the Appointment
Points to consider before being invited in the treatment room:
01. Please expect more communication with us. We will call you the day before the procedure to go over a COVID questionnaire. We will be available at that moment to answer your questions as well
02. Please make sure you are on time for your appointment. Because of the new protocols, and the uniqueness of the situation we are in, we will do our best on stay on time, but any little delay may have a snowball effect.
03. Please bring with you only the strictly necessary items: Driver’s License, Insurance card, Credit Card/Checkbook, phone/tablet. They will be disinfected by us, placed on a disinfected tray which will be handed back to you to carry in the treatment room. Please do not bring purses, bags, etc.
04. We are encouraging to come to the appointment alone. We will allow somebody in the back with you ONLY in exceptional situations (please address this with our front desk team at the time of the appointment confirmation, so we can make the necessary arrangements)
05. Please bring with you a face covering mask. If you don’t have one, we will provide you with a disposable one to use during your visit with us. Please be aware that we are trying very hard to procure disposable masks, and it is still very difficult to get them. Please help us be able to provide the necessary masks for patients who really don’t have any other means to procure them
06. We will take your temperature (please keep you AC running in your car prior to coming into the office in order to avoid false readings), our front desk team will go over the COVID questionnaire again with you, and we will ask you to certify the accuracy of the information.
07. If your treatment room is ready for you, the dental assistant will take you in the back right away. If we still need some time, we will ask you to wait in the car, and we will call you when the room is ready for you.
08. Please keep the face mask in place all the time, except for when we are actively working on you
09. If needed please bring a small throw blanket with you as we will keep the temperature in the office quite low (all the extra PPE we need to wear will take its toll).
Points to consider when in the treatment room
01. Please keep your facial mask on at all times we are not working on you.
02. Your belongings will be on a disinfected tray, so you can have access to them during possible down-times
03. Before sitting down we will ask you to wash your hands thoroughly
04. We will implement a pre-procedural rinse of peroxide and mouth wash (for taste purposes) before all the procedures.
05. In order to minimize the aerosols in the office we will place a small profile nasal mask on you to allow the evacuation of the expelled breathing air outside the office
06. Both me and the hygienists, will work with High Volume Evacuation systems (called Isolite), to minimize the creation of aerosols in the office
07. The operative team will wear disposable gowns, bonnets, facial shields, and level 3 or N95 masks. This may create some difficulties in the communication with us (especially because of my accent), please be patient with us.
08. We would like to encourage you NOT to use the restroom. If you have to use it we will stop the procedure, you will have to place the facial mask back on, and we will ask you to wait for the assistant to be sure that the restroom is available before you can go and use it.
Points to consider at the end of your appointment
01. Please wash your hands thoroughly before leaving the treatment room
02. Wait until your assistant will make sure that no other patient is at the front desk before leaving the treatment room
03. Stop at the front desk for scheduling your next appointment, and make your required payment (if it wasn’t made before the treatment)
We know that all this enhanced protocol is new (both for you and for us). We usually love to chat with you at the end of the appointment, catch-up with the news, and we will return to usual us as soon as possible. As we progress there will be some “hiccups”, and we are asking you to be patient with us, as we assess and improve this new protocol.
Thank you for being our patient, and thank you for being patient. We are all in this together, and we will do everything we can to create a safe environment for you and our team.