May 20, 2020
I’m hoping people are continuing to do well through this time of uncertainty.
Currently, the Department of Health has changed their guidelines to allow dental providers to see non-urgent and non-emergent patients, if we follow the infection control guidance provided by the Department of Health, the CDC and OSHA (including being able to obtain and use proper PPE), and we determine that it makes sense to do so in our clinical judgment. The Department of Health also is encouraging offices to provide only care that is non-aerosolizing, and asking offices to prioritize patients (with the goal to first treat patients whose dental care may impact their other health conditions or may develop into something that would become irreversible).
We have met as an office, and have determined to serve our patients’ needs while following the Department of Health, CDC and OSHA guidelines (although the Department of Health has made it crystal clear that its own guidance should be followed over the CDC and OSHA requirements in the event of any conflict). We will prioritize patients’ needs based on pain, swelling, uncontrollable bleeding, and evaluations needed prior to surgery or chemotherapy. It also is our clinical judgment that it may be impossible to determine patients’ needs without a proper evaluation, and will perform those as necessary; patients that present with bleeding upon probing, or inflammation, may be considered in need of further care.
In order to accomplish those objectives, our current guidelines are as follows:
1) We will use a prescreening phone call to address if the patient has experienced, in the last 14 days, any of the following: fever, muscle aches or chills, coughing, difficulty breathing, has been in contact with anyone with those symptoms, or has had contact with anyone who has been diagnosed with, or is presently being evaluated for, COVID 19. Patients will be rescheduled if they have any of these signs or symptoms.
2) Patients will contact the office when they arrive in our parking lot for their appointment. Patients are to remain in their vehicle and will receive at a text or phone call when we are ready to see them. Only the patient will be allowed in the office, except for patients that need special assistance. Patients will be met at the door, and patients must be wearing a mask when they enter. Staff will be masked and gloved, in order to immediately take the patient’s temperature and blood oxygen level. Patients will be asked immediately to use hand sanitizer, and then re-asked questions regarding their current health and symptoms. This will occur in an area designated for screening or the patient will finish the screening in a hygiene room separate from other patients; these areas will be cleaned and disinfected. If the patient is to be seen by the hygienist, we have eliminated the use of aerosolizing ultrasonic cleaners, and patients are to be hand scaled. Patients who have active periodontal disease that requires the use of ultrasonics are to be scheduled on a day that we can isolate them, and the hygienist is supplied an assistant to help with suction. When patients are not being immediately worked on, they are required to wear their masks. At the end of the procedure, they will be walked out of the office, or staged in the waiting area where social distancing is maintained in order to schedule or settle accounts.
3) All staff will be screened upon entering the office, just as the patients are, with temperature taken and blood oxygen levels read. Staff in contact with patients will be wearing PPE in accordance to the Department of Health and OSHA, which includes an N95 mask, face shield, surgical gown, gloves, and head covering. Plexiglass is being installed at the front desk, but until that time, we have marked the floor and chairs to ensure more than adequate social distancing. We encourage patients to use bathroom facilities prior to arrival, but if bathroom facilities are needed here, they will be cleaned after each patient.
4) Rooms will be disinfected following the applicable guidelines after each patient, and no staff member is permitted to leave the building until they have changed out of their work attire.
We strive to take care of the dental needs of our patients, while keeping them, and us, safe and comfortable. We understand this is a frustrating and confusing time for us and for patients, since guidelines and recommendations are evolving constantly. Since the Department of Health has determined that treatment needs should be based heavily on clinical judgment, at the present time we are planning to see patients on a limited basis until conditions and/or recommendations change. We will continue to prioritize patients, and in many cases, this treatment prioritization will be done based on the information we gain from clinical examination done in conjunction with the hygiene department. We will continue to follow our strict guidelines, which exceed the requirements of the Department of Health, CDC and OSHA regulations, and, as always, welcome your input.