The Impactful Change on Dentistry As We Know It

By Samuel E. Cress, DDS

As of May 1st, 2020, dentists have been offered the opportunity to resume practicing dentistry following the Centers for Disease Control (CDC) and Prevention Guidelines for Dental Settings During the COVID-19 Response.  Based on these guidelines, your routine dental visit will look a little different. There are new rules and guidelines in place not only to protect the dental patient but the dental healthcare professional (DHCP) as well.  The new experience will look something like this:

Pre-Appointment Screening

On scheduling or confirming your dental appointment, you will be asked over the phone several “pre-appointment screening” questions to determine if you are at risk of having been exposed to COVID-19.  Patients will be notified that they may not bring a companion(s) to their appointment, unless the patient requires assistance (eg, pediatric patients, special needs patients, elderly patients, etc.)

Upon arrival, you will be asked to remain in the safety and comfort of your car and call the office to let them know that you have arrived.  One of the DHCPs will come out to your car, take your temperature and escort you straight back to the treatment room.  Both you and the DHCP will be wearing the ever so fashionable face mask.  This protocol is designed to help to minimize possible contact with other patients in the waiting room.  You will notice that all magazines, reading materials and other objects that may be touched by others and which are not easily disinfected have been removed.  You should also notice signage prominently displayed showing the standard recommendations for respiratory hygiene/cough etiquette and social distancing – information that has become all to common for all of us.

Sanitation Protocols

The DHCP has always adhered to these standard precautions, which include, but are not limited to hand hygiene, use of PPE, respiratory hygiene/etiquette, sharps safety, safe injection practices, sterile instruments and devices and clean and disinfected environmental surfaces.  There have been heightened sanitation protocols that are in place as a result of COVID-19, but they are no different than the ones dentists have been utilizing prior to the crisis.  There will be fewer patient appointments per day, which allows DHCP’s additional time between patients to thoroughly clean all surfaces and ensure each patient is entering a sterile environment.  This includes all surfaces from door handles, chairs and any equipment using Cavicide wipes and disinfectant sprays.

Most dental offices will require patients to wash their hands upon arrival before entering the office or use hand sanitizer as they enter the offices.  Patients will be asked to perform a pre-procedure rinse, if medically safe, which is a 30 second rinse of hydrogen peroxide.  You will notice that the DHCP will be wearing an additional layer of PPE than in the past – face shield, hair and shoe coverings, as well as disposable surgical gowns.  If the dental procedure is likely to involve aerosols, the DHCP will be wearing an N95 respirator mask.

Patient Safety

The DHCP must complete the full treatment of one patient before leaving the treatment area to treat another patient.  The DHCP should prioritize the use of hand instrumentation and only hand instruments and low speed polishing tools for hygiene services.  Dental isolation should be used if an aerosol-producing procedure is being performed to help minimize aerosol or spatter.  Some dentists have implemented extraoral dental suction systems into their office that removes aerosols as much as possible.

Post Appointment Care

After a patient’s dental care appointment, the patient will be asked to contact the dentist’s office if they experience COVID-19 symptoms within 14 days after the dental appointment.  Expect your dental procedure to have an additional cost associated with it to cover the cost for the PPE protection.  Each office has their specific protocols that are in place not only for the patient’s protection but the protection of others.  Be patient and follow the guidelines that have been set by the CDC and the governing body, and together, we will get through this.