Dentistry during COVID-19
As the dental practices have opened again and slowly started taking in patients, naturally, the biggest concern is what measurements will be taken when treating patients, such that the risk of any potential infections spreading is minimised as much as possible. In this article we’ll explore how dentists around the UK are working to ensure your safety when visiting. Current health practice guidelines exist to not only protect patients, but the dental practitioners as well.
What are the risks?
The oral cavity harbours millions of microorganisms. This means spread of any droplets from a patient’s mouth can easily occur both through airborne and on nearby surfaces. If an infected patient were to visit a dental practice, they would be able to spread the infection to any nearby patients in the waiting room through droplets from coughing or sneezing, and to the dental professionals either through direct contact during a procedure, or by contaminating any nearby surfaces in the procedure room.
Daily safety practices in dental procedures
Dentistry is already known for working within some of the strictest infection control standards. Below are some of the existing practices that would be upheld throughout a dental procedure.
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All personal protective equipment (PPE) used by dentists and nurses is fully sterilised.
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Hand hygiene – hands washing and/or sanitising after touching instruments and materials or anything in general bare hand. This is done before and after treating patients, as well as before putting on gloves and after removing gloves.
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Use of protective equipment – gloves, masks, eyewear – gloves are used when doing procedures due to risk of touching body fluids, protective clothing is used to protect skin from body fluids, face protection due to risk of body fluid splashes, keeping hands away from face, limit touching surfaces, removing protective equipment before leaving work area
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Respiratory hygiene/cough etiquette – covering the mouth and nose with a tissue when sneezing, sanitising hands after contact with respiratory secretion and contaminated objects. Practice should also have no-touch waste containers for disposal of tissues, etc.
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Surfaces are regularly cleaned and disinfected
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The same pair of gloves is not worn for more than one patient and hands are washed after using gloves.
Aseptic technique during operations
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Sterile gowns, drapes, masks and gloves
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Antiseptic skin preparation for the patient
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Sterile instruments and handpieces used
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Doors kept closed and traffic in and out is minimised, with only the necessary people present
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Only sterile to sterile contact is allowed, so the doctor and their assistant will rely on a secondary assistant
Sharps safety
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Do not recap used needles by using both hands or any other technique involving directing the point of a needle toward a part of the body.
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Using a one-handed scoop technique or a mechanical device to hold the needle cap when recapping needles – minimises chance of pricking hand with a needle
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Disposable syringes and needles, scalpel blades, and other sharp items are thrown away in puncture-resistant containers. The containers are ideally as close as possible to the area where the items were used.
Injection practices
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Injections prepared using the aseptic technique in a clean area.
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Needles and syringes must not be used for more than one patient.
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Single-use containers must not be used for more than one patient.
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If multi-dose vial enters the immediate patient treatment area, it should be dedicated for the single use of that patient and discarded immediately after.
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Multidose vials are dated after opening and discarded within 28 days.
COVID-19 Measures
A disclaimer: this information applies as of the time of writing it, however, it is unknown whether it will change with the development of the situation.
The following is roughly what to expect during a dental visit at the moment and how it will differ from your previous visits before the pandemic outbreak. The main difference in how procedures are carried out is a bigger focus extra protection on transmission through aerosols, as well as surfaces, floors and common areas.
Before your appointment
Firstly, appointments can only be made via telephone and patients are advised not to visit their practice without an appointment. Patients are also advised to come by themselves if possible.
On arrival, patients are asked to sanitise their hands and have their temperature taken with a contact-free thermometer. When entering the waiting room, patients will be asked to wear a protective face mask and shoe covers, and to bring a plastic bag to place any belongings in. The waiting room will have been reorganised to accommodate for social distancing and will be cleaned regularly (any hard to disinfect objects are removed).
It is good to keep in mind that any non-urgent procedures may be delayed. There will also be a delay in between procedures, to allow time for proper cleaning of the procedure room. Your practice will also ensure that the room you are treated in is well ventilated, so that old air doesn’t recirculate.
During your appointment
Patients are asked to use mouthwash before the procedure begins. However, no rinsing is allowed and instead any mouth cleansing will be done only through suction (the little sink next to the dentist chair will also be covered up).
All PPE used by dentists is fully sterilised. Dentists are also currently being fitted with special masks that are more effective than regular surgical ones, to ensure that inhalation of potentially dangerous particles is minimised.
Practices will use equipment and techniques that lower the risk of spray, and any emergency procedures that have a high level of spray will be carried out in a specialised room. Any non-urgent procedures could be delayed.
After your appointment
At the reception, patients are advised to use contactless to pay any charges and bring their own pen to sign any paperwork.
Any post-appointment instructions will be sent by text or email.