Dental practices and COVID-19

The impact of covid-19 on dental practices 

Like many industries in Canada, the COVID-19 pandemic has greatly impacted all businesses, notably dentistry. 90% of dental offices opted for closure except for urgent emergency procedures as per the Centers for Disease Control and Prevention guidelines at the beginning of the pandemic in March of 2020. This affected local dental offices and patients across the country who were experiencing severe discomfort because they couldn't receive care. 

Is it safe to go to the dentist? 

Many Canadians have to ask, "is it safe to go to the dentist?" to maintain their oral hygiene. The main concern is how the virus is spreading respiratory droplets that may make their way into the mouth, nose, and eyes, putting the patient at risk and how likely it is for the virus to spread in the dental office.  

Most people forget to think about the dental hygienist or dentist's health and safety risks who have a higher chance of contracting COVID-19 from the patients. The most common procedures are teeth cleaning that uses water flossing tools to spray water onto the teeth to remove plaque. The concern is that this tool has a higher risk of transmitting the virus into the air and possibly onto the dentist. 

It may seem that patients are more at risk because their mouths are open while being treated. The more prominent risk, however, is for the dental staff. The staff wear gowns, face masks, shields, goggles, and gloves. Doing so makes it much harder for them to produce droplets that would contact a patient. In contrast, a high-pressure tool that sprays water into a patient's mouth can act as an aerosol can.  

Dental PPE requirements 

The goal of PPE within a dental practice is to maintain a healthy, clean, and safe environment for patients and staff inside a dental office.  

Dental PPE includes:  

• Protective clothing such as gowns 
• Non-surgical and surgical gloves 
• Surgical masks 
• Protective eyewear and face shield 

Dental office PPE protocol and preparing to be COVID-19 proof 

Before the pandemic, a dental office upheld strict hygiene practices. All dental offices already practice the standard for cleaning and sanitizing to kill viruses, bacteria, and pathogens transmitted to patients or staff. Due to the pandemic, additional safety precautions were put in place, recommended by the Centers for Disease Control and Prevention. 

Dental office PPE protocol for patients: 

• Avoid attending appointments if experiencing Covid-19 like symptoms.  
• Comply with patient screening; this includes a temperature check. 
• Ensure everyone has face-coverings upon arrival. Patients may remove their face mask when being treated but should put it back on when leaving. 
• Follow social distancing guidelines while in the waiting area by staying six feet apart from others. 

Dental office PPE protocol for staff to follow: 

• Identify any elective procedures, surgeries and non-urgent patients that could be postponed.
• Perform pre-screening for all patients.
• Please limit the number of visitors allowed to accompany the patient to their dental appointment 
• Install social distancing barriers and sneeze guards.  
• Remove toys, magazines, and other frequently touched objects from the waiting room.

Protocol for before treating patients, according to CDC:

• Perform hand hygiene (wash your hands with anti-bacterial soap and use hand sanitizer).
• Put on personal protective equipment that covers clothing and skin, such as a gown.
• Put on a surgical mask. 
• Put on a face shield or eye protection. 
• Put on medical gloves.
• Upon dental procedure, provide the patient with an antimicrobial product mouth wash to swish for 30 seconds. This step may reduce the level of oral bacteria. 

What will the dentist industry look after COVID-19? 

During these unprecedented times, the dental industry faces many challenges as they adjust to the new normal and serve their patients as best they can by implementing additional safety measures. These questions remain unpredictable. 

How will dentists re-evaluate their plan to operate and act accordingly to the constant change of nature? 

Encourage patients to comply with provincial and federal guidelines and cancel appointments if they show symptoms of COVID-19.  

Many individuals are not only raising safety concerns but also financial difficulties. Dental practices will need to work with their patients and staff to prioritize urgent procedures and postpone none urgent checkups. 

Staff concerns with returning to work

When the government allowed dental offices to reopen for elective procedures, many staff members felt the need to opt-out on returning too quickly. Some were caring for an elderly family member, attending to childcare, and felt that putting their loved ones at risk was possible. 

Many employees were concerned with the risks that returning to work entailed. In response, many dental practices operated with small scale teams prioritized urgent procedures and postponed annual checkups. 

Conclusion 

So, is it safe to go to the dentist right now? That question is up to the patient to decide based on their comfort level. If you are experiencing any discomfort that may be an emergency-pain, uncontrolled bleeding, an accident occurred, or any unexpected issue has occurred, it's important to contact your dentist as soon as possible.

Many local dental offices are still open for emergency cases. When your government officials allow elective procedures, it will be up to your discretion. Contact your dental office and ask for their COVID-19 protocols and find out how they are keeping their workplace a safe environment for a comfortable experience.