IF THE column previous to this sounded like very drastic changes to the dental clinic and the dentist that we have been familiar with, read on.
More drastic changes are coming.
Procedures that produce aerosols or air droplets, for example, require additional respiratory tract protection for the dentist and all staff in the immediate treatment area.
These are equipment that many haven’t seen before in dental clinics, for instance, Powered Air Purifying Respirators, N95 filtering facepiece respirators and N95 masks (and not ordinary surgical masks, mind you).
That’s according to an April 7 dental care directive from the California Department of Public Health.
When and if the dental procedure produces an aerosol, dental care cannot be provided in a typical dental office. It must be provided in an Airborne Infection Isolation room with the highest level of respiratory protection for dentists and staff.
There are strict specifications of what an Airborne Infections Isolation room is. The United States Centers for Disease Control and Prevention says these rooms are designed to prevent the spread of air droplets expelled by a patient.
These rooms have negative pressure relative to other parts of a health facility. Negative pressure causes air to flow from the corridors into the room.
Air cannot escape to the other parts of the facility when the door is closed and the ventilation system is operating properly. Air from the room can be exhausted directly outdoors, where the air droplet will be diluted in the outdoor air, or passed through a special high efficiency air filter that removes most (99.97 percent) of the droplet before it is returned to the general circulation.
In addition to these precautions recommended by the California Department of Public Health, dental patients must use an antimicrobial rinse before a dental procedure is conducted; the American Dental Association suggests using a one-percent hydrogen peroxide rinse.
Dentists must minimize operations that can produce droplets or aerosols. A rubber dam should be used as much as possible; this is a protective cover made of rubber that is placed around the mouth.
Other recommendations for dentists: the patient’s oral cavity must be rinsed slowly to avoid unnecessary splatter. Avoid or minimize procedures that may induce coughing – and thus splatter.
After completing dental procedures, room surfaces must be cleaned and disinfected soon after adequate time has passed to allow aerosols to settle.
Single-use Protective Personal Equipment or PPE must be immediately discarded; re-usable PPE must be disinfected in a manner that prevents cross-contamination. If foot coverings were not used, the dentist and the staff must change and disinfect footwear before leaving the clinic.
Upon returning home, the dentist and the dental staff must immediately remove clothes, take a shower and then wash clothes.
Single-use masks or disposable masks should not be washed for the purpose of reusing with other patients./PN
