It is time for your biannual cleaning and checkup. But wait! There is a global pandemic caused by a coronavirus known as COVID-19 happening. What should you do? Can you safely visit your dentist? Or should you put off your checkup for safer times?
Long story short, it is safe to go to the dentist. Read on and I will explain. As a dental hygienist, I would like to explain what is being done for your health and safety during these uncertain times. Rest assured, you can comfortably return to your dental office for emergency or routine procedures.
The American Dental Hygienist’s Association (ADHA) has this statement in regard to COVID-19: “To mitigate the spread of COVID-19, ADHA continues to support the recommendations from the Centers for Disease Control and Prevention (CDC) that balance the need to provide necessary services while minimizing risk to patients and dental healthcare personnel.”
The Centers for Disease Control (CDC) has set up a list of protocols recommended as guidance for dental settings. I will explain what is being done before, during and after your appointment to ensure your safety.
Before Your Visit
Your office will communicate with you before your appointment. You will be asked some screening questions. These questions include:
- Do you have fever or have you felt hot or feverish recently(14-21 days)?
- Are you having shortness of breath or other difficulties breathing?Do you have a cough?
- Any other flu-like symptoms, such as gastrointestinal upset, headache or fatigue?
- Have you experienced recent loss of taste or smell?
- Have you been in contact with any person with a confirmed COVID-19 diagnoses?
- Patients who are well but who have a sick family member at home withCOVID-19 should consider postponing elective treatment
- Is your age over 60?
- Do you have heart disease, lung disease, kidney disease,diabetes or any auto-immune disorders?
- Have you traveled in the past 14 days to any regions affected by COVID-19?
Any positive responses will require further discussion with your dental office and may require you to postpone dental treatment. Treatment can be scheduled when you can answer “no” to all questions.
You will be asked the same series of questions at the time of your appointment. This is to make sure nothing has changed between now and then. To avoid extra people in the office, you will be asked to arrive to your appointment alone. If you are a guardian, you can accompany your child.
When you arrive to your appointment, you will be asked to remain in your vehicle until your dental provider is ready for you. You will be asked to call your dental office upon arrival to let them know you are there. Once your operatory is available, your provider will call you to let you know it is okay to come inside. This eliminates any contact you would have with others in the reception area.
During Your Visit
Your dental appointment may be a routine dental cleaning or you may have an issue with a tooth that requires attention. Either way, you will follow the same protocols for routine as well as dental emergency visits.
You will be required to wear a mask into the dental office. This goes for any person who accompanies you to your appointment. If it is not necessary that they be with you, any extra people you came with are asked to stay in the vehicle until your appointment ends.
Once you enter the office, you will be asked to use hand sanitizer. Your provider will greet you and take your temperature in the entry way. If you are experiencing a fever greater than 100.4 degrees you will not be allowed to proceed any further and your appointment will be canceled. You will be advised to monitor your symptoms for COVID-19. You will be able to reschedule your appointment once you are symptom free.
You may notice there are a few changes within the office for your safety and for the safety of the dental team. At the start of the appointment, you will be asked to swish with a pre-rinse (otherwise known as a preprocedural rinse) containing 1.5% hydrogen peroxide. You will swish for 30 seconds, spit it out and then swish again for another 30 seconds.
There is no evidence at this time for a 1.5% hydrogen peroxide rinse against COVID-19. However, recent clinical trials have proven there is moderate evidence to suggest its efficacy in reducing the bacterial and viral levels in dental aerosols. Dental aerosols are generated during dental procedures with the use of handpieces, air/water syringes, ultrasonics and polishing.
What this means is bacteria and viruses are aerosolized into the air during treatment. These aerosols can travel significant distances from the treatment area. By rinsing with a solution containing 1.5% hydrogen peroxide, you will be reducing the risk of transmission of pathogenic microorganisms to others through the air.
A very common preprocedural solution provided in dental offices is Peroxyl. It can also be purchased for home use. Peroxyl is an alcohol free antiseptic mouth rinse that cleanses with an oxygenating action in addition to its content of 1.5% hydrogen peroxide. This rinse is also recommended by dental professionals to promote healing within the mouth.
What Else is Being Done?
Your provider will limit the use of instruments that can cause aerosols for your safety and for the safety of others. In addition to preventing aerosols, your dental office may have air purifiers stationed within each operatory and also in the hallways. Air purifiers will clean the air and remove any impurities. Your dental provider may have installed special filters in the office for this same reason.
You will notice your dentist, dental hygienist and assistant will be taking extra precautions to protect you. Your provider will be wearing a double mask. They will be wearing an N95 or KN95 mask in addition to a level 3 mask (higher level of protection than the standard level 2 mask) over the top of this mask.
Also, they will be wearing a face shield over the top of eye protection glasses, magnification loupes or goggles. They are also going to be wearing protective clothing including full length scrub jackets or disposable gowns. Their clothing is changed, disposed of or laundered onsite so no “street clothes” are ever worn.
After Your Visit
Products the meet the EPA’s (Environmental Protection Agency) criteria for use against SARVS-CoV-2 are used for disinfection between patients. All surface barriers are removed and replaced with new barriers. A surface barrier is a plastic covering placed over areas that are touched by the dental staff. These areas include such things as tray covers, buttons on chairs used for adjusting the chair, light handles, air/water syringes and handpieces.
Paperwork is no longer recommended for the operatory. Computer entries are to be made using a barrier or plastic covering over the keyboard to prevent cross contamination. All instruments and handpieces used are heat sterilized with an autoclave. Anything that can not be sterilized using an autoclave will be disposed of.
It is recommended that appointment times be spaced out throughout the day. What this means is allowing extra time between patients and having your provider rotate patients between two treatment rooms . By doing this, you will not be treated in a treatment room that was just used. The air purifier will have had a chance to clean the air in the room and the disinfectant will have had adequate time to be effective.
After your appointment, you will be asked to schedule any additional appointments within your treatment room. This limits your exposure to the front desk personnel and other patients coming in or going out. It is recommended that you take care of any financial or insurance related questions over the phone instead of in person.
You are asked to report any COVID-19 related symptoms to your dental provider if you experience any symptoms within the 14 days following your appointment for the protection and safety of others.
Coronavirus and Dental Offices-How to be Safe
By maintaining the highest standards set forth by the CDC (Center for Disease Control), your dental provider can effectively contribute to preventing the spread of Coronavirus. While there is no way to know for sure that you will be protected from contracting COVID-19 while visiting the dentist, you can find comfort in knowing that your safety is their top priority.
As a dental hygienist, I realize that patients have many questions and concerns during this time of uncertainty. Dental health is important and it is a well-known fact that oral health relates to overall health. It is important to weigh the risks of visiting your dental provider versus putting off important dental care.
In case your appointment needs to be rescheduled or delayed, you can do your part at home by keeping up with a good oral hygiene routine. This includes brushing twice a day with an electric toothbrush and cleaning between your teeth once a day with an interproximal brush, floss or an oral irrigator. Adjunctive oral care includes use of supplements like oral probiotics to treat and prevent gum disease and a good oral rinse to maintain the oral microbiome.
No one can make the decision for you, but I hope you would consider visiting your dentist regularly. By knowing all the safety and precautionary measures put in place for you, you will know how to be safe in regard to coronavirus and your dental office and can make an informed decision about your appointment.
Learn more about maintaining your oral health at oralprobiotichealth.com. Please feel free to leave any questions or comments below and I would be happy to help!