COVID 19 update –  21 April 2020

Reduced restrictions on dentistry

 Following a meeting of the Prime Minister and the Australian Health Precautions Principle Committee (AHPPC) on 21st April 2020, a relaxation of medical treatment restrictions was approved.  The Australian Dental Association have now been advised that level 3 restrictions will be relaxed to level 2 restrictions on Monday 27th April 2020.

How does this affect what dental treatment can be provided?

The list of APPROVED DENTAL PROCEDURES under level 2 restrictions include the following:

  • Consultations, examinations and Xrays to allow for simple and complex treatment planning
  • Simple non-invasive dental fillings that can be completed without the need to use high-speed drills with water spray
  • More complex fillings and restorative procedures that require the use of the high-speed drill with water spray (ONLY if used in conjunction with “rubber dam” preventing the aerosolisation of saliva or blood that may contain COVID-19 virus)
  • Simple extraction of teeth that can be completed without the use of a surgical drill or Piezosurgery
  • Limited localised hand scaler cleaning of teeth, but NOT the more effective and thorough high-frequency Piezoscaler cleaning performed by our dental hygienist for the treatment of gum disease. (This will have to wait until restrictions are relaxed further to level 1 restrictions)
  • Investigation and management of soft tissue lesions including ulcers
  • Soft tissue procedures where no drilling is required and no high frequency or Piezoscaling is required.
  • Treatment of temporo-mandibular joint problems
  • Denture work once the Prosthetist returns to work following guidance from his professional association
  • Preventative dental services that include the provision of fluoride and other re-mineralising agents for the treatment of early non-cavitated lesions of dental decay and for the treatment of tooth sensitivity
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What treatment is NOT APPROVED under level 2 restrictions?

Any use of a drill in the mouth creates an aerosol that contains microflora (bacteria and fungus) and viruses that are present in the mouth.  These live organisms and particles can then remain in the aerosol suspended in the air within the dental surgery for some time gradually settling on the surfaces in the room.  This is why all surfaces including the work surfaces, dental unit, dental light and the dental chair must be cleaned well using approved detergent wipes and vigorous rubbing.

The presence of the viral particles in the aerosol is the reason why even at level 2 restrictions, dentists cannot perform treatment that may generate the aerosol.  Some COVID-19 patients may appear well and not appear to have a fever but could carry the virus and if treated then the virus could be transmitted to members of the dental team, land on surfaces that could be accidentally touched and then passed on to other surfaces and other people.

 

For the reasons explained the following dental procedures are NOT APPROVED under level 2 restrictions:

  • Surgical removal of teeth that require bone removal using a surgical drill
  • Surgical removal of teeth that requires that the tooth is sectioned using a surgical drill
  • Placement of dental implants requiring the use of a surgical drill
  • Crown lengthening surgery involving the re-contouring of bone by the use of a surgical drill
  • Restoration of both adult teeth and deciduous or baby teeth where drilling is required, unless rubber dam can be used. Most permanent fillings in both adults and children required the use of the high speed dental drill with water spray
  • Bone grafting procedures where a drill may be used. However, many minor grafts can be provided without the need for drilling
  • Full gum disease treatment by our dental hygienist known as Guided Biofilm Therapy.

 

All our patients waiting for any Approved Dental Procedure will be contacted and an appointment made for treatment.  Alternatively they are welcome to call the practice to make an appointment (telephone 4725 1656).

 

Patients awaiting procedures that remain restricted should keep watching this website for advice regarding the restriction level in force.

 

As soon as level 2 is further relaxed to level 1 restrictions, we can then arrange for the treatment detailed above where aerosol may be generated.

The timing of any further relaxation of restrictions will depend on when the AHPPC considers the risk of transmission for COVID-19 is reduced to a safe level in the community.

 

We will keep our patients and our local community informed of all changes as they occur.

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