Covid-19 and Safe Dentistry

COVID-Safe Dentistry – a patient’s checklist for safe treatment

All routine dentistry can resume for patients, for whom there is no detected health or epidemiological risk factors for COVID-19 infection.

How do you know if you are at risk of having contracted or being likely to have contracted COVID-19?

 

ITEM 1: First you must be asked to complete a COVID-19 Health Questionnaire on arrival at the dentist on each occasion you arrive, not just the first time. 

On arrival, you should be invited to disinfect your hands using a hand sanitizer at reception before you collect a pen and COVID-19 Health Questionnaire to complete.

The questionnaire addresses your health and in particular your respiratory health to ensure you are not currently ill with COVID-19 (fever, sore throat, cough, feeling ill, loss of taste or smell).  You should also be asked if you have been in contact with any other person who has been diagnosed with COVID-19 or who is sick with cold-like symptoms.

If you or other members of your household are unwell, PLEASE DO NOT COME TO THE PRACTICE. Call our receptionist and discuss how to proceed.

The second epidemiological risk identifier is your recent travel experience.  It is important to ensure that if you have travelled interstate or internationally that you have self-isolated for a period of 14 days without any symptoms developing.  These questions are what are known as the “epidemiological risk factors” and help to identify members of the public who either have or may have, the virus.

 

ITEM 2: The next item for your checklist involves avoidance of risk factors for transmission of the virus in the practice.

There should be no magazines, or children’s toys around in the waiting area, the chairs should be set up to prevent patients from different households getting closer than 1.5metres.

Practice appointments should be booked to prevent gathering of multiple patients in the waiting area and allowing sufficient time for thorough treatment room disinfection between patients.

Ideally, patients should attend for their appointment alone unless they are minors, the elderly or they require a carer.

 

ITEM 3: Patients should be asked to use a mouthwash before treatment begins.

Once you are asked to move into the dental surgery, you will be asked to sit in the dental chair and be invited to use a pre-procedural mouthwash for one minute to reduce the number of live bacteria in your mouth.  This is designed to reduce the infective potential of the aerosol generated by the use of dental instruments during treatment including the dental drill, water and air spray, and the scaling machine.

 

ITEM 4: Dental healthcare workers in clinical areas should wear PPE.

Your dentist and his nurse will don their personal protection equipment known as PPE.  This includes the use of a mask, gloves and eye protection.

They MAY also choose to wear a lightweight impervious gown to protect their own clothing from any aerosol resulting from treatment.  These gowns are changed after each patient. The use of gowns is a choice made depending on the level of patient risk and the potential for the generation of an aerosol.  For non-aerosol generating procedures in low-risk patients, gowns are of no additional benefit.

Many dentists may use a sheet of dental rubber dam over teeth while performing certain types of dental treatment.  This isolates the teeth receiving treatment from the saliva and bacteria elsewhere in the mouth and has the benefit of reducing the infective potential of the aerosol generated from the mouth when using a dental drill, air and water spray or a scaling machine.

It is these additional features of PPE that help to minimise any transmission of all infections that could arise from the aerosol that is generated from the mouth.

 

ITEM 5: Time between appointments

Each surgery needs thorough cleaning after each patient.  This involves wiping down all the surfaces with “wipes” using a COVID-approved detergent product.  This is a normal cleaning protocol that took place even in the days before COVID.

Generally “single-use equipment” is used for the provision of dental care where possible.  This means items of equipment are thrown away after they have been used preventing the transfer of infection.

All instruments for re-use are cleaned, bagged and sterilised in a steam-pressure autoclave.  Every instrument bag has a unique “tracker label” and each steriliser load is recorded to ensure that all instruments can be traced and an effective sterilising cycle can be confirmed.

Once the treatment room has been re-prepared, the next patient may enter.

 

ITEM 6: Hand sanitizer after leaving the dental surgery on return to reception

To ensure hands are free of any potential infective organisms after having been in the treatment room, it is wise, but not an absolute requirement that patients disinfect their hands once again on return to reception before making any further appointments and settling their account.  Payment is encouraged using a card payment protocol avoiding the use of cash.   “Tap and Go” is the best option if available.

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