Dentistry and Corona Virus - Guidelines for Dentists and Patients

Our Clinics on Shivajinagar and Nigdi Pradhikaran near Wakad in Pune are now upgraded and ready!

This blog gives you some information on the Corona Virus or Covid19 pandemic, what the guidelines for us dentists are and what patients must remember to do during the time of Corona Virus or Covid19 when you come for treatment in the current scenario.

Dentists are responsible for adopting prevention and infection control measures during or Corona Virus or Covid19 to avoid or reduce as much as possible the transmission of microorganisms during any procedure in their practice. WHO has recently declared a pandemic, caused by the SARS-CoV-2 virus, known as coronavirus disease (COVID-19).

SARS-CoV-2, the virus that causes COVID-19, is thought to be spread primarily through respiratory droplets when an infected person coughs, sneezes, droplet inhalation or indirect contact with nasal, oral, and eye mucosa. Dental workers play a crucial role in the prevention of this viral infection, because aerosol and droplets are the main transmission vectors. Airborne transmission from person-to-person over long distances is unlikely. There are also indications that patients may be able to spread the virus while pre-symptomatic or asymptomatic. The virus has been shown to survive in aerosols for hours and on some surfaces for days. Many dental procedures produce aerosols and droplets (high speed hand pieces, triple syringes, ultrasound, etc) that may be contaminated with the virus. These droplets and aerosols are small enough to remain suspended in air for a long period of time before falling into environment surfaces or entering the respiratory tract of other individuals. Therefore, dentists or dental care workers or providers may enforce even more stringent prevention and control measures, taking into account their individual and specific realities.

The Occupational Safety and Health Administration places DHCP (Dental Health care professionals) in the very high exposure risk category, as their jobs are those with high potential for exposure to known or suspected sources of the virus that causes COVID-19 during specific procedures.

Centres for disease control and prevention has given recommendations:

Postpone elective procedures, surgeries, and non-urgent dental visits.
Proactively communicate to both staff and patients the need for them to stay at home if sick
Contact Patients Prior to Emergency Dental Treatment

Provision of Emergency Care to Dental Patients with COVID-19 During the COVID-19 Pandemic

Assess the patient’s dental condition and determine whether the patient needs to be seen in the dental clinic. If a patient arrives at your facility and is suspected or confirmed to have COVID-19, take the following actions:

Defer dental treatment
Give the patient a mask to cover his or her nose and mouth.
If not acutely sick, send the patient home and instruct the patient to call a medical provider.
If acutely sick (for example, has trouble breathing) refer the patient to a medical facility.

Dental treatment should be provided in a hospital or other facility that can treat the patient using the appropriate precautions.

Provision of Emergency Care to Patients Without COVID-19 in a Dental Clinic like ours on Shivajinagar and Nigdi Pradhikaran near Wakad Pune during the COVID-19 Pandemic

If the patient is afebrile (temperature < 100.4?F) and otherwise without symptoms consistent with COVID-19, then emergency dental care may be provided using appropriate engineering controls, work practices, and infection control practices.

Engineering Controls and Work Practices

Avoid aerosol generating procedures whenever possible.
If aerosol generating procedures are necessary for emergency care, use four-handed dentistry, high evacuation suction and dental dams to minimize droplet spatter and aerosols.

Infection Control Considerations

DHCP should wear a facemask at all times while they are in the dental setting. Surgical masks are generally preferred over cloth face coverings for DHCP because surgical masks offer both source control and protection for the wearer against exposure to splashes and sprays of infectious material from others

The PPE is recommended for DHCP when providing emergency dental care to patients without Corona Virus or COVID-19.

Dental care to patients with acute viral symptoms

There is high risk of virus transmission in dental care, due to the high viral load present in high airways and due to likelihood of exposure to biological material in aerosols generated by procedures. Especially during the COVID-19 outbreaks, it is recommended that dental procedures be restricted to emergency or urgent cases.

General precautions patients should take when arriving at a dental clinic like Dr Kheur Dental Clinics on Shivajinagar and Nigdi Pradhikaran near Wakad in Pune:

Instruct patients that if they have flu-like symptoms or a cough, they should wear a face mask before leaving their homes and follow the following breathing etiquette:

Whenever you cough or sneeze, cover your nose and mouth with your elbow or a tissue;
Use a disposable tissue to clean your nose (dispose of it immediately after using, then wash your hands);
Avoid touching their eyes, nose, and oral mucosa;
Wash their hands (Washing your hands and face: hands and face should be washed with water and soap for 20 seconds).

Covid-19

Hand hygiene technique with alcohol-based formulation
Covid-19

If necessary, sanitize the hands with alcohol-based sanitizer.

Do not touch your face.
Thermometer: request someone to check your body temperature.
Tie your hair and avoid wearing earrings, rings, and wristbands.
Bags: If you decide to enter the clinic with your bag, it is recommended that you sanitize it with 70% alcohol spray.
Wear shoe covers.

General precautions for patients and those accompanying them when arriving at a dental clinic like Dr Kheur Dental Clinics on Shivajinagar and Nigdi Pradhikaran near Wakad in Pune:

Patients and those accompanying them should be instructed to immediately inform the reception whether they have had any flu-like symptoms (such as coughing, a running nose, fever, difficult breathing), and should take appropriate preventive measures like wearing surgical masks as soon as they enter the clinic (surgical masks should be available at the entrance, otherwise, a patient with flu must request them). Practice social distancing;

Wash your hands with water and soap for 20 seconds, dry them with disposable tissues, and sanitize the hands with 70% alcohol-based sanitizer. Let them dry naturally. After sanitizing, do not touch anything else, including your mobile.

As soon as the patient enters the dental clinic, an attendant should check their body temperature with a digital infrared thermometer and update their medical history (even if it is a return patient, always ask about corona virus or Covid19 symptoms or if any relative, friend, or acquaintance has had any symptoms). If the patient’s temperature is above 37.8 degrees Celsius, they should be provided with a face mask and instructed about possible symptoms, then they should return home, rest, and seek medical care.

When entering the clinic, remove rings, wristbands, and other accessories. Turn off mobile phones and place them away, sanitize bags with 70% alcohol spray.

Wear shoe covers.

As the virus is sensitive to oxidation, it is recommended to do a pre-procedure antiseptic rinses in order to reduce viral loads. Pre-procedure rinses (15mL of the solution for 30 seconds) with 1.5% hydrogen peroxide or 0.2% povidine iodine mouthwash for 1 minute. Do not use a spittoon. Use the same sink that had been used for washing the hands and face.

Give the patient a head cap and instruct them to fully cover their hair and ears.

When leaving the clinic, they should return to the restroom to wash their hands with water and liquid soap, dry them with disposable tissues and sanitize the hands with 70% alcohol-based sanitizer. They should wait for their hands to dry before going home safely.

Dentistry and Corona Virus