Dentistry in the COVID Pandemic: Reopening of Dental Practices

If you run a dental practice, you have been affected by the COVID-19 pandemic, as have been many other medical practices across the globe.

In this article, we take a look at everything you need to know about your dentistry practice during these times of the COVID-19 pandemic, specifically the steps you will need to put in place to ensure the reopening of dental practices across the globe.

This article is particularly important because, unlike other medical practices, Dentistry in the COVID Pandemic seems to be one of the practices that place patients and the healthcare workers at the highest risk of contracting the novel coronavirus. The primary reason why we’d recommend reading this article as you plan to reopen your dental practice is because of the aerosol transmission of the coronavirus/ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the one thing that has significantly impacted the delivery of dental care services, hence the stoppage of the provision of some medications, as well as dental therapies.

As dental professionals work on the reopening of dental practices, the methods and equipment used in dentistry come under fire, and the decision to and reopen your dental practice means that you need to pay more attention to your processes. Basically, dentistry practices involve the use of ultrasonic, rotary, as well as the laser-based instruments. All these instruments will produce water-based aerosols every time/ day they are used in the routine treatments for patients, which isn’t a good thing. All the aerosols generated will result in a build-up, reaching other patients and the healthcare workers in no time. Coronavirus is transmitted/ spread via and visible droplets and the invisible aerosols.

So, with the generation of aerosols an inevitable part of the dentistry process, you need to make sure that you come up with ways of making sure that your dentistry treatments are done in a way that does not risk others’ health patients everyone else working at your dental practice.

As you work on ways of reopening Dentistry in the COVID Pandemic, you also need to keep in mind that because of the production of aerosols during all dentistry work, dental procedures are regarded by the CDC (US Centers for Disease Control and Occupational Safety and Health Administration) as one of the highest risk procedures when it comes to the spread of coronavirus and all other respiratory viruses. But it doesn’t mean that you shouldn’t be thinking of reopening your dental practice. Instead, it means that you need to practice extra care during all dental procedures to ensure your worker’s and patients’ protection.

Some of the recommendations regarding the reopening of dental practices include the cessation or postponing of dentistry services/ appointments, screening of all patients before any dental treatments, and the deployment of engineering controls to block or remove the virus from the aerosols through stringent use of personal protective equipment/ gear.

Before we look at some of the practical tips and guides that you could follow to ensure that the reopening of dental practices is done right, let’s first look at the cost of reopening dental practices during a post-COVID-19.

What is the cost of reopening your dental practice during the COVID-19 Pandemic?

As different countries take on the direction of creating new strategies to ensure that businesses go back to normal with ease, several measures have been put in place. Though dental return-to-work guides remain unchanged in the UK, for example, the decision to reopen your dentistry practice at this time would easily mean changing your SOPs (standard operating procedures), especially in the urgent dental care centers, to ensure the safety of the patients and health workers.

As you work on your reopening strategies, these are some of the costs you need to be aware of. Though not specific, they cover the overall costs expected for any dentistry practice looking to reopen their operations.

• Face masks

You need to factor in the cost of the N95 respirators, and also the FFP2 respirators. These masks are regarded as industry standards and the best option on the market because they are capable of filtering as much as 94% and 95% of all airborne particles. These two types of masks are a good alternative to the FF93 respirators, which might be a little pricey, and they are also hard to come by.

In addition to these masks, dentistry practices thinking of reopening also need to buy visors and disposable eye protection equipment for their clinical staff.

There are also powered air respirators, which are a good option as they protect the eyes and fit with a breathing filter. These are often pricey and might not be the most practical option for you today.

For non-AGPs, the standard surgical masks will do just fine, as long as all other AGP procedures are considered.

• Disposable gloves

Your list of new purchases will also include the cost of disposable gloves. It would help if you had many more gloves for your practice, especially because your staff will need to put on new gloves frequently. You might have to settle for two pairs of disposable gloves, per person, peruse, and you need to look out for the best gloves that will fit above and below your gown’s cuffs.

• Disposable gowns

This is the other expense that you need to take into consideration. Save for the receptionist, everyone else in your practice might have to wear a disposable gown, and the gown needs to be changed after every procedure. The best gowns are the disposable plastic aprons for the non-AGPs and fluid-resistant gowns for the dental practitioners and even hygienists.

For dental teams that opt for the non-fluid resistant gowns, they need to have the disposable plastic apron underneath. The good news is that the disposable plastic aprons are rather affordable, and they won’t overstretch your budget. But for reduced future costs, it pays to put in a large initial outlay.

• Suction Systems

As mentioned above, one of the recommendations for any dental practice being reopened is the investment in a controlled environment that would result in the elimination of viruses and other pathogens from the air. For most dental practices, the most effective control measure involves the use of a suction system.

The suction system will ensure that all the aerosols are produced from dentistry preparations like teeth preparation, removal of fillings, and crowns or bridges’ insertion. All these procedures result in aerosols’ production, hence the need for the intraoral suction system that will work effectively at high speeds of up to 3000l/min. At this level of performance, the section device will dramatically reduce the risk of infections for everyone in the room.

The most effective suction system will cost about £2,500 in the UK. A wide-angle canula is an important part of the suction system, and you need to buy these in sets.

Note that you must have the suction system tested by a qualified engineer to determine the suction performance and power/volume of the existing suction system. But to be safe, get a new rubber dam, high volume suction that will reduce the risk of aerosol contamination.

• Air Purifiers

As you look for the best ways of reducing aerosol contamination, it’s obvious that you will also need to look for the best air purifiers. Now, if your building’s existing air purifier works well, you will not need another one, but it would be a good addition.

It’s also important to note that all current studies on the transmission of the coronavirus point to the possibility of transmitting the virus to or via the air conditioning units. There is still no consensus on the same currency, but it would help to have an air conditioning system that works well optimally. If you choose to install a new air purifiers, you will be happy to know that they are affordable.

• Reception Screens

The cost of your reception screen will vary depending on the size of the reception area. It’s important to remember that the reception screen is an important consideration for anyone thinking of reopening their dental practice, and you need to find the best quality reception screens to ensure adequate shielding and the protection of your staff and other patients from viruses that could be brought in by other patients. Before purchase, research widely and opt for the best reception screens you can find.

While the sneeze guard might sound like a good option for you, it’s not the most effective solution for your safety.

• Setup and patient numbers

As you plan to reopen your practice, you need to keep in mind that your clinic will not be fully booked on the first day, primarily because of fear, and also because you need to create a space that supports social distancing. Using social distancing rules, work on your patient number, keeping in mind that you will be operating half the full capacity. Of course, this translates to the reduction of income, albeit in the short term.

• Cleaning

You will also spend extra money on cleaning services, especially because you will need to clean the entire space after a procedure and a complete surface wipe-down. The higher levels of hygiene will definitely cost you more, and you might have to schedule fewer procedures.

Speaking of cleaning and hygiene matters, you will need to introduce one position to your office – the sanitization technician or the environmental dental assistant. This individual will be tasked with keeping all areas sanitized while also ensuring that everyone getting into the office is sanitized.

Other considerations to keep in mind as you consider the reopening of dental practices.

Health and safety

the costs and measures above are primarily the health and safety precautions you need to keep in mind as you plan to reopen your dental practice. But that is not all; you also need to identify all the activities that would result in the transmission of the virus, individuals at risk, ease of exposure, and ways of removing the risk identified.

Patient communication

it would help if you communicated to all your patients how the PPE work.

Handwashing – you must provide handwashing facilities and/or an alcohol-based sanitizer for everyone who visits your premises.

Patient staggering

The other thing you need to work on as you consider reopening is to develop a staggered approach for your appointments. Ramp things slowly, only using your 1-3-5 chairs. You also need to change your confirmation style for the appointments, explaining to them on the phone, specifically when their appointments are confirmed. Also, ask your patients if they have any flu-like or if they are feverish – ask them to stay at home until they feel better if they are symptomatic.

Modify the patient check-ins

this could be as simple as having a closed reception to have all your patient check-ins done over the phone. You can only call in your patients for appointments when there aren’t any other patients and the place sanitized.

Restricted office entry

it would help if you also restricted visitation times, making sure that you only entertain patients with appointments. Have a disinfection or a sanitization technician at the front door. This also applies to all your dental supply deliveries, which should be accepted outside and then sanitized before use or storage.

Aerosol sprays containment

the other consideration you must set up is using a rubber dam to ensure that the aerosols are contained. You will need a dental assistant to help handle the HVE/ High Volume Injector for hygiene procedures.

Removal of all non-essential items

put away flyers, night guard samples, brochures, display models, and implant displays.

Temperature checks

In difficult patients or as an overall safety measure, you must take the patient’s temperature. This also extends to your team and yourself.

Finally, consider ‘soft opening.’ This is where you follow specific rules and basically choose to see the urgent patient cases only.

Conclusion

When it comes to the reopening of dental practices, the measures above will ensure that everyone’s protection comes to your office. Of course, you need to have the funds to ensure that the office is all set up and COVID-19 ready. Start with soft-opening where you only attend to urgent cases, and keep your patient numbers to a maximum of 5, with a dental assistant on hand to help control aerosols. Also, keep procedures short, and have the best PPE for your patients, staff, and yourself.