Nearly all dentists and oral surgeons stopped seeing patients at the onset of the novel coronavirus pandemic in March; more than 90% of offices closed, canceling or postponing non-essential dental procedures in the process. Dentists have had concerns about spreading SARS-CoV-2, the respiratory illness that leads to a COVID-19 diagnosis, as they directly work over patients in chairs. Dentists in particular often create vaporized aerosols as they work in patient’s mouths, and infectious droplets like these can quickly spread throughout enclosed spaces like an operating room. But nearly three months later, dentists in all 50 states are in the process of reopening their offices — according to the American Dental Association (ADA) — to resume scheduled treatments for their patients.
Going to the dentist will feel vastly different than it has in the past, with new rules aimed at preventing those who may be unknowingly sick from spreading SARS to other providers or patients. Recent guidelines released by the Centers for Disease Control and Prevention as well as the ADA will guide dentists to create new procedures to lower COVID-19 risks as best as they can. Mostly, they focus on promoting social distancing between staff and patients where possible, increasing sanitation of shared surfaces, and monitoring both parties for COVID-19 symptoms continuously before and after appointments.
If you’re feeling anxious about returning to the dentist’s chair, you’re not alone — a recent piece published in the journal JAMA: Internal Medicine acknowledged that many patients are foregoing necessary or urgent care due to COVID-19 concerns. Your dentist will give you clear feedback on how urgent your case is for overall dental health, but leading experts and federal guidelines stress that it’s important to continue caring for your teeth and gums as you normally would. If you’re experiencing any kind of dental emergency or prolonged pain (think: bleeding, swelling, trauma) it’s critical that you receive care as soon as possible, as offices have been handling emergency procedures since the pandemic began.
You can view COVID-19 guidelines from the Centers for Disease Control for dentists and oral surgeons here, and guidelines established by the American Dental Association here. As always, it’s important to weigh your personal COVID-19 risk with your healthcare provider, and stay informed with resources provided by the CDC, World Health Organization, and your local public health department.
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What are dentists doing to reduce COVID-19 risks?
Most of the newly enhanced safety procedures designed to keep you safe fall on your dentist. While scheduling your treatment or procedure, be sure to ask your provider about the following recommendations made by the CDC and the ADA — they should be implementing them in their offices now.
- Staggering appointments. A more poignant recommendation from federal officials asks that dentists try to keep their facilities below capacity to encourage social distancing between patients. The CDC asks dentists to keep “clinical care to one patient at a time whenever possible.” Depending on the layout of your dentists’ office, there may be other patients in separate rooms receiving care from other providers, but patients will be spaced out to encourage a streamlined process. You’ll likely be escorted directly into a clinic room, have your consultation, and then be directed to leave the facility promptly afterwards.
- Eliminating shared spaces. No more waiting rooms or lounges, and there’s a good chance that any and all courtesy items — magazines, snack bars, or toys for kids — will be temporarily removed. If you are early for your appointment or if the dentist is running late, you may be asked to wait outside in your car or in a outdoor space until the previous patient has left and the facility has reset.
- Changing procedures to avoid aerosols. Some pieces of equipment (air and water syringes, for one) or certain procedures may end up producing more aerosols than others, and the CDC is asking dentists to adjust these procedures if at all possible. If aerosols are unavoidable (which may be the case for certain surgeries or extensive procedures) then dentists may be asked to use other tools to effectively remove them as quickly as possible.
- Reconfiguring offices and operation rooms. Because it’s impossible to effectively restrict all airborne particles during a dental care session, lots of new care should be taken to address airflow in each space. The CDC has been recommending that healthcare providers update their HVAC systems with new filers and proper maintenance. Officials have also recommended technology known as ultraviolet germicidal irradiation (UVGI) which may allow ventilation systems to better “clean” the air, so to speak. Physical barriers (like plastic dividers) in common areas may help limit contact between personnel and patients as well.
- Increasing sanitation. Dentists will likely have sanitized tools at the ready before you arrive for your appointment, and may even pivot to single-use tools where possible, per guidelines. New procedures will be established to ensure that chairs and non-disposable are thoroughly disinfected between each patient arrives for treatment.
- Doubling down on PPE. Dentists are up close and personal while they work in your mouth, so they’ll be expected to wear face masks and other forms of PPE while they work (including hair nets, face shields, gloves, and full-body gowns and suits). Current guidelines recommend that all medical personnel should change PPE in between patients to minimize risk of cross contamination.
Most importantly, dentists are implementing new screening procedures to make your dentist appointment as safe as possible — and this is where you come in.
How to stay safe while visiting the dentist:
Both the CDC and the ADA are asking patients to self-monitor for any COVID-19 symptoms before and after their appointments, allowing dentists and their teams to notify any patients later on that they may have been exposed to someone who was infected. Here are a few things you can do to keep yourself safe at the dentist:
- Participate in pre- and post-appointment screenings. There’s a good chance that your dentist’s office will call you before and after your appointment to ask you about your health. Be honest with them, and don’t skimp on the details. Some dentists may ask you to provide signed statements or records that signify that you’re aware of COVID-19 symptoms and that you are free of them. At the dentist office, they may take your temperature for awareness — and you should understand that the staff is also likely taking the same precautions.
- Wear a mask when possible. You won’t be able to wear a mask while you’re being operated on, but CDC guidelines push dentists to ask their patients to wear a mask at all other times during the consultation. You should wear a mask whenever possible: while walking through the facility, while discussing your consultation, and on the way out. Doing so may prevent you from unknowingly spewing infectious airborne particles and may even prevent you from breathing them in.
- Wash and sanitize your hands. If you choose to use the restroom or touch a surface with your bare hands, you should wash or sanitize your hands immediately afterwards. Donning gloves right before you head into a dentist’s office is an option, but more commonly, you might be able to use a “contact barrier” (disposable materials like tissues or towels) to keep yourself from handling doors or knobs. Of course, washing your hands is important after you leave the office as well.
The bottom line: Ultimately, your provider will give you the clearest instructions for when it is necessary for you to resume dental care. Likely, they will have a checklist of safety procedures for you to review and adhere to before you arrive for an appointment. Historically, dentists have been well-versed in disinfection when handling tools, and providers are sourcing PPE. It’s most important to keep monitoring for any illness before and after your appointment, especially if you are considered at high risk for severe COVID-19 infections.
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