Safety and sanitisation protocols for dental practices

While the world is plagued with the deadly SARS–CoV–2, the virus that causes COVID-19, the virus that causes COVID-19, doctors and other healthcare providers who are constantly exposed to patients are at a high risk of infection each time they examine a new patient. Dental and maxillofacial doctors and surgeons face an increased occupational risk of exposure to the virus. Social distancing between the patient and the dentist is not possible, considering the close contact the dentist must have with the patient’s oral cavity, blood, respiratory tract secretions, especially the saliva.

The use of dental probes, dental syringe, dental drill, spoon excavator, burnishers, ultrasonic scaler, curette, suction device needs to be done with complete care and precision. Many patients who are asymptomatic may be carriers risking the doctors and the staff including the equipment that can become carriers.

During inspection or procedures, small hoses that aerosolise water are used to remove any kind of obstruction in the form of saliva and debris that can build up in the patient’s mouth. This can prove deadly if the patient is carrying the virus.

Hence, dentists and healthcare providers are taking extra care to ensure their own safety as well as the safety of their staff with proactive measures more than just complying with the prescribed guidelines issued by the government and concerned authorities.

While dental clinics are closed in containment areas and attending to only emergency cases through telephonic consults, the non-containment zones permit dental consultation under the Unlocked Rules. Dental operations, however, have been restricted to emergencies only.

One thing which every dentist has made sure they adhere to before they start seeing patients, is the proper ventilation of the clinical area and avoidance of usage of air conditioners. Air circulation through opening of windows and using of exhaust blower to extract the room air into the atmosphere is a must.

By appointment only

The first and foremost step undertaken by doctors, is not encouraging walk in consultations for patients but consults by scheduled appointments only. A pre-consult phone call happens between the clinic and the patient where the patients can provide a primary description of their distress with a consent form which gives a fair idea to the doctor.

Patients are scheduled at intervals providing ample time for sanitisation processes to be initiated in the time between appointments. The patients are informed to wear masks and gloves and advised to visit alone. Only consideration is provided if the patient is a child, senior citizen, unable to come by self or undergoing a surgical procedure in which case a family member can accompany. Visual alerts have been placed at clinic entrance’s about respiratory hygiene, cough etiquette, social distancing and disposal of contaminated items in trash cans.

Procedures for patient examination and treatment

Once the patient arrives at the clinic, they are checked for mask, sanitised and then a thermal screening is done. This is followed by an inquiry on the person’s general health and travel history. After recording all the data and providing the patient with hand gloves, head cap and foot covers the patient is taken into the operatory.

Here, the patient is then physically assessed for their medical distress. Any positive responses to the diagnoses will determine further course of action. The treatment is then scheduled at an interval of three weeks except in case of emergencies. The dentist and assistant don the personal protective equipment prior to any assessment and the patient is made to rinse the mouth with a one per cent hydrogen peroxide  solution at the start of the treatment.

Throughout the procedure, the dentist, the dental assistant as well as the patient are supposed to stay in their gear and are only allowed to discard the same post the procedure. Ceiling fans are not used during the procedure.

After the procedure, the patient is provided with disposable face mask and given sanitiser for application. Post the procedure, a paperless billing is conducted, and digital invoices are sent to the patient. It is essential to encourage cashless payment to avoid transfer of cash from one person to another. These items often carry a lot more germs than we can imagine.

Post patient examination protocols

Once the patient leaves, the dentist and staff can remove their gear – and the surgical area is cleared, sanitised and the instruments are autoclaved. The clinical area is thoroughly sprayed and cleaned with Sodium hypochlorite which is a chemical compound comprising a sodium cation and a hypochlorite anion with UV lights kept on for around 15 to 20 minutes. It is imperative to discard the bio medical waste with utmost care to avoid the spread of any kind of germs.

The above measures offer a safe environment for the dentist, staff as well as patients, to address dental needs without compromising on the risk of contraction of the deadly virus.