In the past few months, we have seen a worldwide pandemic with global health and economic crisis. Transmission of SARS-CoV-2, the virus that causes COVID19, can occur through direct, indirect, or close contact with infected people through infected secretions such as saliva and respiratory secretions or through their respiratory droplets. In a dental health care setup, risk of cross infection between the dental health care worker and patient is very high. To stop the spread of virus, following trends and changes were taken up by various dental clinics:
- Teledentistry: Various clinics have opted for tele dentistry where the patients call the doctor before coming to the clinic. They give information regarding their signs and symptoms and on the basis of that the dentist takes the decision whether an appointment is necessary or home remedies along with over the counter medication would work. If an appointment is given to the patient a screening form is been sent to the them on their e-mail for a detailed history. The form contains patient’s personal details (name, age, sex, current address, phone number, occupation, etc.) along with a detailed history with the following questions:
- Do you have fever or have experienced fever within the past 14 days?
- Have you experienced a recent onset of respiratory problems, such as a cough or difficulty in breathing within the past 14 days?
- Have you come into contact with a patient with confirmed (SARS)-CoV-2 infection within the past 14 days?
- Are there people with documented experience of fever or respiratory problems within the last 14 days having close contact with you?
- Have you recently participated in any gathering, meetings, or had close contact with many unacquainted people?
- Precautionary measures for Safety of Patients: Before entering, temperature is taken using no-contact thermometer. Patients are asked to sanitize their hands and wear gloves, mouth mask, head cap and shoe covers. Patients are also discouraged from bringing any unnecessary items like laptops and shopping bags inside the clinic.
- Patient Waiting Time & Procedure: In which the waiting area has minimum activity, patients wait in their cars, in the parking lot to receive a text that informs them when the doctor is ready for their appointment. They are discouraged from bringing any unnecessary company with them during their visit, except for instances where they may need help getting home. Indian Dental Association has recommended visual alerts like posters in the reception area to provide patients with instructions about hand washing/sanitizing method, instructions on how to use tissues to cover the nose and mouth and methods to dispose the tissue off, etc.
- Precautions taken during dental procedures:
- All the surfaces in the treatment area should be declutters, only the instruments and materials needed for the procedure should be kept outside.
- Ensure that the oral health care worker undertaking the procedure has washed/sanitized their hands before starting the treatment.
- Ensure that oral health care personnel are trained to use appropriate Personal Protective Equipment (PPE), following a risk assessment and standard precautions: gloves; fluid resistant disposable gown, eye protection (face shield that covers the front and sides of the face or goggles) and a medical mask. A fit tested N95 or FFP2 respirator (or higher) is recommended when AGPs are performed.
- Patients should be advised to rinse their mouth with 1% hydrogen peroxide or 0.2% povidone iodine for 20 seconds prior to examination or starting any procedure for the purpose of reducing the salivary load of oral microbes, including SARS-CoV-2.
- Oral health care involving AGPs should be avoided or minimized, and minimally invasive procedures using hand instruments should be prioritized. Is incase AGP cannot be avoided, four handed dentistry should be used where the dental assistant should use high speed suctions and rubber dams. Dentist and their team should wear PPE kits along with N95 or FFP2 respirators.
- Patient should be instructed to use a cup to spit or high-speed suction should be used for the same.
- Dentist should try to finish all the procedures in a single visit.
- Intraoral Radiograph: dental imaging causes stimulation of saliva and in some patients, it leads to cough and gag reflux. To avoid this, extraoral radiographs like CBCT or OPG has been recommended.
- Post treatment precautions:
- Standard cleaning should be done of the entire treatment area after every patient.
- High touch surfaces like door handles, chairs, phones and reception desks are regularly cleaned.
- All patient-care items (dental instruments, devices, and equipment) must be sterilized or otherwise subjected to high-level disinfection.
- Staff performing cleaning and disinfection should wear appropriate PPE.
- Respirators, surgical masks, gowns and gloves must be discarded after every patient. Re-usable eye protection and face shields must be cleaned and disinfected prior to re-use.
- Dental hospitals should dispose health care waste according to the recommended procedure.
The Dental Roots is one of the top Dental Clinics in India. With our team head Dr Dheeraj Setia, we have started providing all the major dental procedures like Dental Implants in Delhi, smile makeover, and other aesthetic procedures under the guidelines provided by the Indian Dental Association (IDA) and Ministry of Health and Family Welfare, Government of India to ensure minimum risk to patients and dentists. We pride in having the most recent technologies and methods for providing Dental Implants in India.
For appointments, call our front desk.