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Safety Measures in Our Dental Practice In Response to COVID-19

1. OUR PROMISE TO YOU

First and foremost, your safety and well being is our top priority. We have and always will adhere to the CDC, OSHA, IDPH and ADA for guidance on infection control in our dental office. We will continue to stay updated and follow all of the new guidance from these governing bodies and ensure that these protocols are followed consistently, correctly and with great attention to detail. We consider all of you to be a part of our family and will continue to strive for excellence during your care. Thank you for putting your trust in our dental practice, it means more to us then you will ever know. We are always here to help you and your loved ones.

2. TRAINING AND EDUCATING OUR TEAM

One of the most important things that we are doing during this time is to retrain and educate all of our team.

  • The entire team has had extensive refresher training from the CDC, OSHA, and ADA for cleaning,disinfecting, and sterilizing the dental operatories including all dental equipment and instruments.
  • We are implementing new protocols to minimize aerosols generated during certain procedures.
  • We have reviewed the proper hand washing techniques.
  • We have practiced the appropriate use of Personal Protective Equipment (PPE) prior to caring for a patient to prevent contamination.
  • We will employ a Sterilization Specialist whose main focus is strictly on cleaning and sterilization. This team member will be responsible for cleaning, disinfecting, and sterilizing everything in the operatories after every patient. As well as all common areas on a regular basis,bathrooms, counters, door handles, light switches, tables, etc.
  • We have created a specific checklist of protocols for our team to follow so that they keep all of our patients safe, can arrive to work healthy and go home to their families without worry.

3. STAFF PROTOCOL

BEFORE COMING TO WORK

  • Don’t go into work if you or any other family members are experiencing symptoms of illness; cough, fever, sore throat, body aches…etc
  • Remove watch and rings and leave them at home
  • Tie hair up, keep nails short, no facial hair
  • Avoid extra accessories
  • If bringing a lunch, place in disposable wrapping

AT WORK

  • Temperature will be taken for every employee, everyday; If temp is 100.2 or higher employee will be sent home
  • Oxygen Saturation Levels will also be taken; if O-2 is less than 93% the employee will be sent home
  • Change into scrubs and work shoes; preferably plastic/rubber shoes that are wipeable
  • Place all of your belongings in your designated locker
  • Wear PPE as appropriate; scrubs, gowns, surgical cap, gloves, respirator/mask, eye wear, face shield, booties
  • Follow proper protocol for donning and doffing PPE before and after every patient
  • Leave all clutter; pens, phones etc outside of patient operatory rooms
  • We discourage workers from using other team member’s phones, desks, offices, computers etc
  • Do not enter any common area; i.e. bathrooms, break room, reception area until all PPE is doffed and the proper hand hygiene is performed
  • Cell phone use at work is discouraged

AFTER WORK

  • Wash hands and arms with soap and warm water
  • Wipe work shoes clean and place them in your personal locker
  • Remove scrubs and gown and place in the appropriate laundry collection bag
  • Wash hands and change into clean clothes
  • Sanitize phone, glasses, etc
  • Wash hands again

AT HOME

  • Remove shoes and clothes
  • Shower immediately before touching anything (including your loved ones)
  • Wash clothes with detergent and hot water

4. SCHEDULING PROTOCOL

  • Staff will call the patient when scheduling an appointment for care using established and recommended screening checklists
  • Prioritize high risk patients (immune compromised; heart or lung disease, over 65, etc) and appoint with early morning appointments to minimize their exposure
  • Health Screenings will be reviewed prior to the appointment to recognize potential carriers
  • Reschedule a patient who shows any signs of a cough or fever or who describes having any concerning warning signs
  • Instruct patients to reschedule their appointment if they develop symptoms of respiratory infection; e.g. cough, sore throat or fever on the day they are scheduled to be seen.
  • All patient forms must be filled out online, including health declaration form
  • Insurance must be updated prior to appointment

5. SOCIAL DISTANCING WITHIN OUR OFFICE

  • We are making alterations to the schedule so there are less people in the office at one time
  • We will be utilizing a “virtual” waiting room. Patients will call when they arrive and wait in their car until a staff member opens the door for them. Our actual waiting room will be closed until further notice.
  • We ask that all patients come by themselves; unless they are a minor, need an interpreter, or require medical assistance

6. MINIMIZING THE SPREAD OF THE VIRUS

  • A UVC Bipolar Ionization Air Purifying System will be installed and will sanitize the air coming into the office
  • Negative Pressure Air Flow Vents have been installed to frequently exchange and refresh the air
  • All patients must wear their own mask while in our office; when not receiving treatment
  • The vestibule door will remain open at all times to avoid contact with door handles
  • Signs will be posted as a reminder for proper hand hygiene and cough etiquette How and when to perform hand hygiene How to use tissues or elbows to cover nose and mouth when coughing and neezing How to dispose of tissues and contaminated items in waste receptacle.
  • Tissues will be made accessible throughout and trash receptables will also be placed accordingly
  • Alcohol Based Hand Sanitizer will be placed throughout the office
  • The reception desk, bathrooms, door handles, etc will be cleaned throughout the day

7. WHAT TO EXPECT BEFORE, DURING AND AFTER YOUR APPOINTMENT

BEFORE YOUR APPOINTMENT:

  • When Scheduling an Appointment we have set aside priority appointment times for all of our high risk patients
  • All Patient Forms and Insurance Information will need to be filled out and submitted online prior to the appointment.
  • Every patient will be screened for COVID-19 prior to the appointment.

WHEN YOU ARRIVE AND DURING YOUR APPOINTMENT:

  • Upon arrival the patient must call or text the office and then wait in the “virtual waiting room”; their car, until a team member opens the door
  • Once the clinical staff has opened the office door; the patient will need to wear a mask and will be assessed for respiratory symptoms and fever(with a non-contact digital infrared forehead thermometer)
  • If a fever of 100.2 F or higher or respiratory symptoms are present, the patient will be advised to seek medical care and the appointment will be rescheduled
  • The Patient’s Oxygen Level will be checked with an 0-2 Sensor. If a patient’s Oxygen Level is at 93% or lower the patient will be advised to seek medical care and the appointment will be rescheduled
  • Upon entering the facility, the patient must wash their hands with Alcohol Based Hand Rub (60-95% alcohol)
  • The Patient will be escorted directly into an examination room
  • All patient belongings will be put in a plastic container or hung on a hook
  • The patient will be asked to remove their mask and rinse with a hydrogen peroxide solution
  • The Clinical Team will go over medical history and will take x-rays if needed
  • For any Aerosol Generating Procedure, the clinical team will explain to the patient the safety precautions being taken to reduce aerosols from being produced

AFTER TREATMENT AND CHECKING OUT:

  • After the treatment is completed the patient will be asked to wash their hands again and replace their mask before leaving the operatory
  • The patient will be directed to the reception desk where a plastic barrier will be used to protect both the receptionist and the patient

8. PROTECTING OUR CLINICAL TEAM

HAND HYGIENE IS PERFORMED BY OUR STAFF

  • Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing PPE, including gloves
  • After removing PPE in order to remove any pathogens that might have been transferred to bare hands during removal process
  • Washing hands with soap and water or Alcohol Based Hand Rub (60-95% alcohol) for at least 20 seconds

PERSONAL PROTECTIVE EQUIPMENT TO BE WORN:

MASKS

  • N95 respirators or an equivalent will be used during Aerosol Generating Procedures
  • Surgical Ear Loop Masks or N95 respirators will be worn at all other times

EYE PROTECTION

  • Put on eye protection (i.e. goggles and/or a face shield that covers the front and sides of the face) upon entry tothe patient room
  • Remove face shield and eye protection to be cleaned and disinfected prior to re-use

GLOVES

  • Put on clean, non-sterile gloves upon entry into the operatory
  • Change gloves if they become torn
  • Remove and discard gloves when leaving the operatory and immediately perform hand hygiene

GOWNS

  • Put on a clean gown upon entry in to the patient room
  • Change the gown after every patient and before leaving the operatory

SHOE COVERS

  • These will only be worn over shoes that can’t be wiped and disinfected

9. CLINICAL TEAM PROTOCOL FOR INFECTION CONTROL

BEFORE TREATING THE PATIENT:

  • Clinical Staff should strictly follow all infection control practices between patients (e.g. hand hygiene,cleaning and disinfecting non-disposable medical equipment)
  • Clinical Staff will be wearing all of the appropriate PPE
  • Clinical Staff will be wearing a headset, so they are hands free and don’t need to leave the room to obtain needed materials

TREATING THE PATIENT:

  • No other team member should enter the room during a procedure unless absolutely necessary and must use PPE as described above.
  • Special precautions will be taken when preforming Aerosol Generating Procedures (AGP); i.e. any procedure that requires drilling and for ultrasonic cleanings

AFTER TREATING THE PATIENT:

  • After treatment is completed and once the patient has left the operatory, the clinical staff will refrain from entering the operatory to allow sufficient time for the HVAC system to remove any potentially infectious particles
  • The clinical staff will ensure that environmental cleaning and disinfection procedures are followed consistently and correctly using appropriate products to clean surfaces prior to applying an EPA registered, hospital-grade disinfectant to all frequently touched surfaces or objects for appropriate contact times
  • All non-disposable medical equipment used for the patient will be cleaned, disinfected, and sterilized according to the manufacturer’s instructions
  • All disposable materials and supplies will be disposed of properly