We know that the best thing you can do to face the Coronavirus (COVID-19) pandemic crisis is to stay home and stop the spread, but we understand that many dental clinics need to stay open to treat cases that cannot be postponed.
What about you? Is your dental clinic still operating?. In this article we share important recommendations of the COEM (Illustrious Official College of Dentists and Stomatologists of the 1st Region) and the Consejo General de Colegios de Odontólogos y Estomatólogos de España. We hope we can help you to face these days with a little more safety and confidence! Together we can stop the curve!
¿ How to evaluate the dental patient during the Coronavirus crisis?
You need to identify potentially infected patients before they come to your clinic. Thhe best idea is to contact them the day before the appointment and asking them some key questions:
- Have you had a fever (>37.3°C), cold, dry cough, shortness of breath, muscle pain or headache in the last 14 days?
- Have you been in contact with someone with these symptoms in the last 14 days?
- Have you traveled to any risk areas, red zones or quarantine zones in the last 14 days?
- Have you been in contact with anyone with confirmed coronavirus??
- Have you been in close contact with people with a severe respiratory condition in the last 14 days?
If the patient answers "Yes" to at least one of the questions, he or she should not be treated and should be advised to contact his or her family doctor by telephone or to call the telephone line responsible for Coronavirus testing in each Community, and to undergo quarantine.
Recommendations for emergency treatments during the COVID-19 crisis:
The main channel for the transmission of the virus is through saliva, either by inhalation, ingestion, direct mucosal contact, or by contact with traces retained on hands, objects and surfaces that have previously come into contact with infected saliva.
Therefore, dental professionals are exposed to daily risk situations in the facing of the Coronavirus pandemic. But, How to prevent the transmission of the Coronavirus in your dental clinic?. The COEM recommends that you take the following precautions:
1. Wash your hands:
You must wash your hands carefully before and after using the gloves for at least 40-60 seconds, afterwards You should disinfect your hands with alcohol for 20-30 seconds. Last, dry off with paper tissue and use it to turn off the tap.
2. Personal Protective Equipment:
Use Protective glasses with visor, latex gloves, cap and surgical face mask of only one use (this usually have 4-5 layers) and waterproof shoes. The use of valved FFP2 masks is recommended. If you continue to use your regular surgical mask, we recommend that you change it every 2 hours to avoid deterioration and loss of effectiveness.
3. Ask the patient to make a mouthwash:
Before the treatment, ask the patient to make a mouthwash for 1 minute with 1% hydrogen peroxide or 0.2% povidone. Chlorhexidine is not effective against Coronavirus .
4. Always use complete isolation:
Use, whenever possible, absolute isolation with rubber dam. Its use has been proven to reduce the viral load present in aerosols generated by dental procedures by up to 70%. Bearing in mind that, despite its use, aerosols are also usually produced (although to a much lesser extent), reinforcing this technique with a previous mouthwash may be advisable.
5. Uses rotary instruments with non-return valve:
Most of today's rotating instruments include it. Rotating instruments that are not equipped with a non-return valve can suck in detritus, bacteria and viruses, contaminating the air and water circuits, producing a greater risk of cross-infection.
6. Meticulous cleaning and disinfection of all surfaces in the dental office:
Carry ona careful cleaning and disinfection of all the working surfaces after treating each patient. During dental procedures, due to the production of aerosols and direct contact, work surfaces become contaminated.
Cleaning and disinfection should be done with a disinfectant included in the cleaning and disinfection policy of the clinic or with a sodium hypochlorite solution containing 1,000 ppm of active chlorine (1:50 dilution of a freshly prepared solution with a concentration of 40-50 g/litre). This virus is inactivated after 5 minutes of contact with normal disinfectants such as household bleach. Scrub the floor with hot water.
7. Protect dental and decorative objects and instruments:
Remove instruments and objects from work surfaces within the radius of the patient's saliva spray (virtually the entire room). Store them as soon as possible in cabinets or drawers.
Additional recommendations to prevent the transmission of COVID-19
- If you need to take pictures, Remove the camera from the room once you have finished the shooting. Take the straps off the camera. After changing the single-use covers, be careful not to touch the outer surface.
- Wrap the microscope with the cellophane, in case you don't use it or it is not replaceable. Wrap everything with adhesive film wraps, and change everything for each patient.
- Keep an eye on everything the patient touches. Pay attention to everything that comes into contact with the patient (the magnifiers, cables, battery, buttons and light source) and then disinfect it..
- In addition, disinfect the stools after each use if possible always with the windows open and doors closed
- Wireless and mobile phones should be placed in another room or stored .
- Following the advice of the WHO we recommend that you ask your patients to pay for the treatment with debit or credit cards, preferably contact cards, and avoid transactions with cash.
- Unavoidably, following all these measures will take longer than usual to disinfect the cabinet. Therefore, you must space out the consultations of urgent patients so that several do not coincide in the waiting room. If for some reason they do, make sure they keep a distance of at least 2 meters from each other .
- Also, you should ask patients not to come to the clinic with companions as long as possible.
Finally, it is essential that you clean and disinfect all work surfaces after each patient to avoid possible cross-contamination. And as a main guideline, do not attend the clinic if you consider that it does not have the appropriate conditions for care and protection. Only carry out emergency treatment.
Although it's a long list of precautions, the only way to beat the Coronavirus crisis is that we all do our part. From Dentaltix, we want to let you know that we continue working and that our attention will not cease during these difficult days.
Share this information with your professional colleagues about how we can #stopthecurve together and don't forget to follow us on our social networks, we're waiting for you!