infection control
New Expectations in Dentistry
Amid the Coronavirus Pandemic
by Kayce Hollingsworth
18
Many dental offices have begun to open
after being shut down for two months
due to coronavirus. Concerns for the
health and welfare of both the staff members
and patients must be considered
when reopening. Because dentistry is one
of the highest exposure industries, it
is important for dental offices to abide
by the updated protocols for infection
control. The new set of guidelines must
be in place and adhered to as part of the
Interim Transmission-Based Infection
Control Precautions that the CDC and
OSHA have adopted. Now is the time
to embrace and implement these new
protocols.
Before opening make sure all equipment
is working properly, especially the sterilizers.
It is also important to test the water
lines to see what the CFU (colony forming
units) levels are for each room prior
to seeing patients. I recommend using
the Quick Pass in-house testing by Pro
Edge. If necessary, the lines should be
shocked and dental waterline treatment
protocol must be implemented according
to the manufacturer’s instructions of the
product you are using. Make sure to flush
the water lines in each operatory for two
minutes before seeing the first patient,
NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
and then routinely after each procedure
for 20 to 30 seconds.
Make sure you have enough Personal
Protective Equipment for each employee
before opening. There has been a shortage
due to the increased need of medical
personnel and the limitations of manufacturing
in the U.S. Verify that the PPE
being purchased is approved by the CDC
and NIOSH.
To check for approved masks, visit:
https://www.cdc.gov/niosh/npptl/top-
ics/respirators/disp_part/N95list1-
a.html.
Some KN95 masks have been removed
due to testing failures so it is important
to confirm masks are approved and safe.
An initial qualitative fit test must be performed
to make sure the fit is acceptable,
however, the quantitative portion of the
fit test has been waived due to the
COVID-19 circumstances.
Prior to seeing patients, it is important to
have a staff meeting to review new protocols
and practice expectations. If you
have already opened and have not implemented
the guidelines, it would be a good
idea to do so now. OSHA has announced
that it will be increasing its in-person
inspections due to the COVID-19 threat.
The new mandates make it necessary to
have a written procedure for Transmission-Based
Infection Control as an addition
to your current OSHA Infection
Control processes in the practice. It must
include the following:
l
l
l
l
l
l
l
Screening employees before returning
to work and take temperatures on
each employee before seeing patients
every day
Remove all items in the waiting room
that cannot be disinfected (i.e. magazines
& toys)
Place signage for respiratory hygiene
and cough etiquette in the waiting
room
Prescreen patients for potential illness
or exposure prior to their appointment
Schedule patients to minimize contact
with other patients
Advise patients to come alone to
appointments unless patients are children,
elderly or special needs
requiring assistance
Patient’s temperature taken and
recorded upon arrival