W L
DENTAL
THE NEW NORMAL
BY ANDY HEALY, PALL MALL DENTAL
Finally after 76 days of an enforced Lockdown closure, we re-opened
our doors on Monday June 8th. To say that was a relief is a vast
understatement.
The Government blindsided the dental profession with its announcement
on Thursday 28th May and at the same time spectacularly failed to
provide any information on how we could open in a safe manner.
Those Standard Operating procedures (SOPs) only materialised the
following Thursday at 3pm, leaving us just a single working day to
prepare to open. What followed was a superhuman effort by all my team
to be ready for that big day.
What preceded that was intensive preparations involving:
• Creation and deployment of risk assessments for staff, patients,
clinical areas, working practices
• Creation of patient workflows to follow social distancing rules
• Installation of high volume air extraction in each surgery to remove
aerosol created when drilling or scaling teeth
• Acquisition of extensive Personal Protective Equipment (PPE);
waterproof gowns, respirators, face shields, disinfectant fogging
machines etc etc
• Fit testing of our reusable respirators for every staff member
Believe me when I say none of this has been simple. The SOPs we were
given were woolly and lacking in clarity or thought. It is one of the
reasons why many dental practices haven’t yet re-opened. PPE is almost
impossible to come by, and much of what is advertised for sale has fake
certification and would put us and our patients at risk.
In one of my previous articles I discussed the risks of the aerosols that
are created whenever we drill or clean teeth. This aerosol may contain
Covid-19 particles as it is a high velocity mix of air, water and saliva.
Much of the work we have been doing is centred on mitigating that risk.
One of the basic requirements for a dental practice to reopen is leaving
every surgery fallow (i.e. empty) for 60 minutes following any patient
procedure that creates aerosol. As you can imagine this would mean
practices seeing very few patients per day and for many this would be
financially impossible.
We took the decision to install a high volume room air extraction system
across our clinical areas that means the air in each surgery is changed
every 5 minutes. This means we only have to fallow each surgery for 20
minutes making us able to operate more efficiently. Few practices are
fortunate enough to be able to do this and it’s the main reason why we
were able to open safely at that very first opportunity.
I’ve always believed that dental practices are an incredibly safe
environment as we have been dealing with cross infection risks all our
careers. With the added PPE guidelines our patients can be safe in the
knowledge that the surgery environment is quite possibly the cleanest
place they will ever visit.
We have now been back for 4 weeks, working 6 days a week trying to
catch up on all of the treatment that has been postponed these last 3
months. That dentistry doesn’t go away, it is still required.
Our staff have been truly amazing; our patients have been grateful,
understanding and a genuine pleasure to see again. They've all never
been so happy to see me!
Yes we have social distancing and PPE rules to follow, but we are getting
through the backlog and also helping new patients who cannot get
treatment elsewhere.
Finally if your dentist hasn’t reopened yet, please be patient and
understanding of the challenges that they are working hard to overcome.
Many dental nursing staff have young families and childcare is hard to
come by, meaning many practises cannot open as they do not have safe
staffing levels, or are struggling to obtain adequate PPE.
When you do finally get an appointment please remember nobody
wanted to be closed for months, and the service they will be providing in
the short to medium term will be limited by those factors I’ve mentioned
above.
Let’s all hope that this is the beginning of the end of this awful pandemic
and these are the first green shoots of normality returning. Good luck to
all my dental colleagues as we move forward delivering the best care we
can to our patients, in the safest possible environment.
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