By Dr George Druttman

The dental practice is already probably the cleanest, most hygienic environment outside of a hospital theatre that you will experience. Strict infection control procedures have been in place for many years and in the last few, have been rigidly controlled and monitored by the Care Quality Commission (CQC). As dentists restart their practices post lockdown, more extensive measures have been put in place to further protect patients and staff.

What can you expect?

Primarily, we to try to identify anyone who could be infected (even if ‘symptomless’) from entering the premises, let alone the surgery:

• Pre-appointment COVID-19 questionnaire

A patient with symptoms is very unlikely to come to a dental practice. If we can identify those with very mild or even no symptoms, or those who have been in contact with an infected individual, they will be respectfully asked to  delay treatment until they are Covid-19 negative or have no symptoms after 14 days of self-isolation. Pain/infection emergencies in this category will either be put on antibiotics or referred to a dedicated Urgent Dental Care Centre.

• Temperature and blood Oxygen saturation testing at the practice.

A temperature above 37.8C or a blood oxygen saturation level <90 %, although not diagnostic, could be a potential sign of Covid-19 infection. Consequently, anyone with such readings would be considered too high risk to be treated in the practice that day.

• Antigen rapid testing – when available.

This, of course,  is the ‘ultimate screening’. If and when we get a reliable test that gives a result up to 15 minutes, we can reliably screen patients prior to their treatment.

Much greater protection

We will institute additional measures to prevent as much as possible any viral transmission in the unlikely event that an ‘infected’ individual does enter the premises and have dental treatment. New enhanced measures designed to protect our patients, staff and visitors and minimise the risks of transmission include:

• The clinical staff will wear, in addition to gloves, higher filtration masks, face shields, gowns and/or disposable plastic aprons.
• Other than when you are lying in the dental chair,  you will be asked to wear a mask, observe appropriate social distancing and clean your hands with >70% alcohol sanitizing gel , possibly on more than one occasion.
• You will be asked to rinse your mouth with an antibacterial/antiviral mouth rinse ( 1-1/5% hydrogen peroxide).
• Where possible,  we will use rubber dam for filling procedures ( as we have always used for root canal treatments). With rubber dam covering the mouth, patients mostly breathe in and out through the nose .
• Equally where possible the nose will have a nose piece to inhale ‘relaxing gas’ (nitrous Oxide and Oxygen) for those anxious dental patients that would have this routinely. Other patients could inhale normal air and exhale through the tube attached to the nose piece. Air breathed out through the nose piece goes straight into the suction system and not into the air in the surgery.
• We have purchased medical grade air purification units that filter all the air in the surgery 4-5 times an hour. These have 7 levels of filtration/ sterilization (including HEPA, photocatalysis, ionisation , UV sterilization)
• We have also purchased UVC ( ultraviolet sterilization units ) to activate in the surgery in between patients .
• Open air window ventilation or air extraction air-conditioning facilitates the air being extruded outside the building .

We have instituted these measures to enhance our protocols and to try to maintain as relaxed, comfortable and non-threatening environment in order to carry out all the procedures we generally do, in the least disruptive manner and yet,  provide us all with the maximal reasonable level of protection.