The dental professionals have temporarily suspend all non-urgent dental treatment until the Corona virus crisis is over. Potentially life threatening emergencies will be treated in few dental clinics. Dental surgeons avoid treatments in the below categories of patients. Dr. Sarvabowna Addepalli who runs Aaditya Dental Clinic and Joint-Sectetary Indian Dental Association, shares a few insights.
A. All symptomatic individuals who have undertaken International travel in the last 28 days.
B. All hospitalized cases in the last 28 days.
C. All individuals who come from hotspot areas must be tested first.
D. All healthcare workers in hospitals who are symptomatic.
E. Patients with active fever, cough, cold, malaise, diarrhoea etc.
F. History of direct contact with COVID-19 positive cases.
Dental surgeons share the management of patients during and after the pandemic.
1. Scheduling patients with at least 15 mins gap between patients to minimise possible contact with other patients in the waiting room.
2. Patients are requested to come alone and only accompanied if patient is a child/compromised/elderly patients who cannot come alone. However the accompanied person cannot wait in the operator while the procedure is going on.
3. History of travel or any exposure or symptoms related to COVID-19 must be discussed on phone or text before the patients comes into the clinic.
4. We call only those whom we have screened and spoken on phone.
5. For walk in patients, we advise them to call us first on our phone from outside the clinic and initial assessment would be done in telephone before letting them in.
6. We ensure all walking inside the clinic are wearing surgical mask ( or we provide them with one)
7. We ensure cough and sneeze etiquettes are followed.
8. We ensure hand sanitation of all those coming in.
9. We ask patients to wait outside the clinic if possible or in their own vehicles and we will contact them when to come in.
10. Online registration forms.
11. Disposable shoe covers will be placed in the waiting room and all patients must remove shoes and wear them before entering the operator.
12. We insist on the patient to maintain the appointment time strictly.
13. Detailed history in waiting area.
14. Consent form for general and CoVID-19 will be taken in waiting area.
15. Consultation charges and treatment charges are to be paid digitally through Paytm, Phonepe, Google pay etc.
16. Touching unnecessary areas or things in the waiting room to be avoided.
17. The patient will be asked to keep all their belongings such as mobile phones, spectacles, car keys etc in their bags or give it to the accompanying person.
CLINICAL MANAGEMENT BY THE DENTISTS DURING AND AFTER COVID-19 PANDEMIC
1. We remove all the unnecessary clutter and things from the practice that cannot be cleansed easily like magazines, brochures, TV remote control, pens etc.
2. Placement of signage in our offices for instructing patients on standard recommendations for respiratory hygiene/cough etiquette and social distancing.
3. We avoid all unnecessary visitors including medical reps.
4. We keep clinic open and well – ventilated.
5. We ensure hand sanitizers to all coming in.
6. We ensure more frequent surface cleaning of waiting areas with sodium hypochlorite solution
especially surfaces which are more often touched such as reception table top, door handles etc.
7. Front desk/staff will be separated from waiting room using transparent glass or barrier.
8. The patient treatment area will be cleansed after every session using disposable cloth : dental chairs, curing lights, inspection lights, handles, spittoon, respirators, x-ray unit etc.
9. Items that will be cleansed after each session includes taps, sinks, cupboards, floor, bathrooms etc.
10. Items of furniture that will be cleansed at weekly intervals include : window blinds, shelves in cupboards and other accessible areas.
11. Covers will be provided over computer keyboards, mouse light handles etc.
12. X-ray films will be double pouched before keeping it in patients mouth.
13. Air conditioner grilles and mesh cleaning at least twice a day.
14. Front desk personnel will then take the body temperature of the patient and their accompanying person with an infra-red non-contact thermometer and ensure that they do not
have a body temperature exceeding 100 degrees Fahrenheit.
15. The patient is given a mouthwash and asked to rinse for about 30 seconds.
16. The patient is given eye protection goggles before the dentist starts examination.
17. In order to protect the patient, dental staff and oneself from cross-contamination we use goggles, face shield, advanced mouth masks like N95/FFP2, PPE (Personal Protection Equipment), sharps containers, rubber dam, fogger, extra-oral suction, syringe cutter cum needle burner, shoe covers, advanced sterilization equipment and disinfectants.
18. Post-operative instructions and prescriptions will be messaged or emailed to the patient.
19. Clinic will be fumigated at the end of each clinic session.
The circumstances that dental professionals are currently facing are rather unprecedented. All precautions will be put across with the sole intention of ensuring the safety of individuals.