COVID 19 advice

COVID – 19 and dentistry

Thank you for being our patient. We value your trust and loyalty and look forward to seeing you in our clinic.

Since the emergence of COVID 19 a visit to the dentist has changed completely. All of us are looking forward to resuming our normal habits and routines but in dentistry, like in so many aspects of our lives we do not know when that will be. We have an absolute commitment now and always to patient safety.

I hope this document will help explain the reasons behind these changes and to put your mind at ease about attending our clinic during this time. The measures that we have put into place are to ensure that all patients receive high quality, evidence-based dental treatment in a safe environment, just as they did prior to the COVID 19 crisis.

As with all healthcare services, there is a risk to patients from exposure to other patients and to staff working in the dental practice. Emergency dental treatment is an essential service and all healthcare workers in dental services must act to protect their patients, their staff, themselves and their families as well as the wider community.

It is essential to take all necessary infection control precautions for all patients attending a dental practice at all times. We have always maintained the highest standard of infection control practice prior to the COVID 19 pandemic. Older patients and those with pre-existing medical disease are at a higher risk of developing severe disease if they contract COVID 19.

Airborne spread of COVID-19 is a concern in health care settings. Provision of emergency dental care during this crisis aims, where possible to reduce the frequency of Aerosol Generating Procedures (AGPs) performed during this time.

Aims of policies in our practice during COVID 19 crisis:

  • To reduce footfall
  • Minimise workplace contacts
  • Maintain social distancing, in waiting areas and where possible
  • Avoid unnecessary exposure in the clinical environment
  • Reduce aerosol – generating procedures (AGPs) being performed.
  • Maintain good infection prevention and control practice including hand hygiene, respiratory hygiene, cough etiquette, effective environmental hygiene and decontamination
  • Use personal protective equipment (PPE) appropriately in order to manage the risk of contact transmission

 

What does this mean in practice for someone who has to attend the clinic?

Organisational measures:

  • A telephone based triage call, with a series of questions will be performed. This will lead to a decision for the patient to attend the clinic, or for symptoms to be managed without clinical treatment, but with follow up arranged.
  • We will communicate with you beforehand by phone or email to ask some screening questions. You’ll be asked those same questions again when you are in the clinic.
  • All access to clinic is by scheduled appointment only. This might mean that you’re offered fewer options for scheduling your appointment. Scheduling of appointments is managed to reduce patient contact and allow appropriate time for any cleaning and disinfection of the clinical areas required before the next patient
  • We must reduce use of waiting areas and arrange for patients to attend the surgery directly at the appointed time. If patients are in waiting areas we will promote social distancing of 2m to the greatest extent possible. You may see that our waiting room will no longer offer magazines, or children’s toys since those items are difficult to clean and disinfect.
  • We have to try and minimise non-essential interaction (especially physical contact) between staff members and patients and between staff members. This means more contact between our patients and staff by phone and email where this is possible.
  • We will ask for all patient email addresses and send all relevant paperwork, e.g. procedure information forms, health insurance forms etc by email to be completed online or printed and returned to us.
  • If someone does not have email or printing facilities all this paperwork will be posted for completion at home prior to attending the scheduled appointment.
  • We will promote hand hygiene at reception (signage, verbal reminders and provide alcohol hand rub)
  • We will promote respiratory hygiene and cough etiquette (signage, provide tissue and bins).
  • Infection control has always been a top priority for our practice and you may have seen this during any previous visits to our clinic. We will maintain good infection prevention and control practice and ensure we source and maintain supplies required to support hand hygiene and supplies of PPE.
  • In the clinical areas dentists and dental nurses will wear PPE at all times. This is different to all our normal experiences in the dental surgery both as staff and as patients. Please be assured we are smiling behind our masks and will do everything we can to make your experience a good one.
  • We will review all available and new research and evidence based literature in relation to COVID 19 with specific regard to COVID 19 and dentistry.

We are happy to answer any questions you may have about the steps we take to keep you, and every patient, safe in our practice.

Tel: 0719150820 email: info@niamhboyleoralsurgery.ie

A brief summary of the background leading to changes in dental practice procedures during COVID 19

On Friday 27th March, An Taoiseach, Leo Varadkar announced that as part of the country’s response to the ongoing COVID 19 pandemic everyone should stay at home apart from a number of “essential service providers”. Emergency dental practice activities were included on the list of “essential human and health and social work activities”.

Guidance

In our clinic we follow the guidance of the Health Protection Surveillance Centre (HPSC.ie) and our governing body, the Dental Council of Ireland. We also review emerging advice and guidance from the many dental bodies worldwide as they all come to terms with the challenges the COVID 19 virus has presented. We will look for and will act on evidence-based methods that are and will be employed to protect all members of our society from this virus. We aim to be always up-to-date on any new rulings or guidance that may be issued.

On 3rd April 2020 The Health Protection Surveillance Centre issued guidelines for the Guidance on Managing Infection Related Risks in Dental Services in the Context of the COVID-19 Emergency

The Dental Council of Ireland issued the following guidance to dental patients on April 14th   “The precautions set out in the Dental Council’s Code of Practice regarding Infection Prevention and Control help keep both patients and the dental team safe. We would like to assure the public that the measures dentists are taking are aimed at minimising the infection risks from treatment and making the dental surgery as safe as possible”.

http://dentalcouncil.ie/files/covid/14%20April%202020_Advice%20for%20Patients.pdf

COVID 19 disease

COVID-19 is a novel disease in humans. The virus associated with the disease is SARS-CoV-2.

COVID-19 should be considered as possible in anyone with:

  • New onset of fever
  • New onset of persistent cough
  • Acute deterioration of an existing respiratory condition
  • Respiratory tract infection or acute deterioration of existing respiratory disease.

A positive test for SARS-CoV-2 following a nasopharyngeal sample in a patient with suspected COVID 19 symptoms is accepted as establishing the diagnosis. At present testing is not being performed on asymptomatic people (people with none of the above symptoms).

Routes of Transmission COVID-19 virus:

  • Mouth, nose or eyes and hands following contact with surfaces contaminated with droplets, oral secretions or nasals secretions.
  • Direct droplet transmission to the mouth, nose or eyes during close unprotected contact with a person who is shedding the virus. This is of particular significance during dental treatment.

Aerosol generating procedures (AGPs):

In the dental clinic a number of AGPs are performed:

  • using the high-speed dental drill
  • using mechanised dental scalers for cleaning
  • high pressure 3-in-1 syringe
  • surgical dental drill use

 

Non – aerosol-generating procedures

Examinations and assessments

Hand scaling with suction

Non – surgical extractions

Certain surgical extractions with a speed reducing hand-piece

Removal of denture stages

Managing the risk of contact transmission is by good infection prevention and control practice including hand hygiene, respiratory hygiene and cough etiquette and environmental hygiene. Appropriate use of gloves and apron are also important in managing the risk of contact transmission.