Updated May 28, 2020: Dental offices across the nation are beginning to reopen as part of the federal government’s approach to reopening the economy. Because The Doctors Company is committed to supporting your practice and sharing important information during this unprecedented time, we researched guidelines and recommendations to provide resources for dentists and dental professionals around the country.
Reference: Guide to Reopening Your Practice
The Doctors Company has prepared a guide to use as a reference as practices reopen. It was prepared as part of our commitment to serving the medical and dental community as you care for all of us.
The guide is presented in five categories, which physicians and dentists have agreed are essential to the reopening of their practices. Categories include administrative considerations (both office and personnel), environment of care, patient management, and elective surgery considerations. The guide is a comprehensive and useful tool which may be used to meet the needs of both medical and dental practices.
Resource: Dental Practice Toolkit
The American Dental Association’s (ADA’s) Advisory Task Force on Dental Practice Recovery has also prepared an excellent resource, Return to Work Interim Guidance Toolkit, also called the ADA Toolkit. The toolkit provides a road map for safely reopening dental offices, with recommendations on short-term management of dental practices during the COVID-19 pandemic, including the return to providing non-emergent care by some practices.
Among the toolkit’s resources are a welcome back letter to patients, pre-appointment screening guidance with a sample screening tool, in-office patient registration procedures, and reception area preparation strategies. Also included are a chairside checklist with procedures for dentists and staff to follow when providing patient care, staff protection strategies, a shopping list, and an appendix with downloadable documents.
The ADA has a number of other helpful COVID-19 resources that can be found at the ADA Center for Professional Success. As part of our mission to advance the practice of good medicine, we recommend that dentists obtain and review the ADA toolkit when considering reopening their dental practices following COVID-19 closures and dental practice restrictions.
The following are answers to questions you and your staff members may have in light of the pandemic. You may also refer to the ADA’s frequently asked questions.
- How should we handle a case of potential or actual employee exposure?
- Follow the same procedures as with a patient suspected to have, or confirmed to have, COVID-19: Report the individual to your local health department and/or state health department.
- What can we do to prevent transmission in the office?
- Be sure to update patients’ medical histories at each visit and screen patients for international travel, and signs or symptoms of infection. Include temperature readings as part of routine assessment of the patient prior to performing dental procedures. Make sure the personal protective equipment being used is appropriate for the procedures performed. In addition:
- Use a rubber dam whenever possible to decrease possible exposure to infectious agents.
- Use high-speed evacuation for all dental procedures producing an aerosol.
- Autoclave handpieces after each patient.
- Have patients rinse with 1 percent hydrogen peroxide before each appointment. (COVID-19 is vulnerable to oxidation; this will reduce the salivary load of oral microbes.)
- Clean and disinfect public areas frequently, including door handles, chairs, counters, and bathrooms. Remove magazines, reading materials, toys, and other items that are not easily disinfected after being touched.
We recommend you review the ADA Interim Guidance for Minimizing Risk of COVID-19 Transmission.
- How should we maintain the practice’s physical environment?
- The CDC recommends using social distancing whenever possible as an effective way of decreasing the likelihood of transmitting COVID-19. Ask patients to arrive on time for their appointments, rather than too early, since that will minimize the amount of time they spend in the waiting room or reception area. Some practices have effectively closed their waiting rooms and are requesting that patients call the office from their car upon arrival and remain in the car until they are called in to the individual treatment area.
Also, schedule appointments to minimize possible contact with other patients. Remove magazines, reading materials, toys, stuffed animals, and other objects that may be touched by others and that are not easily disinfected.
- Can the same mask be worn for more than one patient?
- No. Guidance from the Centers for Disease Control and Prevention (CDC) for single-use, disposable masks, has not changed. The Food and Drug Administration (FDA) regulates them for single-use. In addition:
- Wear a surgical mask and eye protection with solid side shields or a face shield to protect the mucous membranes of the eyes, nose, and mouth during procedures likely to generate splashing, spraying, or spattering of blood or other body fluids.
- Change masks between patients, or during patient treatment if the mask becomes damaged or soiled.
- What questions should we ask patients in order to identify their symptoms and make decisions regarding appointment cancellation?
- Appropriate questions to screen patients for COVID-19 could include asking if the patient has traveled internationally in the last 14 days or has been in close contact with another person who has been diagnosed with or is under investigation for COVID-19, and whether the patient has a cough, fever, or shortness of breath. Consideration should be given to referring patients who respond “yes” to any of the above questions to a hospital setting as the risk of transmission increases with such exposures.
The ADA has published interim guidance to facilitate the ability of dental professionals to triage, screen, and minimize the risk of COVID-19 transmission for dental patients and healthcare providers for those states that have not lifted the practice prohibition.