COVID-19

Training and Educating Our Team

One of the most important things we are doing during this time is to train and educate our staff.

• Our team has had refresher training in proper hand washing techniques. This may seem basic; however, it is the most important thing we can do to prevent spread of the virus. Research shows that it is often poorly complied with and usually not done well. Consequently, we have spent a lot of time ensuring that our team does it well and often, especially before and after every patient encounter.
• They have practiced the appropriate use of personal protective equipment (PPE) prior to caring for a patient to prevent contamination.
• We encourage staff that is not feeling well to proactively stay home for two weeks.
• We have everyone in the office take their temperature at the beginning of every day and we will immediately send home anyone with an elevated temperature (100.2 F and above).
• Limit the numbers of staff providing their care to facilitate social distancing within the office and among team members.
• We have created a specific checklist of recommendation for our team to follow so that they arrive to work healthy and go home to their families without worry. (see Checklist of Recommendations for Our Team)

Recommendations for Our Team

Before coming to work

• All staff members are taking their temperature prior to each working day and will not come into work if they or any other family member are experiencing symptoms; cough, sore throat, fever, loss of sense of smell or taste, swollen toes... etc.
• They have all practiced the appropriate use of personal protective equipment (PPE) prior to caring for patients to prevent contamination.

At work

• They will be changing into scrubs provided by the office and work shoes (preferably plastic and wipeable) when they arrive.
• They are all using and have the appropriate PPE available to them.
• All personal items (purse, phone, etc.) from home will be limited to the staff breakroom.
• Staff are cleaning any hand held phones after use and we have provided other team members with hands free headsets.

After work

• Staff will be washing their hands and arms with a CDC recommended soap.
• Their scrubs worn that day will be laundered at off-site facility daily.
• They will then wash hands and put clean clothes on prior to leaving the office.
• Any personal items that have come in contact with patients or aerosols will then be sanitized (i.e. glasses) and their hands washed again.

Patient Interviews and Social Distancing

Before your arrival every effort is made to

• Filter patients during the phone call when scheduling appointments for care using established and recommended screening checklists.
• Reschedule patients who show any signs of a cough or fever or who describe having any concerning warning signs, or who have been in contact with a person with a known active COVID-19 infection.
• Instruct patients to call ahead and reschedule their appointment if they develop symptoms of a respiratory infection (e.g., cough, sore throat or fever) on the day they are scheduled to be seen.

To promote social distancing

• We will prioritize high risk patients (immune compromised, patients over 60, etc.) with early morning appointments so they have less contact with other people.
• When booking patients, we are spreading out our schedule so there are less people in the office at one time.
• If you are being accompanied, your escort should wait in the car to limit the number of people in the waiting room and promote social distancing.
• We will be utilizing a “virtual” waiting room: where patients will wait in their car or outside the office. We will then contact you by mobile phone when the Implant and Periodontal Professionals staff member is ready to bring you back to the treatment room.

Safety measures taken upon arrival

• We are leaving the front office doors open to avoid contact with door handles, weather permitting.
• We have now posted signs and posters at the entrance door advising patients of the COVID-19 risk and advising them not to enter the facility when ill.
• Masks and tissues will be made accessible immediately upon entry and instructions are provided on how to use tissues to cover nose and mouth when coughing or sneezing, to dispose of tissues and contaminated items in waste receptacles.
• An alcohol-based hand rub (ABHR) with 60-95% alcohol, a mask if needed, tissues and no-touch receptacles for disposal are available for patients at the entrance, in waiting rooms and at front desk.
• Posters with instructions about hand hygiene, respiratory hygiene, and cough etiquette will be posted at the entrance and in all treatment rooms.
  • This information will include
    • How and when to perform hand hygiene.
    • How to use tissues or elbows to cover nose and mouth when coughing or sneezing.
    • How to dispose of tissues and contaminated items in waste receptacle.

ALL these measures can help to prevent transmission to others!!!

Measures Upon Arrival

Patients will be

• Asked a series of questions about the presence of symptoms of a respiratory infection and history of travel or contact with possible COVID-19 patients.
• Assessed for respiratory symptoms and fever (with a digital infrared forehead thermometer) and they will be asked to sign a health declaration form along with a form acknowledging the risk of having essential dental treatment at this time due to COVID-19.
• Asked to seek medical treatment if a fever temperature of 100.2 degrees F or higher or respiratory symptoms are present and their visit will be rescheduled.
• Escorted into an examination room with the door closed.
• Asked to rinse with a solution of stabilized chlorine dioxide (CloSys) for 1 minute to potentially reduce viral load within the oral cavity.
• As testing for the virus becomes more available, we will be adding this benefit to screening of our patients.

Measures Taken Upon Patient Entry to the Clinic

• We have removed all clutter and anything that is not easily disinfected from the waiting room (magazines, area rugs, pillows, toys, etc.)
• We are also frequently (after every patient) wiping down of waiting rooms, bathrooms, door handles, tables, light switches, computers... etc.
• A UV light filtration system has been installed in our HVAC system prior to air entering our furnace system so that any recirculated air will be safe for employees and patients.

Reception Room and Front Desk Safety Measures

• You will still be greeted by our friendly staff upon arrival, but we will provide our staff with personal protective equipment (mask, face shield, gloves, etc.) to help protect both you and them.
• Our front desk staff will be using handsfree headsets that will not be shared.

Protocols of the Clinical Team

We adhere to the usual Bloodborne Pathogens Standard, provided by OSHA in each operatory, but with greater attention to detail and ensure that procedures are followed consistently and correctly.

Furthermore, we will denote a specific team member/ assistant whose main focus is only on sterilization. This team member will be responsible for cleaning, sterilizing, disinfecting and wiping down everything in the operatories and in the waiting room; chairs, handles, light switches, tables... etc. on a regular basis.

Hand Hygiene is performed by our staff

• Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment (PPE), including gloves.
• After removing PPE in order to remove any pathogens that might have been transferred to bare hands during the removal process.
• Washing hands with soap and water for at least 20 seconds.

Clinical Staff Personal Protective Equipment

• All clinical staff will wear PPE (N95 masks, gloves, cap, eye protection, face shields, and gowns.
• Masks are one time use and replace if soiled.
• N95 respirators will be used, along with a surgical mask and face shield, when performing or present for an aerosol-generating procedure.
• Our surgical mask, clinical gown, eye protection, cap and gloves are all disposable and will be changed after every patient.

Patients in the Operatory

• Dental care personnel (HCP) will strictly follow basic infection control practices between patients (e.g., hand hygiene, cleaning and disinfecting shared equipment).
• We are also limiting the movement of patients outside of the treatment rooms for patient safety.
• Whenever possible the doors to our treatment rooms will be kept closed except when entering or leaving the room, and we will minimize both entering and exiting the treatment room.
• Patients undergoing aerosol-generating procedures are in a separate room.
• Patients will then be asked to wash their hands before leaving the office.

Protocols After the Clinical Treatment

• All non-disposable medical equipment used for patient care should be cleaned and disinfected according to manufacturer’s instructions.
• We are ensuring that all environmental cleaning and disinfection procedures are followed consistently and correctly.
• Our routine cleaning and disinfection procedures (e.g., using an EPA-registered, hospital-grade disinfectant to frequently touched surfaces or objects for appropriate contact times as indicated on the product’s label) are appropriate for SARS-CoV-2 in healthcare settings, including those patient-care areas in which aerosol-generating procedures are performed.
• Once you have left the operatory the room will be disinfected with an electrolyzed water (hypochlorous acid) aerosol to disinfect all surfaces in the room and to help eliminate any aerosols remaining from the treatment procedure.
• A UV light filtration system has been installed in our HVAC system prior to air entering our furnace system so that any recirculated air will be safe for employees and patients.

Safety Measures After the Visit

• At this time, we are encouraging payment by credit card over the phone to encourage social distancing with our front desk.
• Review of estimates and insurance forms can be carried out via phone call or video conferencing and sent via mail.

At the End of the Day

• The office will be cleaned and disinfected from top to bottom in preparation for the following day.

We are confident that these guidelines will help to create a safe environment for all of our patients and team members and hope that you can feel secure in the knowledge that we are doing everything in our power to provide the safest clinical conditions in order to protect our patients, our team and our families.

Sincerely the Implant and Periodontal Professionals team and Dr. Emily