Operating Your Dental Clinic in a Post-COVID-19 World
Best Practices for Cleaning, Disinfecting, Patient Communication, and Dental Treatment
As dental clinics across the country reopen after closures due to COVID-19, there are many precautions and advisories being put out by the Centers for Disease Control (CDC) and the American Dental Association (ADA) that can help make office and treatment areas safer for patients and visitors. These documents include guidelines for patient communication, screening and other best practices for operators and front office staff to follow.
As a manufacturer of dental chair accessories, Crescent Products has taken the time to compile the highlights from these lengthy guides and offers cleaning and replacement guidance for the products it sells.
This guide is intended to help dental clinics navigate the “new norm” and help make treatment safer for operators and patients.
The Patient Communication and Treatment Process
As dental clinics look to welcome patients back to their offices, there are two critical issues that need to be confronted:
- Patient & staff safety
- Patient Comfort
Patients and staff, first and foremost, need to be kept safe, but there is also a level of customer service that needs to be upheld. Patients need to be reassured that they are being kept safe from the moment they enter the door to an office, which is why strong, clear communication should be provided throughout the entire process.
The following may seem like a lot to patients, so it’s important to remind them that this is being done for their safety. This is what the ADA toolkit recommends in terms of patient communication and treatment:
Step 1: The Welcome Back Letter
As dental clinics return to normal business, most will be looking to reach out to patients to let them know they will be accepting patients for elective care. This is the ideal opportunity to provide patients some reassurance by educating them on the cleaning and infection control measures being taken to keep them safe. A sample letter can be found in the ADA toolkit. The letter can include:
Step 2: The Pre-Appointment Screening Process
For the safety of patients and staff, all patients should be screened in advance of their office visit. This can be accomplished over the phone, via video conference or by sending out a screening questionnaire at the time of booking an appointment. These questionnaires can include the following questions regarding the last 14-21 days:
Patients should be reminded that these questions will be asked of them upon arriving for their appointment and their temperature will be taken before being admitted for treatment (temperature should be < 100.4˚F). If the answer to any of these questions is yes, patients may be subject to further screening.
Step 3: Being Prepared for Patient Visits and Treatment
The ADA recommends the following precautions be taken for patient visits:
During treatment, the CDC guidelines recommend the following precautions:
When deciding on treatment procedures for a patient, use your best judgement based on the patient’s history, the prominence of COVID-19 cases in your area, and the requirement/clinical risks of the procedure. Things to take into account are:
Step 4: Post-Procedure Communication and Follow-up
Patients should be instructed to report any signs, symptoms or positive testing of COVID-19 within the next 14 days of their appointment date.
Disinfecting and Preparing Dental Offices and Treatment Areas
Disinfecting and preparing common and treatment areas is a dental clinic’s most powerful infection control tool. The following sections outline ADA and CDC guidelines for preparing and cleaning the different areas of a dental clinic.
Waiting Rooms and Other Common Areas
Hand sanitizer or alcohol-based hand wipes should be clearly labeled and displayed at the entrance of every dental clinic. Patients should be instructed upon entry to use them. These items should also be located throughout the clinic in waiting rooms, bathrooms and patient consultation rooms.
If magazines, toys, remote controls, or any other shared items are present within the waiting room, it’s recommended that they be removed. If they are not removed, they should be regularly cleaned and disinfected. Chairs in waiting room should be placed six feet or more apart, per social distancing guidelines.
Regularly disinfect all surfaces with EPA-approved cleaners. If surfaces are dirty, they should be cleaned with a detergent or soap prior to disinfecting. These surfaces include:
Treatment Rooms
Limit access to treatment rooms to only the patient and those legally required to accompany them (e.g. translators, etc.). Those who do accompany patients should wear masks and/or shields to protect them. Staff should put on masks before entering rooms, as aerosol particles may exist in the air. Providers should also wash their hands upon entry and put on gloves after they have entered the room. If possible, doors to treatment rooms should remain closed unless being used to enter/exit rooms.
Limit the number of items passed between patients and staff and avoid physical contact except for necessary treatment procedures. All paperwork should be digital. If paper charting is being used, cover it with a clear barrier. Keyboards should also be covered with a clear barrier that is swapped out and disinfected after each patient.
If using nitrous oxide, be sure to use a disposable nasal hood and tubing. If disposable tubing is not available, it should be thoroughly sterilized in between uses.
If you are returning to your practice after an extended break (as many will be), make sure to shock your dental unit water lines to clear them of bacteria.
After treating each patient, take the following cleaning measures:
Cleaning and Disinfecting Crescent Products
If you are using dental chair accessories (Dental Headrests, Backrests, Knee Supports, Dental Chair Pads, or Child Booster Seats), remove and clean and disinfect them thoroughly.
All Crescent Products dental chair accessories are covered in a nonporous, medical-grade material that is easy to clean and disinfect. When fluids come in contact with the material, they will collect and remain on its surface rather than seep in and be absorbed (like they might with a more porous fabrics).
The entire Crescent Products Bodyrest System (encompassing all our products) can be cleaned with most detergents commonly used in healthcare settings. They can also be disinfected with medical-grade products like Birex and Cavi-Wipes. Avoid using strong, abrasive cleaners and those that contain bleach, which can reduce the lifespan of your dental chair accessories.
Replacing Crescent Headrest Covers
If needed, replacement covers can be purchased for Crescent Products Dental Headrests. Having a few of these on hand will allow you to quickly change out the cover on your headrest in-between patients so that they may be cleaned in bulk rather than a few times a day. These replacement covers also allow you to renew your Dental Headrests and keep them clean and sanitary without having to purchase an entirely new Headrest.
Replacement covers for Crescent Products Headrests are available here. Be sure to click here to get an instant 25% off and free shipping on your replacement covers.
Staff Safety and Training
Proper training during this time is essential in order to prevent the spread of infectious diseases and protect patients and staff members. This includes the proper use of all PPE and infection control best practices. All employees should also be screened daily using the same questionnaire provided to patients (see above section: The Pre-Appointment Screening Process). Temperature checks should also be implemented at the start of each shift (temperature should be < 100.4˚F).
Note: Pregnant staff members should consult with their physician before returning to work.
Front Desk Staff
Front desk staff should only interact with patients while wearing goggles and masks or face shields, or when behind a glass or plastic shield installed at the reception desk. Clinics can also consider installing individual headsets for phones to reduce the sharing of phone receivers among employees. Front desk staff should avoid all physical contacts and greetings with patients.
Dental Operators
Dental operators should always wear all required PPE when interacting with patients. This includes head and foot covers, masks/face shields, goggles and gloves. All physical contact, except that necessary for treatment, should be avoided. Hands should be washed before and after contact with a patient, and after touching any contaminated surfaces or equipment.
Clothing
If possible, all staff members who will be coming into close contact with patients should wear gowns. These should be removed after each session with a patient and promptly discarded or laundered. Scrubs can be worn under gowns and should be changed into from street clothes upon entry to the clinic and out of before exiting. All scrubs should also be laundered after daily use.
Additional PPE recommendations and information for dental settings are provided by the CDC here.
Additional training materials for staff, including PPE, sterilization and disinfection, and environmental infection prevention and control are available here.