It’s definitely a lousy time to have a toothache. The recent pandemic has severely restricted access to dental care with most practitioners limited to practicing tele-dentistry, which surprisingly has been quite efficacious. Given the very intimate nature of the profession, reopening of dental clinics will entail many new protocols in order to maximize safety for both patients and staff. Fortunately, dentists are adept at employing infection control protocol, as current guidelines are already very strict. So how will things look in what will certainly be the new normal? Here’s what we can anticipate for the next 6-12 months, or until a vaccine or treatment for COVID19 has been developed.
Triage
The days of going to the dentist with a bit of cold are over for now. Likewise, dentists and their staff will be advised to stay home if not feeling well. Much more rigorous screening will be in effect prior to treatment. Should a fast and simple in-office test become available, patients may be asked to take it, likely by finger prick or throat swab, something dentists are good at.
Waiting Room
Sitting in the waiting room flipping through twenty-year-old National Geographics will likely be replaced by waiting outside the clinic until called. For now, the reception area must be kept mostly vacant. If unavoidable, masks will be provided to patients while waiting. Hand sanitizers will be the norm upon entering and exiting the clinic. Expect to see a plexiglass barrier between you and your favorite receptionist, who will likely handle cash as if it’s kryptonite.
Treatments
There will undoubtedly be a backlog of treatments required and dentists will have to prioritize them in order of urgency. I wouldn’t plan on getting that in-office tooth whitening too soon. Elective treatments will likely be phased in gradually, as infection protocols evolve or immunity becomes ubiquitous.
PPE
If you thought your dentist already looked like they were from Mars, get ready to see them looking more like the hospital staff working presently. Visors, N95 masks, and protective robes may all be required before picking up a handpiece or air/water spray. Extra care will be required to avoid touching any non-protected surfaces with procedural gloves to avoid contamination during procedures. Patients may be asked to rinse with hydrogen peroxide prior to treatment and rubber dam usage will be greatly increased.
Bioaerosols
Who knew that the fine spray resulting from the drill, air/water spray, and ultrasonic scalers could be a source of spreading a virus, possibly for hours after a procedure. Much smaller than larger droplets from a sneeze or cough, the science is not yet clear regarding potential virulence of bioaerosols but could pose the greatest challenge to infection control in the office. More research is being conducted presently by dental associations in coordination with teams of experts from relevant disciplines, including microbiologists and infection control experts, who will hopefully find effective solutions that are not too prohibitive for practitioners.
Hope
The safety of our patients and dental teams remain the number one priority when it comes to reopening of dental clinics in the near future. Initially, extra precautions will have to be taken to minimize the risk of contamination and spread. We, dentists, want to get back to work and have been somewhat frustrated while sitting on the sidelines during this pandemic. But while things may not return to exactly as before, it is likely that improvements in how we approach infection control will result. There are often silver linings resulting from difficult times, so have faith for as George Harrison sang: All things must pass.
Dr. Mark Grossman is a practicing dentist and likes to take a bite out of nonsense when it comes to dental issues.
