PPE and Office Disinfecting Recommendations

21 Apr PPE and Office Disinfecting Recommendations

The IDA COVID-19 Task Force has developed the following recommendations for PPE and disinfecting procedures in dental practices. Note that this guidance is intended to help dental practices lower (but not eliminate) the risk of coronavirus transmission during the current pandemic. Dental practices should not presume that following the guidelines will insulate them from liability in the case of infection, and they should also be aware of any relevant laws, regulations or rules adopted by the State of Indiana.

Are gowns required or are scrubs sufficient? 
The decision and selection of appropriate PPE is an exercise of professional judgment. Where available, cloth or disposable gowns should be considered:

• When soiled, disposable gowns should be discarded appropriately.
• Cloth gowns should be laundered on site or by a contracted laundry service.
• Lab coats should be treated the same as cloth gowns and laundered appropriately.

Change your scrubs! 

• If scrubs are worn, long-sleeved garments are the preferred option.
• The importance of changing between street clothes and scrubs upon entry and exit to the office cannot be understated!

Are head and foot coverings required? 

Dentists should use their own professional judgment in deciding whether to wear foot covers or head covers.

Do we have to wear N95s/KN95s for all procedures?

No. It is very dependent upon the procedures being performed.

• It should be noted that some infected individuals lack symptoms, so we cannot assume that asymptomatic and healthy appearing patients are COVID-19 free. Without being rapidly tested, we must treat these patients as potentially infectious.
• Therefore, masks and PPE should be chosen based on the risk of exposure, especially via aerosols, to staff and other patients in proximity.
• The risk of exposure will vary greatly depending upon the type of encounter with the patient.

Do we need a new mask for every patient encounter? 

• Not necessarily. Use professional judgment on mask removal and replacement.
• However, if your mask is soiled, damaged, or hard to breathe through, it must be replaced.
• When removing your mask, do so outside of the treatment room and appropriately dispose of it.

How do we properly clean each operatory? 

• To lessen the likelihood of aerosols still in the air, allow as much time between patients in the same operatory as possible.
• Make sure staff are wearing appropriate PPE when cleaning, including: Gloves, a mask, and face shield or goggles.
• Dispose of surface barriers after each patient; surfaces should be cleaned using a detergent or soap and water prior to disinfection.

Also, consider special scheduling:

• To lessen the likelihood of aerosols still in the air, allow as much time between patients in the same operatory as possible.
• Considering scheduling fewer patients to allow more time between patients for operatory disinfecting.
• If you have operatories that are not in use, consider rotating operatories between patients to increase the amount of time between patient encounters in each room.
• Patients who are elderly or who have health conditions that might make them higher risk might best be scheduled as your first patients of the day.

What happens if my patient tests positive? 
If a positive rapid antigen test indicates that the patient may be infectious, no routine dental treatment should be performed on the patient in a traditional office setting.

What if an employee has a temperature or otherwise presents COVID-19 symptoms?

• If an employee has a temperature, it is best to confirm a heightened temperature with a second test, in a confidential manner, and to consider any explanation the employee may offer for a heightened temperature.
• It is reasonable to send an employee home who has an elevated temperature (100.4 degrees Fahrenheit or higher).
• According to current CDC guidance, an individual who has COVID-19, or symptoms associated with it, should not be in the workplace. Read this Employees Q&A from Faeger Drinker.