Mandate PPE for Dental Hygienists NOW!

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We are concerned that there are still no definitive and mandated protocols for when and how to return to work at dental practices following the Covid-19 work cessation, or “lockdown.” It is unlikely that for-profit dental practices will respond to changes that are only recommended and not enforced by state or federal law due to a perception of reduced revenue and increased costs.

Protocols that should be considered for mandate include but are not limited to:

Stringent PPE requirements including mandatory N95 mask, face shield, and disposable gown, use for dentists, hygienists, and assistants, with every patient regardless of lack of external symptoms of respiratory illness.

Increased patient screening that may include requiring a recent negative Covid-19 test or a positive antibody test.

Requiring patients to wait in their cars rather than in a waiting room.

Limiting the number of patients that can be in a practice’s waiting room by determining how many people can safely maintain social distancing spacing in the space.

Installation of recommended efficient high speed evacuation equipment in each operatory.

CDC recommendations including those currently in development.

The dental field (including dentists, hygienist, and assistants) has the highest infection risk of any profession. Common dental procedures produce aerosols that can linger in the air for up to 3 hours. Even a small office can see 50 patients a day.

A return to business as usual with minimal and outdated standards, including surgical mask use and crowded waiting rooms, could result in thousands of new infections per week per office!

We demand that dental offices remain closed for non-emergency visits until proper Covid-19 protocols are identified, mandated, and implementable. The conservation of public health must be valued above the economic benefit of reopening dental practices. Please help dental healthcare providers keep themselves and the public safe!

References

Froum, S, Strange, M. COVID-19 and the problem with dental aerosols. Perio-Implant Advisory. 2020: https://www.perioimplantadvisory.com/periodontics/oral-medicine-anesthetics-and-oral-systemic-connection/article/14173521/covid19-and-the-problem-with-dental-aerosols

Harrel SK, Molinari J. Aerosol and splatter in dentistry: a brief review of the literature and infection control implications. J Am Dent Assoc. 2004;135(4):429-437. doi:10.14219/jada.archive.2004.0207

Miller RL. Characteristics of blood-containing aerosols generated by common powered dental instruments. Am Ind Hyg Assoc J. 1995;56(7):670-676. doi:10.1080/15428119591016683

Nejatidanesh F, Khosravi Z, Goroohi H, Badrian H, Savabi O. Risk of contamination of different areas of dentist’s face during dental practices. Int J Prev Med. 2013;4(5):611-615.

Williams GH, Pollok NL, Shay DE, Barr CE. Laminar air purge of microorganisms in dental aerosols: prophylactic procedures with the ultrasonic scaler. J Dent Res. 1970;49(6):1498-1504. doi:10.1177/00220345700490065701

Guidance on preparing workplaces for COVID-19. US Department of Labor. Occupational Safety and Health Administration. 2020. https://www.osha.gov/Publications/OSHA3990.pdf