3 Pillars of Protection in the COVID 19 Pandemic

Flashback: Friday the 13th of March 2020, COVID-19 is sweeping the globe – sickness, death, and economic destruction in its pathway. Educated and concerned dental professionals are stopped in their tracks with little scientific guidance as to how COVID-19 will impact the industry. Anxiously, we wait. The media bombards us with horrific accounts of how the virus has perplexed and overwhelmed the medical community. Fear-ridden, we wait. Dentistry is flooded with webinars, best practice protocols, evolving guidelines. Economically fragile and uncertain, we wait. As we gain an understanding of the virus and rise out of this fear-based state of paralysis, we begin to act.

 Play Today: Now, 3 months later, we are eager to resuscitate our practices and do what we do best: provide quality care. However, questions remain:

  • How long does the virus stay suspended and viable in an aerosol state?
  • Does the virulence of the virus differ when encased in an aerosol droplet versus free from?
  • How far does the virus travel in an aerosol form?
  • How do we protect employees and patients while researchers answer these critical questions?

At this stage of the game, we find ourselves between a rock and a smart place. By adopting the 3 Pillars of Protection, we can regain our practices with a sense of confidence and economic security. The 3 Pillars of Protection highlight principles and protocols related to patient screening, facility preparation, and team protection.

 Patient Screening – A thorough and truthfully answered screening of dental patients prior to appointments may significantly reduce the risk of exposure to SARSCoV-2 per Dr. Purnima Kumar during webinars for the AAP and ADA. Empower the team to review medical histories with the goal of identifying high-risk patients.

  • Utilize automated systems/online resources to facilitate a thorough COVID-19 questionnaire.
  • Employ COVID-19 testing prior to patient appointments. OralDNA® OraRisk® COVID-19 PCR salivary sample and nasal swab collection is a great tool to facilitate this process.
  • Utilize Teledentistry: Inform all patients prior to entering the practice that their temperature and pulse oximeter will be taken. Pre- and post-appointment communication via teledentistry will allow for reduced exposure time while safeguarding quality care and relationship.

 Facility Preparation – When the virus breaches the door, how do we safeguard against transmission? Contact an HVAC expert for guidance.

  • Study the airflow dynamics of your physical plant.
  • Investigate the use of HVAC systems utilizing bipolar ionization and MERV 14 filters.
  • Research plasma air purifiers that aid in killing the virus via DNA disruption. Appropriate positioning of purification systems is critical to reducing viral transmission.
  • Reduce dental aerosols via high volume evacuation. Your evacuation should pull at 1liter/minute. Both intra and extraoral systems are available to capture dental aerosols.
  • Consider fogging the facility with hypochlorous acid, a biocompatible solution that penetrates the viral cell wall delivering a rapid kill time.

 Team Protection – Protect your most valuable asset. Open, honest leadership is critical.

  • Allow your team to express concerns in a safe format and utilize a team approach when creating protocols.
  • Consider COVID-19 testing the team during the initial days and by monitor testing. This will instill confidence and ensure your measurements are effective.

We have the capacity to recapture our practices and resume a reasonable semblance of normalcy. The above-mentioned guidelines help position you to take your lives back. Be safe and curious.

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Gwen Smukowski, RDH, BS, MBA
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