How did we respond to COVID-19 with changes to Emergency Dental services:
Dr. Michael Kezian, along with his office staff members would like to begin the limited reopening of his dental office during the Covid-19 crisis. We are committed to maintaining the highest level of safety and protection during this time. This is because we believe it is our duty to defend our community of patients and staff. We would like to share the updated emergency dental covid-19 protocol changes and new office protocols with our patients. We have instigated these in our office of dentistry to preserve our promise to minimize cross contamination and promote safety.
Dr. Mike quickly shut his office down in response to the virus all the way back in March. He sought to follow government guidelines and American Dental Association recommendations. He chose to remain available and limit his services to vital care, only to perform severe emergency dental procedures. This included treatment of painful teeth, infected areas, or injuries.
Dr. Mike did not dawdle during this shutdown. Rather, he decided to use this time to research and institute all potential safety updated emergency dental COVID-19 protocols to be a forerunner of safely practiced dentistry in a post-COVID world. At the current time the country is beginning a multi-phase reopening, while stay at home instruction limitations are being eased. Dr. Kezian wants to reopen the dental clinic so that he can take care of his patients’ dental needs.
At this office during this time, we will still be limited to treatment of essential procedures. The American Dental Association set guidelines for what is and is not essential, which includes root canals or endodontics, gum treatments or periodontics, and dentures, crowns and bridges or prosthodontics, will be allowed. Treatment of optional, not vital, procedures and routine hygiene will still be controlled currently during the primary reopening. Essential treatments will include procedures that must occur to prevent a patient’s condition from getting worse if it is not performed.
Once you visit our offices, you can witness some amazing changes that we are incredibly proud to share with our patients. We have engaged in these new protocols for community protection and the safety of our patients and staff.
PUT VIDEO HERE https://www.youtube.com/watch?v=VqM1mAHu3Bs
Air Filtration in the Clinical Areas
At our office, we want you to breathe easy. One of the important measures put into use in our office was the setting up of two HEPA 500 Air Scrubber hospital grade air filtration units. These two units are tactically placed in our office. One unit is positioned within the patient waiting room area, and another unit is located within the back office dental clinic, where emergency dental procedures are done. The same filtration units cleaning the air of hospital treatment facilities are the ones that you will see in our office. These devices each cycle the environmental air in the office over three times per hour. This filtration will supply clean air and a clean sterile environment to our patients and staff, because it will also eliminate any potentially infectious particles. These HEPA air filtration units do produce a fair amount of environment noise, but we believe that it is worth it to safely protect our patients.
Minimizing aerosol generation during procedures
During dental visits, one of the principal causes of concern is the reach of aerosols. A second important addition was the invention and introduction of a novel aerosol suction unit in every operatory. This device is positioned close to the patient’s oral cavity during procedures, and the strong suction from the device eradicates any potentially infectious aerosolized droplets in the air that could be created throughout dental appointments.
This special system is tremendously successful in removing and filtering floating particles that remain in the air and is extremely imperative in reducing cross contamination. We have revealed how victorious this system is in our video, where we exhibit the powerful ability to remove smoke out of the air. In our video it is shown how all particles of smoke were sucked into the tube, no matter how far away the source was. When the suction is turned off, the smoke rises into the air and lingered just like aerosolized particles would. Once the suction was turned on again, all of the smoke was sucked out of the air again. In this field test, we combusted a piece of paper and held it further than six inches away from the opening of the suction apparatus. This smoke reproduces and visualizes the aerosol that can be created throughout a dental procedure. The setting up of these devices was distinctively designed by Dr. Mike with the intention of maximizing patient to maximize suction power, while minimizing noise and patient discomfort. Just like the HEPA filters, these units might be a little noisy, but we believe very strongly that the noise is a small price to pay to guarantee your safety.
New Personal Protective Equipment
A third updated emergency dental COVID-19 protocol modification is the implementation of new Personal Protective Equipment, or PPE, protocols. All staff members as well as patients are required to participate before entering our clinic facility. We have sourced from reputable medical suppliers new articles of personal protective equipment that we are offering to all of our patients. This includes full body gowns, hair coverings, face masks, and shoe covers. If you have your own face mask you may wear that, if not we will be more than happy to provide a face mask for you. At the end of your emergency dental procedure, we will collect your personal protective equipment and dispose of it according to infection control guidelines. This protection will ensure that you do not leave our dental office with potentially infectious particles on your clothing and body.
All of our staff members wear the gowns, hair covers, shoe covers, and masks, and they also wear full face shields and gloves at all times. Gloves are changed before and after every patient, and face shields are disinfected. We have also installed tall plexiglass dividers in areas where you need to speak to members of our office staff, including the front desk receptionist and the treatment planning coordinator. This plexiglass will allow you to speak and communicate, but will prevent the spread of any infectious particles.
Social Distancing Guidelines for patients
Another updated COVID-19 dental protocol is the social distancing that we have implemented. We have staggered appointment scheduling to limit the number of patients in the office at any time. Once you arrive to our office, prior to your appointment, we ask that you remain in your car and call our front desk. If there are too many people receiving treatment or waiting in the waiting room, we will ask you to remain until there are fewer. In the waiting room, the chairs are set over six feet apart from each other, and during all communication this social distance will be observed. We also implement updated screening protocols including a short contact tracing and symptom questionnaire and a forehead temperature reading.
Just as a reminder, there are many other measures which we follow to limit the spread of infections according to the American Dental Association and the Center for Disease Control. These are protocols that we have been observing in our practice since before the outbreak. This includes that we change masks and gloves between patients or during patient treatment if the mask becomes wet, according to dental guidelines. Our staff members completely sterilize every possible surface in the operatory both before and after a patient is treated. They use Bactericidal and Virucidal disinfectant spray. All dental instruments are sterilized, autoclaved, and cleaned after each patient is seen. All biohazard materials including tissue and gauze are eliminated safely and appropriately. We regularly disinfect and clean public spaces and high touch surfaces. These include bathrooms, door handles, and chairs.
New research from the National Institutes of Health and the Center for Disease Control has shown that the virus can remain alive on surfaces and in aerosols for several hours to days. We use the most powerful disinfectants which have been guaranteed to be effective in eliminating the Coronavirus and preventing its transmission.
How our patients can help
We ask that our patients work with us to make certain as much protection as we can. We advise that our patients maintain exceptional oral hygiene at home and be careful to prevent any traumatic injuries to their teeth or oral cavity. Hands should be washed frequently and avoid touching the face, eyes, and mouth. You should avoid directly contacting others and engage in proper social distancing.
Self-evaluation is the best thing patients can do to decide if they are starting to display signs and symptoms of the disease. Signs and symptoms can appear 2-14 days after exposure and may include fever, cough, shortness of breath. Emergency warning signs include difficulty breathing, a persistent pain or pressure in the chest, new confusion or inability to arouse, and bluish lips or face. This is not necessarily comprehensive, and you should consult a medical provider for any other symptoms that are concerning or severe.
These updated emergency COVID-19 dental protocols are an easy way that we can perform our duty to help prevent the spread of this disease in our community. While the shelter in place restrictions have been incredibly successful, the reality of the situation is that our patients’ dental requirements did not stop. We are proud to be able to meet those needs, but know that our obligation is to defend our community from further spread of this terrible disease. We at Dr. Kezian’s office appreciate your participation and understanding during these difficult times. As soon as we can resume business as usual, our patients will be the first to know.
Press Contact
Dr. Michael A. Kezian DDS
581 N. Larchmont Blvd
Los Angeles, CA 90004
(323) 467-2127
https://www.larchmontdentists.com
References:
https://www.nature.com/articles/s41368-020-0075-9
https://www.smileperfected.com/reopen-dental-office-post-covid-19/