It outlines modifications to our normal procedures that we intend to employ once dental practices can be reopened once the COVID-19 pandemic peak of infection has subsided.
It is not known as to whether these procedures are temporary or whether they will become a permanent feature of the way dental practices must be run to ensure patient and staff safety in the future. The worldwide COVID-19 pandemic is still being evaluated and studied and policies and recommendations are likely to change in line with new scientific evidence over time.
We would like to thank all of our patients for their patience during this long period of practice closure and for their understanding and cooperation whilst we implement new measures at the practice which will protect you and all our staff for future dentistry.
It is our intention for all staff members to return to work on Tuesday 26th May unless an extension to the current lockdown recommended by the government or professional bodies. The DB team will spend a few days preparing the practice for reopening and practising updated procedures before patients return to the practice. I am sure you will appreciate the importance of this.
It is envisaged that the practice will reopen to normal patient treatments commencing Monday 8th June.
We would of course like to continue providing necessary dental care to all of our patients in the safest possible environment. We therefore respectfully request your full cooperation with any new or modified procedures at the practice.
The manner in which we prioritise our patients to be seen will start with patients with dental problems who have contacted us during the period of lockdown. Our reception team will start contacting these patients first confirming their appointments.
Our patients with ongoing or delayed courses of treatment will be prioritised in the first two months of opening.
We will request that all patients who are returning to the practice for treatment, update their standard Medical Questionnaire. These forms will be emailed to you few days before your appointment. Your appointment reminder will include a link, that will direct you to a secure portal where you can securely complete your forms.
We will phone you before your appointment to go through a new, more detailed, questionnaire regarding your recent activity and symptoms, which will allow us to assess your level of risk for coronavirus infection before you attend the surgery.
Our normal cross-infection control protocols at DB against all previously known pathogens are already woven into all clinical activity carried out at the practice. It should be remembered that the dental practice is already a very clean environment compared to public areas and it is not possible for us to control sources of infection outside the dental practice.
There have been multiple suggestions from many sources as to how the risk of transmission of COVID-19 can be reduced in a dental clinical environment. Some of these are straightforward and some of these are patently impractical when carrying out fine and detailed dental procedures.
We have collectively evaluated all of these and feel that the following measures will reduce risk to an acceptable level at the practice. Please be assured that all of our clinical staff will also be complying with these procedures to reduce the risk of cross infection in both directions.
The DB team will have spent time critically looking at every aspect of the practice with a view to removing all non-essential items in the open to reduce the number of objects that may act as fomites (surfaces on which microorganisms may reside and can potentially be the cause of cross infection). You will find that the practice may appear to be quite bare when you attend.
All clinical and common areas including door handles and surfaces will be disinfected using hypochlorous acid solution (electrically activated water) which is potently viricidal against COVID-19 and other microorganisms and can be used safely on all work surfaces and indeed within dental water lines and for operative procedures.
DB has been using hypochlorous acid solution for many years on its dental chairs and will increase production for additional use as a surface disinfectant in addition to our normal surface cleaning protocols between patients.
DB will be providing an additional 10-minute buffer period between patients to allow additional time for decontamination procedures, allow for any treatment overruns and allow preparation time for the next patient so that they do not need to wait in the reception area. The buffer time will depend on the procedures being carried out.
We have recently purchased and installed patented HEPA™ viricidal air filtration units in the reception area to ensure clean air.
All future appointments will be made and confirmed by email or telephone to limit your time spent at reception.
All dental staff will be upgrading their personal protective equipment (PPE) in line with current recommendations and evidence. We apologise in advance for the necessary reduction in social interaction that this will necessitate. Whilst our garb may make us appear impersonal and distant, please be assured we are still the same friendly team underneath it all!
We are especially mindful that most dental treatments are aerosol-generating procedures (AGP’s). It is almost impossible for us to carry out meaningful dental procedures without generation of some level of aerosol. Aerosol suspended in the air is a potential source of infection which we wish to keep to a minimum.
• Currently the dental literature suggests:
Our use of our normal high-volume suction reduces aerosol production by over 90%.
The use of dental rubber dam which is also routine in the practice further reduces bio aerosols by a further 30 to 90%
Our regular facemasks filter approximately 60% of remaining airborne particles.
FFP2 and FFP3 masks filter 94% and 99% respectively of airborne particles in both directions (patient to clinician and clinician to patient).
We therefore feel that our normal dental procedures can be carried out with minimal risk with use of high-volume suction, dental rubber dam and FFP2/3 masks.
We have recently purchased and installed patented HEPA™ viricidal air filtration units in every surgery to ensure clean air.
We will also ask all patients to rinse their mouth with Colgate Peroxyl (containing hydrogen peroxide) before each appointment in surgery.
We will carry out a pre-attendance assessment via your completed Medical Questionnaire at least three days before your appointment and, if necessary, a follow-up telephone conversation to assess relative coronavirus infection risk. Our staff will contact you to remind you of this in case we have not received your completed questionnaire.
If we feel that you are high risk of having possibly been infected with the coronavirus infection, even if you are asymptomatic, we will respectfully request for you to delay booking any appointments with us for at least two weeks and then we will re-assess.
We would recommend that patients in high-risk groups delay non-essential dental treatment for as long as possible until the trend of the pandemic becomes clear. To find out whether you are in a high-risk group please see this information page on the NHS website.
In view of the potential seriousness of this disease, please note that we respectfully insist that this Medical Questionnaire is completed at least three days before your appointment.
Dental Beauty will operate a payment-in-advance policy for treatment courses and we would request that payment is made where possible online via BACS for your appointment prior to you attending.
We would extend this policy to regular examination and hygienist visits (which were normally made on the day of your visit) during this period. Advance payment will be requested when your appointment is booked and should be completed before attendance. This reduces the requirement for unnecessary contact or use of card terminals at reception.
When travelling to the practice, we would recommend that you limit your close contact with other members of the public as far as possible. If you are able to drive or be driven and picked up by somebody with whom you live, this would be ideal.
Please carry hand sanitiser with you at all times, use regularly and avoid touching your face. Please wash your hands thoroughly for at least 30 seconds at every opportunity.
We would like to eliminate waiting times in reception as much as possible so that you are not in close proximity to other patients. Accordingly, appointments will be staggered so that patients do not arrive or leave at the same time as other patients as far as we are able to manage.
When you attend the practice, we will welcome you and ask you to use the hand sanitiser (situated near the front door) to clean your hands for 30 seconds.
We will then give you a mask to wear and our receptionist will digitally take your temperature. If your temperature is above 37.8°C, you would not be permitted to enter the practice and will be asked to return home and self-isolate as per current government guidelines.
If you are well, we will direct you straight to the surgery (where possible), if you need to wait in the waiting room, please ensure you keep 2m away from anyone else and prevent touching any surfaces (where possible).
When using the restrooms, please do your best to ensure that you leave the facilities as you would expect to find them. The restrooms will be regularly disinfected between patients and we would respectfully ask that make our team’s task easier by being considerate. After using the restroom please wash your hands thoroughly for 30 seconds with the antiseptic hand wash provided.
This policy will be constantly reviewed and updated as necessitated by circumstances over time.
If you have any questions regarding this policy or about your dental care at DB please do not hesitate to contact us at firstname.lastname@example.org
Thank you and assuring you our best attention at all times.
Dr. Ravi Desai – Principal Dentist
BDS King’s College London 2018