Safety, both yours and our own, has always been something that we at Smithtown Dental Care take very seriously.
- Our office has always followed the strictest guidelines for prevention of disease transmission in the dental office. These include recommendations made by the American Dental Association (ADA), the U.S. Centers for Disease Control and Prevention (CDC), and the Occupational Safety and Health Administration (OSHA). We are up to date on any new rulings or guidance that may be issued. You may see some changes when it is time for your next appointment. We made these changes to help protect our patients and staff.
A little history for context.
- These protocols, developed in compliance with ADA, CDC and OSHA standards, were significantly overhauled in the 1980’s in response to the HIV/AIDS crisis. They’re designed to prevent transmission of blood borne pathogens such as HIV and Hepatitis B, which are spread primarily via droplet splatter to mucous membranes (eyes, nose, and mouth), and by hand to mucous membrane transfer via touching of contaminated surfaces. Hepatitis was used because it’s a very tough virus to kill, unlike HIV (or coronavirus for that matter) which practically any disinfectant easily kills. You may remember a time not all that long ago, when dentists did not routinely wear gloves, you didn’t often see masks or shields worn during procedures, and plastic barrier film did not cover handles and other high touch surfaces. But we’ve all gotten so used to these precautions that now that it’s hard to imagine it was ever any other way.
- The Blood Borne Standard (OSHA) and Universal Precautions (CDC) worked spectacularly well. We have 35+ years of data that show that people do not get HIV from going to their dentist. And dentists do not get Hepatitis B at higher rates than the general public (prior to 1980’s dentists had 5X higher rates of Hep B).
Now we are faced with Covid-19, caused by a new (novel) corona virus: SARS-CoV-2. This new pathogen is highly transmissible, but fortunately the virus itself is easy to kill. Ordinary soap and water, many household cleaning products, ordinary laundry detergent, and practically any surface disinfectant will kill it. The science on how it is transmitted is incomplete but we’re learning more about it every day. Procedures and strategies to cope with it are evolving rapidly. Out of an abundance of caution you will notice some additions to the precautions we were already taking. Soon these too will seem as normal to us all as the changes brought about by HIV.
- We’ve all been tested and vaccinated for Covid-19, and we encourage you to do the same. Any reason to get tested again is promptly acted on. Screening is simply part of our daily routine now.
- We encourage staff who are not feeling well to stay home (with paid sick time). All of us have our temperature taken as we come in to work every day. Anyone with a temperature above 100.3 F will be sent home.
- We’ve developed specific checklists of procedures so our staff arrives healthy to work and returns to their families without worry.
- We will be frequently wiping down high touch surfaces such as doorknobs, faucet handles, and counter tops. To disinfect the air as well as surfaces we fog the rooms with Hypochlorous Acid (HOCl), one of the most effective and safest disinfectants used to kill
Sars-Cov-2 (the Covid-19 virus) and many other germs and viruses. In fact, our white blood cells naturally produce HOCl to fight infection in our bodies We have disinfectant wipes and hand sanitizer everywhere, but carrying your own pens, wipes, and hand sanitizer are good habits to develop in these times, and we encourage you to do so.
- We’ve placed Honeywell True HEPA Air Purifier units throughout the office. True HEPA captures up to 99.97% of microscopic allergens and particles, 0.3 microns or larger from the air that passes through the filter. That’s small enough to capture viruses, including the coronavirus. We bought Extra Large Room size units that will provide 5 air changes per hour in a 465 sq. ft. room. We put those Extra Large units into treatment rooms that are only 90 sq. ft., so that continuous air changes happen even more rapidly.
- Sorry, there are no longer magazines, which are high touch and impossible to disinfect. We do have internet access. The network is “DentalPatients” and the password is “ThankYou”.
Social distancing, temperature checks, screening questions, and masks everywhere.
- When we make an appointment for your dental care, you will be asked screening questions to determine if you’ve been sick or with someone who’s been sick, have you been tested, are you at greater risk? And so on.
- When you get here we ask that you remain in your car. Call us to let us know you are here. Someone will come out to your car and ask questions again in case something has changed.
- We will take your temperature with a no-touch thermometer. If you have a temperature above 100.3 F we will reschedule your treatment and recommend you call your physician.
- To comply with social distancing requirements we are limiting the number of people in our office. We’ve gone to a “Virtual Waiting Room”. Please wait in your car. When we have your treatment room prepared we will come out to get you and escort you directly there.
- Patients only please in the office except for special circumstances. If someone else came with you we ask that they please remain in the car.
- Please try to avoid congestion in our hallways and at our desk. We may ask you to step outside until we are ready to help you, so that people can remain 6 feet apart when not in a treatment room. You’ll notice plexiglass sneeze guards have been hung to protect us and you at our desk.
- Everyone in our office is required to wear a mask at all times (we’ll tell you when to take yours off for treatment). If you forgot to bring your own mask we’ll provide one to you.
Our staff has received extensive training in Infection control protocols that have been updated specifically to deal with Covid-19.
Our team has had refresher training in proper hand washing techniques. This may seem basic; however, it is the most important thing we can do to prevent spread of the virus yet research shows that it is often poorly complied with and usually not done well. Consequently, we have spent a lot of time ensuring that our team does it well and often, especially before and after every patient encounter.
- They have received extensive training in infection control protocols that have been updated specifically to deal with Covid-19.
- Staff come to and leave from our office in clean street clothes. We change out of our scrubs and sneakers here. Staff are encouraged to leave personal items like rings and other jewelry at home, and keep phones and purses out of the treatment rooms. Plastic storage totes have been provided for them to keep their stuff in.
- They have practiced proper use of appropriate Personal Protective Equipment (PPE) prior to caring for a patient to prevent contamination.
- PPE requirements have changed in response to Covid-19. N95 masks may look similar to surgical masks but in fact they are technically respirators. They have to fit very tight against the face to form an airtight seal and must meet specific requirements to manage an airborne risk. They are uncomfortable to wear and harder to breathe in than surgical masks. Due to shortages, obtaining an adequate supply of N95 masks is problematic at the moment. When we can’t get them we go to reusable elastomeric respirators (like you’d use for spray painting) with N95 or higher HEPA filters rather than compromising our safety with lower level masks. They’re even more uncomfortable and our voices are somewhat muffled, but we have enough of them to not have to worry about running out. Fortunately respirators are not needed for all procedures, but we wear them when appropriate.
The unique nature of dental treatment places our clinical staff (Dental Hygienists, Dentists, and Dental Assistants) among the highest risk occupations for exposure; higher than other doctors, higher than nurses, higher than Emergency Medical Technicians and other first responders (
- What we do requires us to wear an appropriately high level of Personal Protective Equipment (PPE) to manage our unique situation and high level of risk. We can do this safely for you and for us, but these precautions add an additional layer of cost to providing your care. Right now we are in a time of high demand for scarce supplies which drives prices higher. We have not raised our fees, and some insurance companies have yet to adjust their fee schedules to meet the need. It is an evolving situation and we ask for your understanding going forward. So far the response from our patients has been overwhelmingly positive and supportive, we are truly grateful, thank you.
We recognize that these are trying times. People have been impacted by this crisis to differing degrees, and we’re all a bit on edge. We’re all just trying to do our best to navigate through these uncharted waters. With a little trust, patience, and understanding we’ll all get through this together. Our mission is unchanged: to provide excellent dental care in a comfortable and caring environment. And that we will always do.