In these uncertain times, we know our dental community is focused on minimizing risk of infection. One of the keys is the reduction of aerosol and splatter during procedures.
With the recent pandemic affecting countless lives globally, it is our responsibility as a member of the dental community to share information on best practices to ensure the safety of clinicians and patients. As such, we’ve created a comprehensive checklist of items clinicians are recommended to do to minimize risk of infection (see above).
We believe that a multi-layered approach involving standard protective measures (which you’re probably already doing in the office) alongside aerosol protection measures needs to be in place.
Every multi-layered approach should include the following measures:
1. Patient Evaluation
Screen your patient by asking the following questions:
1) Have you experienced a recent respiratory illness such as coughing, shortness of breath, or difficulty in breathing?
2) Have you experienced a recent fever?
Check your patient’s temperature using a non-contact forehead thermometer.
2. Hand Hygiene
Wash your hands regularly. Avoid touching your face, eyes, nose and mouth.
3. Universal Barrier Precautions & Personal Protective Equipment (PPE)
Cover all items in the room (e.g. keyboard, mouse, overhead light handle) with a plastic barrier, which should be replaced and wiped down between patients. Use barrier precautions to prevent microbial transfer such as wiping down goggles, throwing away gloves and gowns, and placing “sticker barriers” on places often touched. Wear your own personal protective equipment (PPE) at all times, including mask, gloves, face shield, cap, and gown.
4. Pre-Procedural Antiseptic Mouth Rinse
Have each patient perform a pre-procedural mouth rinse (e.g. chlorhexidine, 1% hydrogen peroxide) prior to every procedure. This will help reduce the microbial load within the mouth.
5. Continuous Suction with DryShield
A modern isolation and mouthpiece system like DryShield should be part of the plan in keeping your risk down to the lowest possible levels. In addition to isolation, retraction, and keeping the working environment clean, a modern isolation system provides continuous suction to help control and reduce aerosols.
6. Use High-Volume Evacuation (HVE) with DryShield
Using an HVE can help provide additional suction when working on certain areas of the mouth. Position HVE tip opposite of the dental tool (handpiece, ultrasonic scaler, prophy angle) and close to the working tooth.
7. Maintenance of Suction Equipment
Be sure your compressor is properly rated for the number of operatories you have, and maintain the compressor as recommended by the manufacturer. Flush all dental unit waterlines between every patient and procedure. Clear out traps between each patient and every day.
In addition, this recent excellent article in Perio-Implant Advisory from Scott Froum, DDS and Michelle Strange, MSDH, RDH provides detailed evidence on the threat of aerosolization. With the recent pandemic affecting countless lives globally, we take our responsibility as a member of the dental community seriously. Please reach out and let us know what we can do to support you in providing essential care during this time.