For many of us, getting back to the way things were before the COVID-19 pandemic, may never happen. The last few weeks have left us wondering if gathering in large crowds, shaking hands, high fiving and venturing into a store with no mask could be a thing of the past. However, how many of us have thought about our next dental visit? In fact, Business Insider ranks Dental Hygienist, and General Dentist as #1 and #2, most unhealthy jobs in America, respectively. One of the main contributing factors to these rankings are bioaerosols in the dental office. The oral environment is full of bacteria, in some cases, viruses, and even fungi. During most dental procedures these microorganisms can go airborne from dental equipment that sprays air and water in and around the mouth. Airborne tissue, bacteria, viruses, and fungi are known as bioaerosols. The CDC says these bioaerosols can remain suspended in the air for HOURS! Uh oh!
Now, this isn’t a new problem in dentistry. However, the COVID-19 pandemic has brought the concern of bioaerosols to the forefront. So, is it safe to keep your next dental visit? In short, it depends, I will run through a couple things you can look into before your next dental appointment to make sure you and your loved ones are staying as safe as possible.
When it comes to Infection Control, dentistry follows the guidelines created by the Centers for Disease Control (CDC) and Occupational Safety and Health Administration (OSHA). Infection Control has come a long way in dentistry. In the 1970’s and early 80’s a lot of dentistry was done with bare hands, Personal Protective Equipment (PPE) was not a concern. By the mid 80’s the CDC came out with its first Infection Control guidelines for Dentistry and these guidelines have been constantly evolving since. Many of the current regulations in place deal with barrier protection, PPE, and instrument sterilization. Although, things are still very fluid, some of the new recommendations coming out for dental offices post COVID-19 are the use of N95 masks and the use of face shields. But what about the area of bioaerosols, and the stuff flying around and staying suspended in the air you are breathing? Is there anything being done?
I have researched the topic of bioaerosols and participated in discussions with other Dentists about post COVID-19, and what we can do to keep our dental office safe. Some Dentists are taking certain measures to minimize bioaerosols and others are not going to change anything, business as usual. So how do you know if your dentist is doing everything they can to keep you safe? Do you want your dentist taking extra measures? Here are some questions you can ask your dentist to make sure you are comfortable and safe at your next appointment:
If your dental office is trying to follow recommendations by the State Dental Board, they should be checking temperatures of team members every morning. They should also be screening patients over the phone before their visit and taking temperatures of the patients when they arrive at the office. These measures are done to minimize the risk of having the office exposed to COVID-19.
The first thing they should be doing, which hopefully they were doing before, is surface disinfection. For example, wiping chairs, table tops, door handles, counters, etc. However, hopefully they are doing this more frequently now. The next thing you want to listen for here is “bioaerosols,” or “aerosols.” We know the virus spreads through aerosols. We know that dental offices have a high concentration of bioaerosols, particularly in their treatment rooms. What are they doing to minimize the bioaerosols, are they doing anything at all? We know from a CDC article, that bioaerosols in a dental office can sit suspended in the air for hours. So, we have one of two options: we can let the room sit vacant for a couple hours between patients, or we need a way to clean the air in the treatment rooms. At our office we have implemented HEPA air purifiers for each treatment room, and for all the common areas (waiting area, hallways, staff lounge, etc.). We elected to go with Medical Grade H13 HEPA air purifiers to give us medically clean air by filtering out 99.97% of particles down to 0.1 microns. The next thing we are deploying is a vacuum system to catch aerosols before they have the chance to fly out of the patient’s mouth and into the room air. By taking these measures, along with current measures we already have in place, we are making sure that not only our patients are in a safe dental environment, but we are making sure our team is spending their day in a safe working environment.
At the end of the day you should feel comfortable and safe wherever you and your family are getting their dental treatment. If you have any concerns or questions call your dentist office, ask them what they are doing to keep patients and team members safe. If you don’t feel comfortable at your dental office seek out a second opinion! If you don’t feel well stay home, and reschedule your visit. Dentistry is a team game. To have a healthy and happy patient-dentist relationship, you, your dentist, and their team need to be operating on all cylinders in a comfortable, healthy environment.
Dr. Justin Yun