Over the past three months over 200,000 dentists have had to suspend dental treatment due to the national shut down order. We were considered a non-essential business. Many dental procedures were interrupted and placed on hold for the past three months placing many of our patients at risk for more dental disease and/or treatment.
During this time, I learned a lot about COVID-19. It affects people of all age groups but predominately 65 years of age and older. People in the at-risk group are those with co morbidities like obesity, heart disease, lung disease, asthma, COPD, Liver and Kidney disease, Immune deficiency or immune disorders and diabetes People who smoke or vape or a combination of the two are three times more susceptible. These are the people most susceptible and at risk if exposed. That is not to say that if you are in an at-risk group and you catch COVID -19 you will pass away. You will have a more challenging time with it and may end up in the hospital versus people who are exposed to COVID-19 and are not in the at-risk group. This group stays home for two weeks and have a 90+% survival rate. Some do not know they were ever exposed to COVID-19.
COVID-19 is highly contagious. COVID -19 is two times bigger than the flu virus. Viruses mutate to survive which is why finding a consistent and predictable vaccine is hard. As viruses mutate, they get weaker. But the people who are in the at-risk categories are always going to have more problems even with a weaker virus than the healthier population. The flu virus mutates 4 times faster than the COVID-19 virus. Because of this fact, once a vaccine is found for COVID-19 it will be a more stable vaccine for a longer period of time. In other words, the same vaccine for COVID -19 could be used for 2-3 years before having to be modified unlike the Influenza A and B vaccines which needs to be modified every year.
What makes it challenging as a dentist, is that COVID -19 like other airborne corona viruses like the Flu, H1N1, SARS, MERS and yes even the common cold all spread through the air via a sneeze, a cough and a dental drill. AIDS when it first came to the United states in 1981 was also feared because we could aerosolize it with the drill. The airborne models for COVID -19 are similar to the AIDS virus models and how it would travel if it were aerosolized.
The mouth (oral cavity) is our domain and which we work closely with. This is the Front Line when dealing with COVID -19. But with the AIDS virus we learned how to protect our patients and staff and provide a healthy and safe work environment. We created and implemented sterilization and disinfection techniques to deal with all the current bacterial and viral contaminants. As such there have been no reported cases of dentists or dental staff contracting the AIDS virus. The few cases reported over the years where some patients contracted AIDS in the dental office was due to dental offices not practicing any disinfection or sterilization procedures at all and were using dirty instruments to treat patients.
Many of the procedures we utilize today to disinfect and sterilize our offices will easily kill the COVID-19 Virus as it does the AIDS virus, Hepatitis B and C, SARS and MERS viruses to name a few. If you feel your dentist did a good job before COVID -19 in terms of providing a safe, healthy and clean environment for you then what you will see now is that he/she has kicked it up a notch or two.
Many of us have reviewed the OSHA, CDC and PA Department of Health guidelines to reopening our practices. Many of us have made changes to our HVAC systems to improve and decontaminate the air within our offices as we are working on patients as well as upped our game in terms of disinfection of our offices several times a day as opposed to once or twice a day.
So, what will the New Normal look like in the dental office. The Parking Lot will replace the warm and friendly waiting room. You will receive a cell phone call when you are ready to be seen. You will enter the office wearing a mask where you will receive a squirt of hand sanitizer and asked a series of COVID-19 related questions and have your temperature taken. Then you will be escorted to the treatment room by an assistant who is dressed like they are escorting you to an operating room. Once seated your temperature will be taken again and the COVID-19 questionnaire reviewed. You will then rinse with a mouth rinse which will reduce the viral load in your mouth. The tooth or teeth that are to be worked on will be isolated to reduce aerosol spread and the procedure will be performed and completed. You will then be asked to rinse again before leaving the treatment room, receive a squirt of hand sanitizer and escorted to the front desk where you make any follow up appointment and pay for your services from behind a sneeze guard by a masked patient coordinator. Once done you will be asked to leave by another door office so as to not cross paths with another patient. Meanwhile everything that you could have possibly touched or breathed on will be disinfected and sanitized. If you use the rest room a staff member will come in right behind you wiping and disinfecting everything that you could have possibly touched or breathed on.
Many of these things most dentists have been doing already to maintain a high standard of infection control within their office. The big difference now is that disinfection measures will be more visible. You will see the staff watching making sure you are not touching anything and cringe when you do.
For the time being the most dramatic change for most offices will be the number of patients in an office at any given time. For now, we will be limited to one in and one out for each provider with no one waiting in a waiting room. For dentist who are used to seeing 2or 3 patients at the same time or offices with multiple doctors with each use to seeing 2 or 3 patients at a time this will be a big and challenging change.
Like I said, we have been down this road before. With every new virus dentist are on the front lines. We are adaptative and cognoscente of what we need to do to protect our patients and our staff and what is necessary to provide a clean, safe and healthy environment.
In the meantime, I hope everyone continues to follow the Corona Virus Task Force guide to STOP the SPREAD which is to maintain social distancing, wear a mask when out and wash your hands. As we begin the re-opening process please do not become complacent. COVID-19 is still a viable virus for which currently there is no cure. We have come too far to let our collective guard down now. We are all in this together and together we will all get through this.
James A Vito, D.M.D.
ADULT RESTORATIVE, COSMETIC & IMPLANT DENTISTRY
523 East Lancaster Ave
Wayne, PA 19087
610-971-2590
www.jamesvito.com