Safety Protocols in Dental Practice: What You Need to Know

In the current pandemic, safety protocols in dental practice are of utmost importance. To ensure professional safety, health workers must wear personal protective equipment (PPE) that includes a disposable long-sleeved gown, a cap, a surgical mask, a face shield, protective goggles and gloves. PPE should be used for both diagnostic tests and any dental procedure. The Occupational Safety and Health Act requires employers to comply with safety and health rules and regulations enacted by OSHA or by a state with an OSHA approved state plan.

Additionally, the General Duties Clause of the Act, Section 5 (a) (), requires employers to provide their employees with a workplace free from recognized hazards that could cause death or serious physical injury. The Centers for Disease Control and Prevention (CDC) offers infection prevention and control recommendations for dental procedures during the COVID-19 pandemic. The OSHA blood-borne pathogen standard (29 CFR 1910,1030) applies to occupational exposure to human blood and other potentially infectious materials, including saliva in dental procedures. The standard on blood-borne pathogens does not specifically apply to occupational exposure to respiratory secretions, although saliva may contain respiratory secretions (and, in dentistry, the standard applies to occupational exposure to saliva).When carrying out dental procedures, appropriate controls must be implemented.

And when engineering controls, labor practices and administrative practices are not feasible or do not provide sufficient protection, appropriate personal protective equipment must be provided and used correctly. OSHA recommends using a combination of standard precautions, contact precautions, and precautions against drops, including eye protection (p. ex. When workers are exposed when performing aerosol-generating procedures, take standard precautions, contact precautions, air transport precautions, and eye protection (p.

In areas with ongoing community transmission of SARS-CoV-2 and based on current hazard assessments, consider only emergency dental procedures and evaluate whether elective procedures, surgeries, and non-urgent outpatient visits should be postponed. If possible, use directional airflow, such as that from exhaust fans, to ensure that air does not move from patient treatment areas to staff work areas. An industrial hygienist, ventilation engineer, or other qualified professionals can help ensure that ventilation eliminates, rather than creates, workplace hazards. Perform a health evaluation at or immediately before patient registration to determine if a patient should be considered a suspected or confirmed case of COVID-19. Use teledentistry (p. Advise patients, and anyone who accompanies them, to cover their faces with cloth when they enter the center and at all times, except during treatment.

Consider extending business hours or reducing the number of appointments to minimize the number of patients in the clinic at the same time.

Isolation Protocols

In accordance with the general interim guidelines described above, isolate patients with suspicion or confirmation of COVID-19 to avoid transmitting the disease to others. Minimize aerosol-generating procedures and take all appropriate precautions to protect workers. Avoid aerosol-generating procedures completely if proper precautions are not in place. Minimize the number of personnel present when performing aerosol-generating procedures.

When performing the necessary aerosol-generating procedures, it is particularly important to exclude any staff members who are not needed for the procedure itself.

Cleaning & Disinfecting

Increase the frequency of cleaning and disinfecting rooms and equipment; at a minimum, ensure that rooms and equipment are cleaned between patients. Dental employers must provide, and dental workers must use, appropriate PPE when exposed to potential sources of SARS-CoV-2 in the workplace. Workers may need more sets of protective PPE when performing aerosol-generating procedures in areas with continuous community transmission compared to the sets of PPE that may be needed for routine patient care in areas where the transmission of COVID-19 has decreased.

Adapting Guidelines

It is important for dental offices to keep abreast of changing conditions of the outbreak including spread of virus and availability of tests in their community so they can update hazard assessments and implement infection prevention measures accordingly. As states or regions meet criteria for moving forward through phases of Guidelines for Reopening the United States they can adapt this guide along with general recommendations of OSHA Guide on Returning to Work to better adapt to changing levels of risk and control measures needed in their workplaces.