Around Good People is using CDC guidance to address the unique risks of contagious agents in the dental environment. CDC Covid19 guidance is updated frequently.
It is not possible to eliminate all risks. It is possible to employ precautions that mitigate risks and protect our faculty, staff, students, and patients. Universal body substance precautions remain as the front line for reasonable risk reduction. However, when dealing with a contagious agent that is spread by droplet contact, we need to recognize the need to manage our generation of aerosols as a prudent additional measure. This AGP Covid protocol seeks to implement additional risk reduction while still maintaining a reasonable level of service for our outreach/partner dental hospital patients and community. This protocol will be updated frequently as local and national public health information is available.
AGP Covid-19 Dentistry Protocol
- All elective procedures are suspended until further notice. Procedures that generate aerosols are permitted only under tightly controlled conditions as stipulated below and after COVID-19 testing. (Aerosol procedures involve the use of a hand piece, ultrasonic unit, and/or air-water syringe.) For all other procedures that generate minimal amounts of aerosol, the patient may rinse their mouth with water from a disposable cup. The water may be removed with an evacuation straw, not a high-volume suction, or the patient may expectorate into another cup, especially if their mouth is anesthetized.
- The following is a guide to what may be regarded as urgent procedures. Urgent care includes any patient needs that are urgent, such as:
- Pain (including chronic ulcerative mucosal disease management)
- Swelling of gums, face, or neck
- Signs of infection such as a draining site
- Trauma to face, jaw, or teeth, including fractures
- Pre- and post-transplant, radiation, or bisphosphonate patients with oral symptoms (evaluate by telephone screening first)
- Pre-transplant evaluations
- Referrals made by physicians or other health care providers
- Potential malignancy
- Broken tooth
- Ill-fitting denture
- Final crown/bridge cementation if the temporary restoration has broken
- Repair or replacement of a provisional restoration
- In all cases, it is desirable for the urgent care provider to evaluate the patient by telephone call or teledentistry prior to advising the patient to come in for care.
Students are not allowed to participate in patient care until further notice.
All personnel, including faculty, staff, and students, must self-assess their health daily before reporting to the designated supervisor-in-Charge of its Dental Placement. They must respond “No” to all the following questions:
- Fever >100.00 F
- Sore throat
- Shortness of breath
- Flu-like symptoms
- Recent and abrupt loss or reduction of the sense of smell and/or taste
- Close personal contact (without PPE) with a suspected or laboratory-confirmed COVID-
19 patient in the past 2 weeks
- Travel within the past 2 weeks to a region with high rates of COVID-19 disease activity
If they may be ill or may transmit a communicable disease, or if their temperature is >100.00 F, they must not come to work but must report in sick.