How we have responded to Coronavirus with Update Emergency Dental Protocols
Dr. Arthur A. Kezian and his office staff members are dedicated to maintaining the highest level of safety and protection during the limited reopening of his dental office during the Covid-19 crisis with updated emergency dental services and protocols. We all feel it is our direct responsibility to protect our patients, our staff, and our community. We would like to share with our patients the updated dental emergency coronavirus protocol changes and new protocols we have implemented in our dental office to maintain our commitment to safety and reduction of cross contamination.
In March, Dr. Kezian immediately shut his office down in response to the virus, in accordance with government guidelines and American Dental Association recommendations. He chose to remain available and limit his services to urgent care, only to perform severe emergency dental procedures. This included treatment of oral pain, infection, or injury.
During this closure, Dr. Kezian did not stand idly by, instead he chose to take that time to research and implement all possible safety updated dental emergency COVID-19 protocols to be a pioneer of safe dentistry in a post-COVID world. Now that stay at home order restrictions are being lifted, and our country is beginning its phased approach towards reopening, Dr. Kezian wants to open his dental office again so that he can take care of his patients’ dental needs.
Treatment of elective, not essential, procedures and routine hygiene will still be limited at this time during the initial reopening. Essential treatments that will include root canals or endodontics, gum treatments or periodontics, and dentures, crowns and bridges or prosthodontics, will be allowed. According to guidelines set forward by the American Dental Association, essential treatments are procedures that need to occur in situations where a patient’s condition will be worse if they do not have the procedure done.
The new protocol updates in our office
When you come visit our offices, you will see some interesting differences that we are very proud to share with you. We have taken these measures for your safety and the safety of our community.
Managing the spread of aerosol during procedures
One of the biggest concerns in emergency dental procedures is the spread of aerosols. One of the important measures implemented was the invention and installation of a unique aerosol suction unit in every operatory. This device is placed close to the patient’s mouth during procedures, and the powerful suction from the device removes any potentially infectious aerosolized droplets in the air that may be generated during dental procedures.
This special system is extremely effective in removing and filtering suspended particles that linger in the air and is incredibly important in reducing cross contamination. We have shown how effective this system is in our video, where we demonstrate the powerful ability to suck smoke out of the air. In this experiment, we burned a piece of paper and held it over six inches away from the opening of the suction device. This smoke simulates and visualizes the aerosol that can be generated during a dental procedure. In our video you can see that every single particle of smoke was sucked into the tube, no matter how far away the source was. When the suction was turned off, the smoke rose into the air and lingered just like an aerosol could. Once the suction was turned on again, all of the smoke was sucked out of the air again. The installation of these devices was uniquely designed by Dr. Kezian specifically to maximize suction power, while minimizing noise and patient discomfort. It is a little noisy, but we believe very strongly that the noise is worth it to safely updated dental emergency coronavirus protocol.
Introduction of Air filtration
When you visit our office, we want you to breathe easy. A second important addition in our office was the installation of two HEPA 500 Air Scrubber hospital grade air filtration units. These are the air filtration units that you could potentially see cleaning the air of hospital treatment facilities. These two units are strategically placed in our office. One unit is located directly in the patient waiting room area, and a second unit is located within the back office dental clinic, where emergency dental procedures are done. These devices each cycle the environmental air in the office over three times per hour. This filtration will also remove any potentially infectious particles and will provide clean air and a clean sterile environment to our patients and staff. Just like the aerosol suction devices, these HEPA air filtration units do generate a lot of background noise, but we believe that this noise is worth it to ensure your safety.
Updated Personal Protective Equipment
A third updated dental emergency coronavirus protocol modification is the introduction of new Personal Protective Equipment, or PPE, protocols. All staff members as well as patients are required to wear this PPE before incoming our clinic facility. We have acquired new articles of personal protective equipment from trustworthy medical suppliers. We are offering these to all of our patients and staff. These articles include full body gowns, hair bonnets, face masks, and shoe covering. If you brought your personal face mask you are encouraged to continue wearing it, if not we will be more than happy to supply a face mask for you. All of our staff members wear the gowns, hair covers, shoe covers, and masks, and they also wear full face shields and gloves at all times. Gloves are changed before and after every patient, and face shields are disinfected. At the end of your emergency dental procedure, we will gather your personal protective equipment and dispose of it following proper infection control guidelines. This defense will make certain that you do not depart our dental office with any infectious particles on your body and clothing.
We have also put in large clear plastic dividers in areas where you have to communicate with members of our office staff, such as the treatment planning coordinator and the front desk receptionist. This barrier prevents the spread of any infectious particle, but will still permit you to communicate and see our staff.
Patient social distancing
One of the most important updated dental emergency coronavirus protocols s the social distancing that we have introduced. We have alternated scheduling appointments to minimize the quantity of patients in the office at a given point. Once you have made it to our office, we ask that you stay in your car before to your appointment and notify our front desk. If there are too many patients, we will ask you to stay until there are less people receiving treatment or waiting in the waiting room. In the waiting room, the chairs are positioned more than six feet apart from each other, and during all interaction this social distance will be enforced. We also introduced updated screening protocols including a forehead temperature reading and a short symptom and contact tracing questionnaire.
Signs and symptoms can emerge 2-14 days after exposure and may comprise fever, cough, and difficulty breathing. Emergency warning symptoms include difficulty breathing, a persistent pain or pressure in the chest, new confusion or inability to arouse, and bluish lips or face. This is not necessarily all-inclusive, and you should check with a medical professional for any other symptoms that are strong or cause concern.
Just as a reminder, there are many other procedures in place to limit the spread of infections according to the Center for disease control and the American Dental Association. These are protocols that we have been observing in our practice since before the outbreak. This includes that we change masks and gloves between patients or during patient treatment if the mask becomes wet, according to dental guidelines. All dental instruments are cleaned, autoclaved, and sterilized after each patient is seen. All biohazard materials including gauze and tissue are disposed of properly and safely. We frequently clean and disinfect public areas, including door handles, chairs, and bathrooms. Before and after a patient is seen, our staff members completely sterilize every possible surface in the operatory with Bactericidal and Virucidal disinfectant spray.
New research from the National Institutes of Health and the Center for Disease Control has shown that the virus can remain stable for several hours to days on surfaces and in aerosols. We use the highest quality disinfectants which have been proven to be effective in killing the Coronavirus and preventing the transmission.
What can you do to help us?
We ask that our patients work with us to ensure as much safety as possible. We recommend that our patients maintain excellent at home oral hygiene and be careful to avoid any traumatic injuries to their teeth or oral cavity. Limit direct contact with others and practice social distancing. Wash your hands frequently and avoid touching your face, mouth, and eyes.
The best thing patients can do is to self-evaluate to determine if they are beginning to show signs and symptoms of the disease.
These new updated COVID-19 dental protocols are just a small way we can do our part to help limit the spread of this disease in our community. While shelter in place efforts have been remarkably successful, the fact of the matter is that our patients’ dental needs did not stop. We are proud to be able to meet those needs, but recognize our duty to protect our community from further spread of this terrible disease. We at Dr. Kezian’s office appreciate your participation and understanding during these difficult times. As soon as we can resume business as usual, our patients will be the first to know.
Press Contact
Dr. Arthur A. Kezian DDS
443 N. Larchmont Blvd
Los Angeles, CA 90004
(323) 467-2777
http://www.drkezian.com
References:
https://www.nature.com/articles/s41368-020-0075-9
https://www.smileperfected.com/reopen-dental-office-post-covid-19/