Getting routine, elective dental work done is possible once more, as dentists across Frederick County are beginning to reopen their practices. But a routine cleaning most likely won't look quite like it did before the COVID-19 pandemic began.
Dr. Harvey Levy reopened his practice on Thomas Johnson Drive on June 16 with a slew of changes to ensure his staff and patients are safe. He had been closed for 90 days, which gave him and his staff plenty of time to prepare.
Dentists are considered to have one of the highest risks when it comes to working in the time of COVID-19, since they are working in their patients’ mouths and at close proximity. Even with gloves, water used in dental procedures can create an aerosol and spread germs from the patient toward the dentist and throughout the room.
The first new precaution in Dr. Levy’s office is a screening which all patients must undergo in order to enter the practice. Dr. Levy’s staff transformed a consultation room into a screening room, which is two doors down from the entrance.
An environmental hygienist – a new role for the practice – checks visitors’ temperature, blood oxygen levels, and asks them to sanitize their hands. Patients must also answer a few screening questions regarding symptoms such as shortness of breath and cough before they can be approved for entrance.
Once the patient enters the room of their hygienist or doctor, they are asked to wash their hands for 20 seconds and then rinse with peroxide for 20 seconds in order to kill lingering germs in the mouth. They must keep their masks on at all times, except for when they are having work done.
The staff have taken precautions on their end, too. All doctors and hygienists are wearing two masks, two pairs of gloves, a face shield and a gown as personal protective equipment (PPE).
Before their first day reopening on Tuesday, the staff went through several “trial runs” where they did work on their friends and family in order to anticipate any challenges that might come up once they began appointments again, said Deborah Mason-Rooney, office manager.
Dr. Levy said he was surprised how much the extra PPE affected him and other staff members. It can get quite hot under the double layers, but they have been trying to keep the office cold to account for the discomfort.
“It’s a small price to pay to resume the semi-normal operations,” Dr. Levy said.
After a patient leaves, the environmental hygienist sprays any staff member who worked with the patient with hypochlorous acid, which is used to kill germs. It’s commonly used in salad bars to keep produce fresh, and in neonatal intensive care units to safely and gently disinfect the space.
The staff members put on new PPE while the environmental hygienists disperses hypochlorous acid with a fogger all over the room. While hypochlorous acid is nothing new, it’s not frequently used in dental practices. Every plastic and glass surface in the room is also sprayed and wiped down with a disinfectant, twice.
Patients then check out at the desk, which has a plexiglass screen protecting the staff members, and then exit through the entrance. The waiting room is only open for people who are waiting for a patient, and has been reduced to three chairs. All magazines have been removed from the room as well.
Samantha Franklin, front desk team leader, said the staff has been planning on reopening for the last 90 days, and studied guidance and webinars from the Center for Disease Control and Maryland State Dental Association in order to plan safely. They’ve begun to use electronic forms for patients and have been using an instant-messaging service in the practice itself so staff members do not need to move around to talk to each other.
“We don’t want to take anything home to our families, nor do we want our patients to take anything home to their families,” she said.
The phones have been ringing nonstop this week, Franklin said, as patients, including those of whom had appointments scheduled for the last three months, try to get back in to the office.
Lindsey Rippeon, a dental hygienist, is six months pregnant and feels safe coming back to work with all the precautions that are in place. She thought the first day back went great.
“It was different, getting used to a new routine, but I think we all worked together,” she said. “It went smoothly.”
Dr. Levy’s office is currently operating 40 hours a week instead of their usual 60. He said once the staff get more accustomed to working with the new precautions, they will expand their hours again.
He, like everyone, does not know when it will be safe to stop using extra precautions and go back to “business as usual.” But he’s prepared to continue as long as is necessary.
“If it’s forever let it be forever,” Dr. Levy said, “but we need to keep the patients, family and staff safe, as long as it takes.”