The COVID-19 pandemic has placed great stress on many businesses, including dental practices. For several months, dentists were forced to close as the UK entered lockdown. Upon phased reopening, new measures have been put in place restricting the services that can be offered or creating new rules around these services which can disrupt normal business in view of prioritising customer health. The embedded short video looks at the rules surrounding dentists reopening.
Jonathan Alexander-Abt is an orthodontist working within the new guidelines and legislation. According to the British Orthodontics Society (the BOS), there has been limited guidance so far from Public Health England regarding the use of aerosol generating procedures, or AGPs, for routine dentistry. The infographic attachment looks at PHE in figures.
The BOS is therefore recommending alternatives to using AGPs wherever possible.
AGP Alternatives
There are a variety of AGP alternatives that can be used to treat dental patients for routine and non-routine procedures. These include non-AGP bonding and debonding techniques which can be accomplished by hand for removing, repairing or fitting fixed braces.
Where possible, dentists should implement techniques that do not require the use of equipment classed as producing AGPs, such as most forms of drills, sandblasters, 3 in 1 air/water syringes, and sonic and ultrasonic handpieces.
Suction, including both high volume and low volume, is not in itself considered an AGP and can be used to help minimise airborne particles during procedures. However, even when High Volume Suction is combined with pre-procedural mouthwash and a dental dam to limit the bio impact and aerosol, precautions must be taken.
AGP PPE
When AGP must be carried out due to urgently required dental care, specific PPE must be worn, and hygiene rules must be adhered to. Arms should be bare from the elbows down and hands thoroughly washed and sanitised, with only approved clinical clothing worn beneath PPE.
The appropriate PPE includes a visor or goggles, gloves, a respirator mask, and a fluid-resistant long-sleeved gown. All PPE should be changed after each patient using the correct doffing technique to minimise risk of transmission.
PHE has provided guidance on cleaning and sanitising rooms and equipment after use, which should be followed. There are also strict regulations for waste management and transfer of appliances and impressions to the laboratory.
A description of aerosol generating procedures can be found in the PDF attachment to this post.