COVID-19 Prevention in Dental Settings

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Questions and Answers

When performing aerosol-generating procedures in dentistry, what combination of techniques is recommended?

Three-handed dentistry with medium suction and dental dams.

Two-handed dentistry with low suction and no dental dams.

Four-handed dentistry with low suction and no dental dams.

Four-handed dentistry, high evacuation suction, and dental dams. (correct)

What is the primary recommendation regarding the number of dental health care personnel (DHCP) during a procedure?

Include extra personnel for training purposes.

Maximize personnel for efficiency.

Limit personnel to only those essential for the procedure. (correct)

The number of personnel should not be a factor.

Regarding preprocedural mouth rinses (PPMRs), what is the current state of the evidence on their effectiveness in reducing viral transmission?

PPMRs are highly effective in preventing transmission of viruses.

There is no published evidence showing that PPMRs reduce viral transmission. (correct)

PPMRs are deemed effective because they reduce oral bacteria.

PPMRs are clinically proven to reduce viral loads significantly.

What action should dental clinics request from patients after a dental appointment, with regards to COVID-19 related symptoms?

Contact the office within 2 days if they develop signs/symptoms or are diagnosed with COVID-19. Signup and view all the answers

What should patients or DHCP do if they believe they experienced a COVID-19 exposure outside the dental healthcare setting?

Inform the dental office about the potential exposure. Signup and view all the answers

Which precaution is recommended before a patient enters the dental clinic?

Contacting all patients for a pre-appointment telephone screen for COVID-19 symptoms. Signup and view all the answers

Which dental procedure is considered to pose a higher risk of infection transmission due to aerosol generation?

Surgical extraction involving the oropharynx. Signup and view all the answers

During the COVID-19 pandemic, what should dental healthcare providers (DHCP) do in addition to their standard practices?

Implement additional infection prevention and control practices. Signup and view all the answers

When should DHCP consider postponing elective procedures?

When the risk to the patient of delaying care and risk to DHCP is considered. Signup and view all the answers

If personal protective equipment (PPE) and supplies are limited, what should be prioritized?

Prioritizing dental care for the highest need, most vulnerable patients. Signup and view all the answers

What is the primary goal of respiratory hygiene and cough etiquette in dental settings?

To limit the transmission of respiratory pathogens spread by droplet or airborne routes. Signup and view all the answers

Which individuals should be targeted by respiratory hygiene/cough etiquette measures in a dental setting?

Patients, accompanying individuals, and any DHCP with signs of illness. Signup and view all the answers

What should DHCP do to determine when to resume non-emergency dental care during the COVID-19 pandemic?

Consult the framework for “providing non-COVID-19 Clinical Care During the COVID-19 Pandemic” and local health department. Signup and view all the answers

Prior to appointments, what should DHCP do using teledentistry or triage protocols?

Contact all patients and screen them for COVID-19 symptoms. Signup and view all the answers

At what point should respiratory hygiene measures be implemented in regards to patients?

Beginning at the point of entry to the facility and throughout the visit. Signup and view all the answers

During the pandemic, what is crucial for DHCP to monitor regarding local data?

Trends in local case counts and deaths, especially for high-risk populations. Signup and view all the answers

What instructions should be included on signs posted at entrances regarding respiratory hygiene?

Instructions to cover mouth/nose when coughing or sneezing, use and dispose of tissues, and perform hand hygiene afterwards. Signup and view all the answers

Besides tissues and receptacles, what else should be provided in or near waiting areas to support respiratory hygiene?

Resources for performing hand hygiene. Signup and view all the answers

When should masks be offered to individuals in a dental setting?

To coughing patients and other symptomatic persons when they enter the dental setting. Signup and view all the answers

What action should be taken if a dental patient reports symptoms of COVID-19?

Avoid nonemergent dental care and use the Phone Advice Line Tool. Signup and view all the answers

In addition to providing masks, what other measure should be taken to avoid contact between symptomatic patients and others?

Encouraging persons with symptoms to sit as far away from others as possible. Signup and view all the answers

When should dental care be delayed for a patient?

Until the patient has ended isolation or quarantine. Signup and view all the answers

What is NOT an aim of educating DHCP on infection prevention measures?

To help diagnose patients with respiratory infections. Signup and view all the answers

How should patients initially be screened for dental care needs?

Through telephone triage to assess their condition. Signup and view all the answers

What is a suggested alternative to in-office dental care during the pandemic?

Implementing telemedicine options instead of in-person visits. Signup and view all the answers

What should patients be advised regarding accompanying individuals to their appointment?

To limit the number of visitors to only necessary individuals. Signup and view all the answers

Which measure is required for everyone when entering a dental facility?

To wear a facemask and undergo screening for fever and symptoms of COVID-19. Signup and view all the answers

What should be available at entrances, waiting rooms, and patient check-ins?

Supplies for respiratory hygiene and cough etiquette, including ABHR, tissues, and no-touch disposal receptacles. Signup and view all the answers

Which of these is an appropriate physical barrier to install to help protect staff?

A glass or plastic window at reception to limit close contact. Signup and view all the answers

What is a key recommendation for managing transmission in non-patient care areas?

Emphasizing source control and physical distancing. Signup and view all the answers

How should physical distancing be implemented for dental team members (DHCP) during meetings?

By designating areas where individuals can remain at least 6 feet apart. Signup and view all the answers

What should a DHCP who is showing signs of COVID-19 do?

Immediately return home and notify occupational health services. Signup and view all the answers

What type of sick leave policy should healthcare facilities implement for DHCP?

A flexible policy consistent with public health guidance. Signup and view all the answers

What is recommended procedure regarding routine self-monitoring for DHCP?

Regularly monitor themselves for symptoms and fever. Signup and view all the answers

What should DHCP receive when needing to stay home when ill or under quarantine?

No penalties. Signup and view all the answers

What type of airflow pattern is recommended for ventilation systems?

Air movement in a clean-to-less-clean flow direction. Signup and view all the answers

What is a recommended adjustment for HVAC systems to improve infection control?

Increasing filtration efficiency to the highest level. Signup and view all the answers

When treating a patient with suspected COVID-19, where should dental procedures ideally be performed?

In an individual patient room with a closed door. Signup and view all the answers

Which type of respiratory protection is recommended for DHCP entering the room of a patient with suspected COVID-19?

An approved N95 or equivalent or higher-level respirator. Signup and view all the answers

What should DHCP do if a respirator is not available when treating a COVID-19 patient?

Use a standard surgical mask instead. Signup and view all the answers

Which of the following is NOT recommended during dental procedures for a COVID-19 positive patient?

Wearing appropriate PPE. Signup and view all the answers

What kind of eye protection should be worn to reduce the risk of splashes and sprays during dental treatment for a COVID-19 patient?

Safety glasses with no gaps between glasses and face. Signup and view all the answers

Which of these is the correct procedure to follow when a patient with suspected COVID-19 needs to move from their room?

The patient should wear a facemask to contain secretions. Signup and view all the answers

If a COVID-19 patient cannot wear a facemask when moving from their room, what is the immediate alternative?

The patient should use tissues to cover their mouth and nose. Signup and view all the answers

If aerosol-generating procedures must be performed on a patient with suspected COVID-19, where should they ideally take place?

In an airborne infection isolation room. Signup and view all the answers

Study Notes

Prevention of Coronavirus Disease 2019 (COVID-19) in Dental Settings

This course provides guidance for dental settings on preventing the transmission of COVID-19.
The presentation covers respiratory hygiene/cough etiquette measures, precautions before patient entry, recommended infection prevention and control practices, implementing teledentistry and triage protocols, universal source control measures, patient placement, and administrative controls and work practices.

Introduction

Respiratory hygiene and cough etiquette aims to lessen the spread of respiratory pathogens through droplets and airborne routes.
Strategies target patients and accompanying individuals with potential undiagnosed respiratory infections, as well as anyone exhibiting signs like cough, congestion or increased respiratory secretions.

Respiratory Hygiene/Cough Etiquette

Implement measures to halt respiratory secretions at the point of entry and throughout the patient visit.
Educate dental personnel (DHCP) about infection prevention measures to control the spread of respiratory viruses when examining and treating patients.
Post signs at facility entries to inform patients with symptoms to cover their mouths and noses when coughing or sneezing, use and dispose of tissues, and perform hand hygiene after contacting respiratory secretions.
Provide tissues and no-touch receptacles near waiting areas for hygienic disposal.
Provide hand hygiene resources in or near waiting areas.
Offer masks to patients experiencing coughs or other symptoms.
Provide space for patients with COVID-19 symptoms to wait away from others, if possible.

Precautions Before Patient Entry

Assess patient risk for deferring care.
Ensure sufficient personal protective equipment (PPE) and supplies.
Prioritize dental care for patients with the highest need and/or those at the highest risk of complications.

Recommended Infection Prevention and Control Practices

Surgical procedures that generate aerosols or involve regions with high viral loads (nose, throat, oropharynx, respiratory tract) might pose a higher infection risk.

Implementing Teledentistry and Triage Protocols

Contact all patients before treatment.
Screen patients by phone for COVID-19 symptoms.
Avoid non-urgent care for patients with COVID-19 symptoms and use the Phone Advice Line Tool for Possible COVID-19 patients.
Delay dental care if possible when patients are in quarantine or isolation.
Assess the necessity for dental care, and triage all patients needing care.

Implement Universal Source Control Measures

Advise all patients and accompanying individuals to wear face masks upon entering.
Provide screening for fever and COVID-19 symptoms.
Facility-wide respiratory hygiene and cough etiquette, and hand hygiene practices are necessary.
Post visual alerts (e.g., signs, posters) at facility entrances and in relevant areas to instruct patients about good hand hygiene, respiratory hygiene and cough etiquette.
Facemasks, alcohol-based hand sanitizer (ABHR), tissues, and no-touch receptacle bins should be readily available at facility entrances, waiting areas and patient check-in areas.
Use physical barriers (e.g., windows) at reception areas to minimize contact between triage personnel and patients.
Remove frequently touched objects from waiting areas.
Ensure all personnel and patients wear their own cloth face coverings, or provide masks when necessary.
Screen all individuals entering the facility for COVID-19 symptoms; include fever screening.
Advise patients of self-quarantine criteria.

Patient Placement

Prefer individual treatment rooms whenever possible.
In facilities with open floor plans, maintain 6 feet between patient chairs.
Use physical barriers.
Orient operatories in the direction of airflow.
Consider patient positioning near the return air vents.
Plan sufficient time to disinfect operatories between patients.

If a Patient Arrives Confirmed to Have COVID-19

Defer non-urgent dental treatment
Provide the patient with a facemask
If no emergency warning signs for COVID-19 exist, send the patient home and instruct them to contact a primary care physician.
If emergency warning signs exist (e.g., difficulty breathing) refer the patient to the appropriate medical facility or call 911.

What about DHCP?

DHCP members should prioritize physical distancing in common areas outside of patient care.
Implement flexible sick leave policies consistent with public health recommendations.

Administrative Controls and Work Practices

DHCP should only include essential personnel for patient care and procedure support.
Avoid aerosol-generating procedures unless necessary.
If necessary, use four-handed dentistry and suction, and dental dams.
Preprocedural mouth rinses are not definitively effective in preventing viral transmission.
Inform occupational health services about potential COVID-19 exposure.

Optimize the Use of Engineering Controls

Proper maintenance of ventilation systems, moving air from clean to less-clean areas to better contain contaminants, is essential.
Understand and manage clinical air flow patterns and ensure appropriate air changes per hour.
Increase filtration efficiency to minimize contamination.

Additional Information

Refer to appendix B & C in the designated book for additional information.

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Description

This quiz focuses on guidelines for preventing COVID-19 transmission specifically in dental environments. It covers crucial topics such as respiratory hygiene, patient management, and infection control practices. Enhance your knowledge on implementing effective safety measures in dental care settings.