COVID Protocols

Overview

  • Your health and safety remain our top priority.
  • Right now, it’s more important than ever to remind you that oral health affects overall health. A recent study concluded that periodontitis is associated with a higher risk of negative outcomes in patients with COVID-19.
  • Regular dental care can prevent chronic inflammation and may reduce your risk of becoming seriously ill with various health conditions.
  • In addition, the heightened stress of living in the COVID world has led to a marked increase in the number of tooth cracks and breaks. Pain associated with bruxism or grinding is also on the rise.
  • It’s important to continue with regular dental care, in order to keep small problems from becoming big ones.
  • Dental providers are using their training as infection prevention and control experts to help keep dental offices safe during the pandemic. Unlike other health professionals, the entire dental staff has been using universal IPAC precautions long before the arrival of COVID. As a result, we had a good head-start on implementing protocols for this life-changing pandemic. Even so, there now are more safety measures in place.
  • Appointments are scheduled to allow physical distancing and disinfecting between patients. This might mean less flexibility when scheduling your appointment.
  • You will be screened for COVID-19 symptoms both before your appointment and upon arrival at the office.
  • You will be asked to wear a mask while in the office except during treatment.
  • Patients are asked to PLEASE stay home if they have flu-like symptoms (fever, cough, or difficulty breathing) or have been exposed to someone with COVID-19. If you are sick and have an upcoming dental appointment, call your dental office to report symptoms, reschedule, or ask about other care options.

Our protocols

Cliffcrest Dental is committed to providing a safe space for patients, the community, and the dental team. In order to best meet those needs, detailed guidelines were drafted upon the office’s re-opening in June, 2020. Following information in the Royal College of Dental Surgeons of Ontario (RCDSO) document entitled “COVID-19: Managing Infection Risks During In-Person Dental Care” released on May 31, 2020, Cliffcrest Dental created its comprehensive protocols as outlined below. These protocols continue to be amended from time to time based upon changing events.

Daily wellness screening of staff

  • Every day, upon arrival at the facility, every team member is asked to report any changes to their overall health since their last day at work.
  • Any staff member that is ill is not permitted to work and will be sent home.
  • If the symptoms are COVID-related, that individual will be asked to get a COVID19 test and must confirm that they are COVID19-negative before being returning to work.
  • Our office expects all of its staff members to continue best practices for safety even when we are not working. This includes regular, thorough hand hygiene, maintaining a physical distance from others, and wearing a mask when in crowded settings outside one’s home.

Staff clothing & uniforms

  • All staff members wear freshly-laundered clothing each day in the office. Clinical staff wears scrubs or uniforms and administrative staff may choose to wear business clothing.
  • Our clinical staff does not wear soiled scrubs or uniforms outside the office.
  • The office also provides its staff with protective gowns that can be worn over scrubs and uniforms. These gowns are intended to add another layer of protection, particularly during aerosol-generating procedures.
  • Soiled gowns are changed between patients.
  • All used gowns are kept in a designated receptacle, then removed from the office by a cleaning company, professionally cleaned, and returned for re-use.

Hand hygiene

Still the most important part of infection prevention and control, staff, patients, and all individuals entering the office must conduct hand hygiene upon arrival and frequently thereafter throughout the day, by using an alcohol-based rub (ABHR) or soap and warm running water.

Physical distancing

Whenever possible, all staff and patients are asked to maintain physical distance of at least of 2 metres (6 feet) except as required to provide patient care and to maintain, clean, or sterilize equipment and operatories.

Masks

While in the office, staff, patients, delivery people, etc. no longer are required to wear a face mask at all times.  All clinical staff continues to wear masks while providing dental care, as they always have – even before 2020.

Appointment scheduling & confirmation

  • Upon scheduling and confirming appointments, every patient will be asked to provide updated information regarding their current health status
  • Wherever possible, patients are asked to attend their appointments unaccompanied
  • Cliffcrest Dental office is not providing dental care to patients who currently have COVID-19.

Once a patient has recovered and has been deemed clear of COVID according to the latest Public Health advisory, then he or she can receive dental treatment at our office again.

Walk-in patients

Our office continues to see patients at appointed times.   Walk-ins will only be seen when providers are able to accommodate them.

Patient check-in

  • The front door of the office is no longer locked.
  • The wearing of masks is left to personal choice.
  • Everyone is asked to report changes in their health upon arrival.
  • Patients who are ill are asked to postpone their visits.

Waiting room

  • After screening and hand sanitizing, patients will be asked to maintain social distancing while waiting in the reception area.
  • The number of people and length of time spent in the waiting room is to be kept to a minimum; the dentist, hygienist, or assistant will escort the patient to the treatment room.
  • Patients are asked to attend their appointments unaccompanied where possible, to help us keep occupancy at a minimum.
  • Patients are asked to keep their belongings with them and not leave any personal items in the waiting room area.

Restroom

  • Our office restroom is available for patient use only, in order to minimize exposure. Surface transmission has been shown to NOT be an issue with respect to COVID, but we want everyone to feel safe and secure in all areas of the office. Disinfecting wipes are provided and the surfaces are cleaned throughout the day.

In the dental operatory

  • Many physical changes have been made throughout the office to aid in managing infection control.
  • Plexiglass barriers separate patients from administrative staff in the front office and also have been added to the tops of operatory walls, in order to isolate each room.
  • In addition, entries to the operatories have been closed off with plastic doors.
  • All operatories are equipped with air purifiers with HEPA-filtration. These units run continuously, set for maximum germ control efficiency. They control airborne allergens, filter and destroy germs, and are able to remove at least 99.97% of airborne particles in 5 to 10 minutes.
  • Movement in and out of the operatory is limited as much as possible. Staff will have to exit and enter from time to time, but they must ensure that PPE is properly changed where applicable. Patients are asked to remain in the operatory for the duration of their appointment.
  • By its nature, providing dental care requires physical contact. However, the time of exposure is to be kept to a minimum, with vigilant infection prevention and control measures used throughout the visit.

 

Air purifiers

Prior to our June 2020 re-opening, the office underwent a comprehensive HVAC evaluation. In this process, we determined the airflow in each room. This assessment provided us with the exact cubic feet per minute (CFM) in each area of the office – that is, the amount of cubic feet of air that can be moved or exchanged each minute. The air purifiers being used in our office have increased our air change rate (ACR) in keeping with recommendations of the CDC and RCDSO.

In the administrative areas

  • Plexiglass barriers separate patients from administrative staff in the front office.
  • Patients are asked to maintain a distance of 2 metres (6 feet) between each other if more than one patient is waiting to be assisted by the receptionist or account manager.
  • In an effort to expedite all tasks and minimize the need for contact, dentists and hygienists will provide billing information to the account managers at the end of your appointment.
  • Payments continue to be accepted by Interac, VISA, MasterCard, AMEX as well as by cash or cheque. Please note that the office keeps very little cash on hand and may not be able to provide change.
  • Payments are also possible by e-transfer. This method of payment is fast, easy, and does not require a physical visit to the office.
  • Patients are encouraged to manage their payments remotely, helping the office to minimize occupancy and exposure.

Cleaning the dental operatories

  • At the end of the patient treatment, used trays, handpieces, and instruments are removed from the room and taken directly to the sterilizing area for processing.
  • Single-use items are discarded in designated receptacles.
  • Following every appointment, the room is cleaned using regular disinfection methods in keeping with standard IPAC principles. The patient and provider chairs, countertops, lights, fixed equipment, etc. all are cleaned before another patient can be allowed to enter the treatment area.

Miscellaneous

  • Some of our schedules were altered as a result of COVID protocol management.
  • Dentist and hygienist start-times vary and lunch breaks now are staggered in order to minimize exposure.
  • Our professional cleaners have adapted their systems to address the added precautions needed for COVID prevention.
  • Sharing of workstations is kept to a minimum, with computers, phones, etc. disinfected as needed through the workday.
  • Movement through the office is limited to everyone. Unless necessary, everyone is encouraged to minimize physical exposure.

Vaccination

All of our staff is fully vaccinated.

Regardless of vaccination status of providers or patients, universal precautions continue to be used throughout all areas of the office.

In the event of a COVID-positive diagnosis of staff

  • Anyone who has received a positive COVID diagnosis is required to inform office management as soon as possible.
  • The entire staff then is notified and an assessment of exposure is conducted. (i.e. who they treated or helped, where, how long, under what circumstances, etc.).
  • Additional professional deep cleaning is done as needed.
  • Given that PPE is always used, the patient’s risk of exposure is small. In cases where there has been prolonged unprotected exposure (eg. staff sitting closely together, eating or drinking, for 15 minutes or more without PPE), then those individuals must immediately obtain a COVID test.
  • While awaiting the results of testing, staff will remain isolated in their homes.
  • Staff may return to work following a negative test and usual screening.
  • The individual who has been diagnosed with COVID must follow the direction of Public Health and remain quarantined for the prescribed time (usually 5 days). Once he or she has been given clearance, they may return to work.

In the event of a COVID-positive diagnosis of a patient

  • Anyone who has received a positive COVID diagnosis within 2 weeks of treatment is asked to inform office management as soon as possible.
  • The entire staff then is notified and an assessment of exposure is conducted. (i.e. who they treated or helped, where, how long, under what circumstances, etc.).
  • Screening records are available in the event that contact tracing is needed. These records include all individuals who have been on-site during the affected time(s).
  • Additional professional deep cleaning is done as needed.
  • Given that PPE is always used, the patient’s risk of exposure is small. In the unlikely event where there has been prolonged unprotected exposure (eg. staff and patient sitting closely together, for 15 minutes or more without PPE), then those individuals must immediately obtain a COVID test.
  • While awaiting the results of testing, staff will remain isolated in their homes.
  • Staff may return to work following a negative test and usual screening.
  • The individual who has been diagnosed with COVID must follow the direction of Public Health and remain quarantined for the prescribed time (usually 5 days). Once he or she has been given clearance, they may return to the office, following the usual screening protocols.

We’re all in this together

Throughout the pandemic, it became clear that we all rely on each other … for moral support, to minimize risk of exposure, and to maintain the health of every patient, member of the community, and staff member.

Our amazing, loyal, considerate patients have enabled us to continue providing dental care through these difficult months and years.

We look forward to loosening protocols, adapting to new criteria, and continuing to care for your dental needs.