As we cautiously ease back into our regular routines during the times of COVID-19, some people are understandably apprehensive about making their biannual return to the dentist’s chair. Because they are essential workers, appointments remained available with dentists, oral surgeons and endodontists on an emergency basis during the first two months of the pandemic’s wave. But since May 20, most offices, like the mouths of patients, have been open for business.
Dr. Maureen Sharnick shut down her Shelton practice on March 14, even before Gov. Ned Lamont issued the order. When she opened back up for emergency appointments, she worked two days a week. Now her office is open six days a week, with four of those workdays lasting until 7 p.m. to accommodate new safety measures and keep patients feeling comfortable. We checked in with Sharnick for a glimpse at the changes patients across Connecticut will see at their dentist’s office.
BEFORE YOUR VISIT
For peace of mind, Sharnick says patients can call their dentist before an appointment to check on protocol and proper precautions. But she feels that’s not really necessary. “There’s no question that their office is going to be doing everything they’re supposed to do,” Sharnick says. The Connecticut State Dental Association was clear that offices could not open until they were equipped, both in supplies and setup, with everything that was needed. It’s all detailed in the American Dental Association’s Return to Work Interim Guidance Toolkit and COVID-19 Hazard Assessment.
If that’s still not enough to put your mind at ease, pay a visit to your dentist. “Once you go in,” Sharnick says, “you’ll see how things have changed.” Among the ADA toolkit requirements, she says, is a stipulation that dentists have at least a two-week supply of personal protective equipment, which includes N95 masks. “I started ordering back in February or March because I saw that something was going on,” Sharnick says. “We have a whole closet now of PPE, so we have more than enough.” A company visited the office to fit-test everyone who worked there with the N95s and to go over guidelines.
IN THE WAITING ROOM
When Sharnick says patients will see how things have changed, the first sign will be sneeze guards at the front desk. Temperature checks are performed on everyone entering the building, touch points are wiped down throughout the day and there is hand sanitizer everywhere. She says half the chairs have been removed from the waiting room and all the magazines and reading materials are gone.
But sterilization is nothing new for people in the medical field. “We always wiped down our rooms anyhow with a solution that killed a lot of different viruses, and corona was one of them, so that didn’t really change,” Sharnick says. “I have air purifiers in every room now that recirculates the air every 15 minutes. Each room has a HEPA medical-grade filter so it filters out very small particles, which is enough to get the coronavirus if it’s in the room.”
Only two providers work at any given time, so it’s Sharnick and a hygienist or two hygienists when she’s able to take a day off. They wear disposable gowns and book more time for each appointment so fewer patients will be at the office, leaving “less of a footprint.”
IN THE CHAIR
Being in the dentist’s chair won’t be much different, with a few small exceptions. The dentist will now wear a face shield and the patient will rinse their mouth with diluted hydrogen peroxide, which reduces the mouth’s viral load. UConn researchers published a new study in June that says a 0.5 percent solution of povidone-iodine inactivates the COVID-19 virus in the oral cavity. Sharnick says she dilutes it and mixes it with Listerine because of the odd taste. She hasn’t started using that mixture yet, but probably will in the future. That requires checking each patient’s allergy situation, and she wants to make sure everyone is comfortable before introducing it into her practice.
Hygienists no longer use ultrasonic scalers to clean teeth because the instrument generates a lot of aerosol. Cleanings are now done with manual scalers. Sharnick can still use an ultrasonic scaler when a hygienist is assisting her with a high-volume evacuator for suction. She says she ordered a Purevac HVE System kit, which combines an evacuator and a mirror — allowing two hands to hold the three necessary instruments — back in early May but the product is still on backorder. Also, battery-powered prophy angles — devices with soft cups used to polish individual teeth — are used now instead of motorized versions.
Sharnick says it’s been frustrating trying to keep up with the ever-changing information and guidelines. Many state dentists have joined a Facebook group called the CT Dental COVID-19 Information Exchange for dentists to give and take ideas to help their practices be as safe and efficient as possible. Sharnick says the resource has been invaluable.
Despite the anxiety and uncertainty so many people are facing, Shanick says patients are getting more comfortable and are happy to resume their appointments. “When you look at all the reports,” Sharnick says, “there hasn’t been an incidence in dental offices. So that looks good for us.”