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Going to the dentist in a pandemic: What can patients expect when restrictions ease?
VANCOUVER -- The B.C. Dental Association is working on a plan for what it could look like at dental clinics after the province eases further restrictions related to the pandemic.
For now, dentists are only treating emergency and urgent cases. But what can patients expect when that changes?
The association's past-president, Dr. Alastair Nicoll, told CTV News Vancouver he expects the return to work will be gradual and will incorporate some of the precautions that are now being put into practise at clinics that are still open, including distancing and personal protective equipment for staff.
“We’ll be in an interim period until a vaccine or till there’s significant immunity in the population as a whole,” Dr. Nicoll said. “I don’t think we’re going to see a return to what will be the new normal for quite some time yet.”
Dr. Nicoll is involved with the association’s back-to-work task force and said he anticipates there will be screening for COVID-19 symptoms or possible exposures over the phone before patients come in. Financial and insurance transactions may take place in a similar way.
Dr. Nicoll said scheduling will be managed so that there won’t be too many people in the waiting room at one time, where distancing will also be incorporated. He added people would be brought into the treatment area promptly, and anyone with the patient might be asked to wait in their vehicles, if possible.
“So we’ll see fewer people, they’ll be wider spaced apart, both physically and also time-wise,” Dr. Nicoll said. “We’ll be employing essentially the same standards of protection that people would get in hospitals as well.”
Dr. Nicoll said though dental clinics have already used masks and gloves "forever," patients can likely expect to see other personal protective equipment (PPE) such as face shields and gowns or even a hair covering.
“PPE is in incredibly short supply, and we do need to be respectful of the fact that hospitals need to have it on hand, so that’s one of the big, big barriers,” Dr. Nicoll said. “And to some extent, we have to look towards government, who now have control over the PPE supply chain, to help us out as we move forward and restrictions are eased.”
Dr. Nicoll said they will also be trying to minimize the use of equipment that creates aerosols, or droplets in the air, because of the requirement for additional steps and precautions.
“So perhaps a hygienist when cleaning somebody’s teeth, will be more inclined to use hand instrumentation, than an ultrasonic scaler,” Dr. Nicoll said, and added if a scaler is used, they may have to have another staff person there using equipment to help evacuate any aerosol produced.
At the Royal Centre Dental Group in Vancouver, dentists and hygienists don gowns and face shields as well as their usual protective equipment before seeing patients who need urgent treatment.
Dentist Dr. Ken Phillips said they’ve been getting 30 to 50 calls a day, and the emergencies they’ve treated have been varied.
“We’ve had skateboards in the face, and we’ve had people breaking fillings, breaking teeth,” Dr. Phillips said.
The clinic has spaced out seating for distancing in the waiting area, and a physical barrier at the reception desk. Patients are brought in one at a time.
“I think in doing all those protocol changes, that it’s a very safe environment for people to come back into,” Dr. Phillips said.
Dr. Nicoll said dentists have already had extensive experience in managing infection risks from a variety of illnesses, from hepatitis to the flu.
“We have solid practices in place to prevent cross-infection,” Dr. Nicoll said. “What is different here is that COVID-19 is very infectious and there are a number of people out there who already have the disease or who are infectious and simply don’t have any symptoms so they don’t know about it.”
Dr. Nicoll said the additional personal protective equipment is in response to that potential risk for staff.
When asked if there are concerns people may delay seeking treatment, as has been expressed by medical doctors, Dr. Nicoll said he hasn’t heard that when it comes to dental patients, and added they should not be afraid to come in.
“We’re well aware of the steps that have to be taken to keep patients safe,” Dr. Nicoll said. ‘If you need urgent care, whether it’s dental or medical, don’t refrain from doing it, because the system is set up to see you safely.”
You can find information on dental clinics that are open for emergency treatment here.