Training and Educating Our Team

One of the most important things we are doing during this time is to train and educate our staff.

• Our team has had refresher training in proper hand washing techniques. We have spent a lot of time ensuring that our team does it well and often, especially before and after every patient encounter.
• They have practiced the appropriate use of personal protective equipment (PPE) prior to caring for a patient to prevent contamination.
• We encourage team members who are not feeling well to proactively stay home and self-isolate for 14 days.
• Every team member will have their temperature taken at the beginning of every day. Anyone with an elevated temperature (38 degrees Celsius and above) will not be allowed to work.
• We will limit the numbers of team members providing care to a patient in order to minimize social contact.
• We have created a specific checklist of recommendations for our team to follow so that they arrive to work healthy, and go home to their families without worry (see below).

Recommendations for Our Team

Before coming to work

• Take their temperature – do not report to work if they or any other family member are experiencing symptoms such as cough, sore throat, fever, etc.)
• Remove watch, rings, and extra accessories, and leave at home
• Tie hair up, keep nails short
• Place phone in a Ziplock bag that you will discard at the end of the day
• If bringing a lunch, carry it in disposable bag or container
• Eliminate the use of cash, and use ‘tap’ for debit/credit cards
• Bring work clothes in a washable bag (i.e. pillow case), or a disposable one
• Don/wear the appropriate use of personal protective equipment (PPE) prior to caring for a patient to prevent contamination.

At work

• Change into scrubs and work shoes (preferably plastic and wipeable) as soon as you arrive
• Use PPE as appropriate
• Leave all clutter (phones, papers, etc.) outside of dental operatories
• Sanitize all telephone handsets, computer keyboards and mouse after use
• Discourage cell phone use at work

After work

• Wash hands and arms with soap
• Remove scrubs and place in washable (or disposable) bag, or leave at work
• Sanitize cell phone (and glasses if applicable)
• Wash hands and put clean clothes on

At home

• Do not touch anything
• Remove shoes and clothes
• Wash clothes/scrubs in washing machine with detergent and hot water
• Shower immediately with soap and water before touching anything (including loved ones)

Patient Interviews and Social Distancing

Before patient arrival every effort is made to:

• Triage patients during the intake phone call using recommended, up-to-date screening checklists and scripts
• Prepare scripts and questions to identify potential carriers of the COVID-19 virus
• Reschedule patients who show any signs of a cough or fever, or who describe having any concerning warning signs
• Instruct patients to call ahead and reschedule their appointment should they develop symptoms of a respiratory infection (e.g., cough, sore throat or fever) on the day they are scheduled to be seen.

To promote social distancing:

• We will prioritize high-risk patients (the immunocompromised, those over 60 y.o., etc.) with early morning appointments, in order to have less contact with other people
• We are creating a schedule so that there are fewer people in the reception area (a maximum of 2 people at a time)
• If a patient is being accompanied, their escort should wait in the car to limit the number of people in the reception area
• We will create a ‘virtual’ reception area, where patients can opt to wait in their car or outside the office. They can then be contacted by mobile phone when they are ready to be brought into the operatory and be treated.

Safety measures taken upon arrival

• Limit points of entry to the clinic.
• Leave office door open to avoid contact with door handles
• Visual alerts (e.g. signs, posters) posted at the entrance door advising patients of the COVID-19 risk, and advising them not to enter the facility when ill.
• Masks and tissues are accessible immediately upon entry and instructions are provided on how to use tissues to cover nose and mouth when coughing or sneezing. Coughing into one’s sleeve is preferred. Waste receptacles readily available to dispose of tissues and contaminated items.
• Provide supplies such as alcohol-based hand rub (ABHR) with 60-95% alcohol for hand sanitation upon entry
• Post photos at the entrance and in waiting room to provide patients and HCP (Health Care Personnel) with instructions (in appropriate languages) about hand hygiene, respiratory hygiene, and cough etiquette

Reception/Front Desk safety measures

• Install physical barriers or partitions (e.g., glass or plastic windows) if possible, at reception areas to limit close contact between reception and potentially infectious patients.
• An air-purifying system has now been installed

Protocols of the Clinical Team

Sanitation

• In addition to an abundance of focus on infection prevention and control, we will employ an additional team member whose main focus is only on sterilization. This team member will be responsible for continual cleaning, sterilizing, disinfecting and wiping down everything in the operatories and the reception area – chairs, handles, switches, flat surfaces, etc.

Hand Hygiene

The Endodontist and any team member will engage in thorough hand hygiene before and after all patient contact, contact with potentially infectious materials, and/or before donning and doffing personal protective equipment (PPE), including gloves. The washing of hands will be with soap and water for at least 20 seconds.

Personal Protective Equipment

Masks, gloves, caps, eye protection, face shields, gowns will be worn during all procedures. Shoe covers may be worn if the team member is wearing shoes that cannot be wiped down and disinfected. Any disposable items will be discarded after the procedure is complete and the patient dismissed. Reusable items will be cleaned and disinfected according to the manufacturer’s reprocessing instructions. N95 respirators will be used instead of a facemask when performing or present for an aerosol-generating procedure.

Patient treatment

• Before treatment, the patient will Immediately be escorted to a hand washing station
• Once in the dental operatory, they will then be asked to rinse with 1% hydrogen peroxide to sanitize the oral cavity
• The Endodontist will then screen the patient again for the possibility of any COVID-19 symptoms (fever, cough, body aches, etc.)
• A test for the COVID-19 virus when it is available
• Health care personnel (HCP) will strictly follow basic infection control practices between patients (e.g., hand hygiene, cleaning and sanitizing non-disposable equipment using EPA-registered, hospital grade disinfectants).
• We will limit the movement of the patient into or out of the room
• No other team member should enter the room during a procedure, but if absolutely necessary, will use PPE as described above.
• Once the patient has left the operatory, HCP refrain from entering the op until sufficient time has elapsed to remove potentially infectious particles.
• After this time has elapsed, the room should undergo appropriate cleaning and surface disinfection before it is returned to routine use – at this time, 3 hours is recommended
• As always in Endodontics, a rubber dam will be used. An aerosol-generating procedures are in a separate op.

Safety Measures After the Visit

• We encourage payment by e-Transfer, ApplePay, or debit/credit card (possibly over the phone) – the transaction processing machine will be sanitized thoroughly after each use
• Review of estimates and insurance forms can be carried out via phone call or video conferencing, and sent via mail/email
• Patients are encouraged to wash hands again before leaving

We are confident that these guidelines will help to create a safe environment for all of our patients and team members and hope that you can feel secure in the knowledge that we are doing everything in our power to provide the safest clinical conditions in order to protect our patients, our team and our families.