COVID-19 and Dentistry

New Rules to be followed onwards – Post COVID-19 situation

 

1)       Only one person is allowed inside the clinic with the patient if the patient is a female/child.

2)       Do not bring your children inside the clinic if he/she is not a patient.

3)       If there is a gathering of other patients outside the clinic, please do maintain social distancing.

4)       Try to visit only at the scheduled time given by the Doctor. If there is a delay or you are planning to postpone the appointment, do inform the doctor at least 2 hours before your appointment.

5)       If you are unable to visit on time due to some reasons then please do call and take another appointment.

6)       If there is a patient inside the chamber, do not rush in. Please wait outside till the doctor asks you to come in.

7)       After attending each and every patient we need to clean our clinic as a whole to reduce the chances of residual contamination. It has shown in study that to clean a chamber properly and to let the aerosol settle down we need 45 minutes at least. Here is given time frame to sterilize the clinic regarding every case that we attend.

§  After Consultation :                                             6-10 minutes

§  After Mobile tooth extraction :                         15-20 minutes

§  After a surgical tooth extraction :                     30-45 minutes

§  After Root Canal Treatments :                           30-45 minutes

§  After Scaling and Oral prophylaxis :                 1-2 hours

*This may vary depending upon the work process.

 

8)       Protocols to be followed by a patient:

§  Do not visit any dental clinic without a mask.

§  Do not rush inside the chamber just after a patient goes out. Let the doctor clean the area and call you in.

§  Please do carry a hand sanitizer while coming to the clinic.

§  Before entering the clinic the Doctor or the assistant will give you hand sanitizer and a Spray on your clothing. (The chemical may or may not damage your clothes color)

§  Do not remove your mask till the doctor asks you to do so.

§  Do not enter the clinic with your shoes on.

§  Do not touch any object inside the clinic unnecessarily. If there is a kid with you please do hold him/her.

§  After sitting on the operating chair, the doctor will give you a mouthwash to rinse. Only then you will remove your mask and rinse with the mouth wash for 60 seconds.

§  Do not spit hard or rough that the splash scatters everywhere. Gently spill the mouth rinse in the spittoon just beside the chair.

§  If you have or had fever, cold and cough. Tell the doctor before entering the clinic.

§  If you or any family member of yours has travelled from another state or country within 2months tell the doctor before entering the clinic.

§  If you have any history of asthma or COPD, please do visit any nearby Polyclinic Set up or hospital with Dental OPD facilities.

§  If you have any chronic diseases like Diabetes, Hypertension or Thyroid issues, let the doctor know before any treatment is done.

§  If you are taking Steroids as your daily medications please inform the doctor.

§  Help the doctor by providing every detail of your chronic diseases or travels or meetings with any COVID 19 positive patients in recent past.

§  Do not hide any details of your exposure or susceptible link to an exposure with a COVID 19 case. Hiding will harm you more than any others.

9)       Put on your mask before leaving the operating chair.

10)   Do not rinse or spit after leaving the chair. You have to swallow the saliva.

11)   Ask your queries at once before leaving the chamber. Once you are outside you have to go through the same protocols as before just to enter the clinic again. You can call if necessary.

12)   If any of the prescribed medications are not available at your known medicine shop. Ask them to replace that medicine with same composition and grade of the available brand. Just check the quality and expiry date of the medicine. (If possible the power and composition.)

13)   Please do use the hand sanitizer of your own just after leaving the chamber. If possible wash your hands with soap once you reach home/or before having foods.

14)   If possible pay your charges through GooglePay/PhonePe/AmazonPay/Paytm or UPI payment systems/IMPS.

15)   If you need a receipt please do come on the next day for it.

 

Ø  Why the charges are so high?

§  Previously there was no requirement for Personal Protective Equipment in Dental procedure if not necessary (eg. HIV/Hepatitis B/Hep-C etc.). Now it is almost mandatory to attend the patients with PPE set. The price of PPE set ranges from Rs. 850-1700/- according to the type of PPE set used.

§  There was no mandatory requirement to clean the chamber thoroughly after each and every patient.

§  High standard of sterilization and increased use of disposable materials are now mandatory.

§  There is no chance of re-using any disposable object; hence price negotiation is not possible now.

§  This sudden rise of demand has hyped the market prices about 3 folds than the previous charges. In our work we can do nothing without any product or instruments.

§  Recurrent use of autoclave will add on to our Electricity charges.

§  Private clinics do not have any source of donations or Government help. The whole set up runs with the patient to a dentist.

Ø  What are the restrictions after this COVID-19 pandemic?

§  Any extensive treatments, like surgical extraction of deeply impacted wisdom tooth, are not possible now onwards for at least 6-8months.

§  Dental Implant placement is not allowed in my clinical set up for at least 1 year.

§  It is not possible to go for any Full mouth rehabilitation with fixed prosthesis cases now onwards.

§  Procedures of multiple visits, such as Full mouth dental extraction followed by prosthetic rehab are not possible.

§  Temporary Dentures or Cosmetic rehab is not possible now onwards.

§  Older patients with the history of COPD or severe Bronchial Asthma cannot be treated in this set up.

§  Diabetic patients with HbA1C marker more than 6.8% should be treated conservatively.

§  Anemic patients should be treated with in the mentioned range of safety.

§  Cardiac patients under Clopidogrel/Warfarin/Heparin etc should be treated in a hospital set up.

§  Same day procedure is not advisable if not necessary.

§  Treatment of any patient with a history of returning from a COVID affected state/country within 3 months is not possible.

§  Treatment of any patient with a history of exposure to a COVID19 positive case is not permissible.

§  Treatment of any diagnosed COVID-19 positive patient (recent/past) is not permissible.

Ø  Request to my patients:

§  Please do share your travel history, or chances of exposure before any treatment is done.

§  Please do not visit the clinic if you are suffering with fever, cold and cough or breathlessness.

§  Please do not hide any symptoms relatable with COVID cases. Any aerosol producing procedure can harm your lungs unknowingly if you are ignorant about your symptoms.

§  Please do not compare with other clinics or dentists modalities and prices. If you feel comfortable with the charges then only start the procedure.

§  Please do not bargain, as I am not able to compromise with any of these additional costs that are added after this COVID19 crisis.

§  Please do cooperate with all the mentioned rules and protocols to treat you better and to treat you safe.

§  Please do not keep any dues.

§  Avoid unnecessary visits to keep yourself safe from any kind of exposure.

§  Please take an appointment over phone prior to the visit.

§  Please maintain social distancing outside the clinic.

Ø  Why all of these sudden changes?

§  COVID-19 causing virus SARS-CoV-2 mostly resides in the oral cavity, nasopharynx and larynx areas. We have to deal with your oral cavity to diagnose the problem, to do the extraction or to fill a tooth. All of these procedures and our instruments make an immense amount of aerosol in the air. Our patient will spit and those splashes will scatter over the area. As we know Corona virus can sustain in the stagnant air for more than 4 hours as a droplet, or on any surface for more than 8 hours, we have to clean the whole area with care. Any breach in the protocol will be harmful to my patients or to me.  

 

#Help me to treat you better and to keep you safe.

#Help me to maintain my clinical set up healthy for all.

#Help me by maintaining the above mentioned rules.

 

 

                                                                                                                                                                Dr. Arka Bhattacharya

                                                                                                                                                                DentArk Dental Clinic