Provincial PPE Guidelines

For your reference:

Currently as of July 1, 2021 STAGE 3 

These considerations replace previous guidelines.

For both CRDHA and ADA & C NEW: Key Considerations for Dental Practice Moving Forward During COVID-19 

Summary of required PPE:

Treatment to be completed in the operatory with dental staff (Dentist/Dental Assistant/Hygienist/Float)

Low risk (NAGMP - Non-aerosol generating medical procedure)

• Level 2 or 3 mask
• Face shield or protective eye wear
• Scrubs
• Gloves
• Protective Clothing 

Mod/High risk (AGMP - aerosol-generating medical procedure)

• N95  fitted (N95 info here )or equivalent with appropriate
  protective eye wear or, a Level
  3 mask and Face shield
• Face shield or protective eye wear
• Scrubs
• Cap
• Lab coat with cuff or gown
• Gloves
• Protective Clothing

High Risk - NO treatment in a general dental office

Disinfecting treatment rooms for all procedures: Follow ADA &C IPC standards

• Level 1 mask minimum
• Protective eyewear
• Gloves
• Scrubs (or clothing not worn outside the practice)

Reception area: Staff (Administration staff/Treatment coordinator/Manager) Arrival screening/temperature readings

• Level 1 mask minimum or plexiglass separation
• Protective eyewear
• scrubs

Disinfection of Reception area: Follow ADA &C IPC standards

• Level 1 mask minimum
• Protective eyewear
• Gloves
• scrubs

For your reference:

November 19th/21

• Prescription Eye Protection Selection Requirements - This tool can be used to ensure that your prescription eye protection meets health and safety standards with respect to fit and required protection - Updated November 19, 2021

Personal Protective Equipment (BCCDC Website)

http://www.bccdc.ca/health-professionals/clinical-resources/covid-19-care/infection-control/personal-protective-equipment 

BC's Restart Plan and Oral Health Care (July 15, 2021)

As COVID-19 continues to circulate in our communities we anticipate that COVID-specific guidance for oral health care providers in BC will remain in effect until the pandemic is resolved. It is encouraging that BC’s COVID-19 provincial state of emergency was lifted at the end of June, and that the province has moved into step 3 of its restart plan. In light of this, CDSBC’s Standards & Guidance Committee is currently considering updates to Oral Health Care During Phases 2 and 3 of the COVID-19 Response to ensure it contains the information that oral health care providers need to continue providing safe care as the province moves through its reopening. Registrants will be advised of any updates to the guidance. 

Infection control IPAC guidelines: https://www.cdsbc.org/CDSBCPublicLibrary/Infection-Prevention-and-Control-Guidelines.pdf

Summary of required PPE:

Treatment to be completed in the operatory with dental staff (Dentist/Dental Assistant/Hygienist/Float)

Low risk (NAGMP - Non-aerosol generating medical procedure)

• Level 2 or 3 mask
• Protective eye wear (goggles with side vents, or protective eye wear, or prescription glasses 
• Gloves

Mod/High risk (AGMP - aerosol generating medical procedure)

• N95 or equivalent fitted (N95 info here )
• Face shield with goggles with side vents, OR protective eye wear
• Long sleeve Lab coat with cuff or gown
• Patient drapes and protective eyewear or goggles
• Gloves

High Risk - NO treatment in a general dental office

Disinfecting treatment rooms for all procedures: Follow IPAC infection control guidelines

• Level 1 mask minimum
• Protective eye wear
• Gloves
• Gown or lab coat
• Protective Clothing

Reception area: Staff (Administration staff/Treatment coordinator/Manager) Arrival screening/temperature readings

• Level 1 mask minimum or plexiglass separation
• Protective eyewear

Visitors or escorts (non NAGP only)

Visitors or escorts who have signs or symptoms or potential exposures to COVID-19 (including via the patient they accompany) should be instructed to

• perform hand hygiene or alcohol-based hand rubs (ABHR) with a minimum of 70% alcohol
• put on a medical mask and
• asked to wait outside or return to pick up the patient after their appointment.

Disinfection of Reception area: Follow IPAC infection control guidelines

• Level 1 mask minimum
• Protective eyewear
• Gloves 

For your reference:

Dec 20/21 https://www.gov.mb.ca/covid19/prs/orders/index.html 

December 17, 2021 - Orders Requiring Vaccination or Testing for Designated Persons (pdf)

Infection Control Guidelines: https://www.gov.mb.ca/health/publichealth/cdc/ipc.html

See the April 20 , 2021 “Interim IPC Guideline” here Download--same as June 2020

Infection Control Guidelines: https://www.gov.mb.ca/health/publichealth/cdc/ipc.html

Restoring safe service Phase 3 june 19/20-no change

Restoring Safe Services Phase 2, starting June 1 2020 https://manitobadentist.ca/PDF/COVID-19/May%2022%202020%20Pathway%20and%20Interim%20IPC%20Guidance%20for%20Patient%20Care%20During%20Phase%202%20of%20the%20COVID-19%20Response.pdf

Summary of required PPE Phase 2:

Treatment to be completed in the operatory with dental staff (Dentist/Dental Assistant/Hygienist/Float)

Low risk (NAGP - Non aerosol generating procedure)

• ASTM Level 3 mask or Fitted N95
• Face shield or protective eyewear or goggles
• Gloves

Mod/High risk (AGP - aerosol generating procedure)

• N95 fitted (N95 info here ) or equivalent as suggested by Health Canada with appropriate protective eyewear or ASTM Level 3 Mask and face shield
• Bouffant/surgical Cap 
• Fluid resistant gown 
• Gloves

Point of care risk assessment to be undertaken for all patients at all times. Consideration for level of transmission in areas of outbreak or when extensive community transmission has occurred will affect risk assessment and determination of need for care, level of caution and level of PPE employed.

High Risk - NO treatment in a general dental office

Disinfecting treatment rooms for all procedures: Follow IPC standards

• Level 1 mask minimum
• Protective eyewear
• Gloves
• Gown or lab coat

Visitors or escorts (non NAGP only)

• alcohol-based hand rub (ABHR) (60-90%),
• ASTM Level 1 masks  or physical distancing

Reception area: Staff (Administration staff/Treatment coordinator/Manager) Arrival screening/temperature readings

• Level 1 mask minimum or plexiglass separation

Disinfection of Reception area: Follow IPC standards

• Level 1 mask minimum
• Protective eyewear
• Gloves

For your reference:

As of July 19th, 2023 the College’s COVID-19 specific guidance for in person care has been rescinded (see the message to the membership).   While this is an important step to reduce the burden of additional precautions on dental practices, it does not mean that dentists no longer have IPAC responsibilities with respect to COVID-19. These ongoing responsibilities can broadly be categorized as follows:  

• Responsibilities that are based in routine practices and the College’s Standard of Practice on Infection Prevention and Control in the Dental Office 
• Responsibilities that are based in the ongoing COVID-19 guidance of provincial and national public health authorities.
• What has changed
  To download a PDF copy of the chart below click here.

August 3, 2022 https://www.rcdso.org/en-ca/standards-guidelines-resources/2019-novel-coronavirus/covid-19--managing-infection-risks-during-in-person-care Dec 22/21 New mask requirements

August 2021

https://www.rcdso.org/en-ca/rcdso-members/2019-novel-coronavirus/covid-19--managing-infection-risks-during-in-person-care#b2 

Proper Donning and Doffing: https://www.publichealthontario.ca/-/media/documents/R/2012/rpap-recommeded-ppe-steps.pdf?la=en

RCDSO IPAC standards: https://az184419.vo.msecnd.net/rcdso/pdf/standards-of-practice/RCDSO_Standard_of_Practice_IPAC.pdf

Summary of required PPE:

Treatment to be completed in the operatory with dental staff (Dentist/Dental Assistant/Preventive dental Assistant/Hygienist/Float)

Low risk (NAGP - Non-aerosol generating procedure) If patient screens negative

• ASTM Level 2 or 3 mask
• Face shield OR protective eye wear
• Gloves
• Protective gown for all patients ( optional)

Low risk (NAGP - Non-aerosol generating procedure) If patient screens positive

• N95 respirator (fit-tested, seal-checked), or the equivalent, as approved by Health Canada
• Face shield OR protective eye wear
• Gloves
• Protective gown for all patients ( optional)

Low risk (AGP - Aerosol generating procedure) if patient screens negative or positive

• seal-checked N95 respirator (or the equivalent, as approved by Health Canada) for all in-person patient interactions and for the provision of all direct clinical care or must don a well-fitted surgical/procedure mask, a KN95 respirator, or a non-fit-tested N95 respirator (or the equivalent, as approved by Health Canada). Dentists must make reasonable efforts to ensure that all staff who are not yet fit-tested for an N95 respirator obtain fit testing at the earliest opportunity.
• Face shield OR protective eyewear 
• Protective gown or Lab coat with cuff 
• Gloves 

High Risk - NO treatment in a general dental office

Patients if positive entering office

• Minimum ASTM level 1 mask prior to entering office

Visitors present during AGP

• PPE to be determined by a risk assessment for the visitor (to include the nature of the procedure, the degree of prior exposure of the accompanying visitor to the patient, and the ability to maintain appropriate distancing). For more information, see RCDSO’s COVID-19 FAQ. 

Reprocessing Area

• ASTM level 2 or 3 procedure/surgical mask
• Heavy duty utility-gloves 
• Eye protection or face shield
• Protective gown

Reception area: Staff (Administration staff/Treatment coordinator/Manager) Arrival screening/temperature readings: Follow IPAC guidelines

• ASTM Level 1 mask must be worn minimum
• physical barrier (plexi-glass separation)          

Common and staff areas (administrative and other tasks).

• ASTM Level 1 mask minimum

Disinfection of Reception area: Follow IPAC guidelines

• ASTM Level 1 mask minimum
• Protective eye wear
• Gloves

For your reference:

Dec 6th/21 Mask and Isolation order from public health

Stage 3>>> CDSS Guidelines for Phase 6 : July 15/21 FAQ

CDSS IPC Interim Protocol Update - Phase 6

Dental Hygiene SDHA:

SDHA July 11/21 https://sdha.ca/wp-content/uploads/2020/07/SDHA-COVID-PROTOCOL-UPDATE-reopen.pdf 

*** Aerosol Control Environments (ACE) are no longer required but recommended for risk of the spread of Variants of Concern (VoC), further waves of COVID-19 and/or unvaccinated individuals ***

Summary of required PPE:

Treatment to be completed in the operatory with dental staff (Dentist/Dental Assistant/Hygienist/Float)

 Low risk NAGP/(NAGP - Non-aerosol generating procedure)

• ASTM Level 2 or 3 mask
• Eye protection  (glasses / goggles / face shield)
• Gloves
• Mandatory routine precautions as per the SOHP Infection Prevention Control (IPC)
  Standard for Oral Health Care Facilities (04-01 to 04-05)

Mod risk (AGP - aerosol generating procedure) 

• N95 respirator (fit test with documentation) or equivalent OR Level 3 surgical mask if rubber dam used
• N95 under face shield if not using rubber dam
• Face shield or protective eyewear- goggles (goggles can replace face shield when using a dental dam)
• Fluid resistant cuffed gown or lab coat
• Gloves and gown or lab coat (to cover gown or coat cuffs)
• Gown and barrier for patient
• cap or bonnet

High risk (AGP - aerosol generating procedure)

•  Properly fit KN95 or N95 respirator (fit test with documentation) *
• Face shield or protective eyewear- goggles (goggles can replace face shield when using a dental dam)
• Fluid resistant cuffed gown or lab coat
• Gloves (to cover gown or coat cuffs)
• Gown or barrier for patient
• Cap or bonnet

*Given the shortage of N95 respirators many health care providers are wearing an N95 respirator and covering it with a face shield to prevent droplets and or splatter on the N95 respirator.

High Risk - NO treatment in a general dental office

Disinfecting treatment rooms for all procedures: Follow SOH infection control IPC standards

• Level 1 mask minimum
• Protective eyewear
• Gloves
• Gown or lab coat

Reception area: Staff (Administration staff/Treatment coordinator/Manager) Arrival screening/temperature readings

• Level 2 or 3 mask minimum or plexiglass separation
• Protective eyewear

Disinfection of Reception area: Follow SOH infection control IPC standards

• Level 2 or 3 mask minimum
• Protective eyewear
• Gloves