We are taking steps to help all our members as we begin the process of returning to work in the dental practice. We want to ensure that everyone is safe in the workplace amidst these uncertain times. We expect that there will be new changes in most practices returning to work and we will try to help as best we can so that we can all manage this process as smoothly as possible.
The reopening of dental offices has begun in some provinces and in other dates are not yet set. Guidelines have been made for each of the provinces regarding PPE (Personal Protective Equipment). We have compiled some resources and links to provide as much information as we can for each of the provinces. As we receive new information, we will update it as quickly as we can to help guide you in your return to work.
The PPE guidelines post-Covid-19 have been set up based on the 2 types of procedures.
1. Non-Aerosol generating procedures (NAGP): Any dental procedure that does not produce aerosolized particles. These include exams, hand scaling, simple extractions, or orthodontic procedures.
2. Aerosol Generating Procedure (AGP): Any dental procedure where aerosolized particles are expected to be generated by dental instrumentation. This includes the use of ultrasonic scalers, high-speed handpieces, surgical handpieces or air-water syringes at any point in the procedure.
Provincial PPE guidelines
The health and safety of every member are important. Each province has established guidelines of when PPE is to be used and what types of PPE are required and recommended.
For your reference:
ADA & C Standard of practice guidelines, IPC: https://www.dentalhealthalberta.ca/wp-content/uploads/2019/03/Standard-of-Practice-Infection-Prevention-and-Control.pdf
Expectations and Pathway for Patient Care during the COVID-19 Pandemic: https://www.dentalhealthalberta.ca/wp-content/uploads/2020/05/Expectations-and-Pathway-for-Patient-Care-during-the-COVID-19-Pandemic_6.11.2020.pdf
Dental hygiene: https://www.crdha.ca/public/download/files/133161
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
- A lab coat or gown if contact with the patient
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
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
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:
Infection control IPAC guidelines: https://www.cdsbc.org/CDSBCPublicLibrary/Infection-Prevention-and-Control-Guidelines.pdf
Transitioning oral healthcare to Phase 2: https://www.cdsbc.org/Documents/covid-19/Transitioning-Oral-Healthcare-to-Phase-2.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
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:
Infection Control Guidelines: https://www.gov.mb.ca/health/publichealth/cdc/ipc.html
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
COVID guidelines Phase 1: https://manitobadentist.ca/PDF/COVID-19/April%2030%202020%20Interim%20IPC%20Guidelines%20Related%20to%20COVID-19%20Management%20Effective%20May%204.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 2 or 3 mask
- 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
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:
Phase 1: Emergency and urgent care at specific locations only. Phase 2: Unknown date
Managing In patient Care guidelines. Phase 2: https://az184419.vo.msecnd.net/rcdso/pdf/standards-of-practice/RCDSO_COVID19_Managing_In_Person_Care.pdf
Emergency and Urgent Care Guidelines: https://www.rcdso.org/en-ca/rcdso-members/2019-novel-coronavirus/covid-19---guidance-on-emergency-and-urgent-care-
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 only if patient is screened positive
Low risk (AGP - Aerosol generating procedure)
- N95 OR ASTM Level 3 if patient screens negative
- N95 fit tested DDS/DA OR equivalent approved by Health Canada (N95 info here ) if patient screens positive
- Face shield AND protective eyewear (both negative/positive)
- Protective gown or Lab coat with cuff (optional for negative screened patient)
- Gloves (both negative/positive)
High Risk - NO treatment in a general dental office
Visitors or escorts and patients
- alcohol-based hand rub (ABHR) (60-90%),
- ASTM Level 1 mask
Disinfecting treatment rooms for all procedures: Follow IPAC guidelines
- ASTM Level 1 mask minimum
- Protective eye wear
- Gloves
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 minimum or physical barrier (plexi-glass separation)
- Maintain physical distancing
Common and staff areas (administrative and other tasks).
- ASTM Level 1 mask minimum OR
- Maintain social distancing
Disinfection of Reception area: Follow IPAC guidelines
- ASTM Level 1 mask minimum
- Protective eye wear
- Gloves
For your reference:
CDSS guidelines: https://saskdentists.com/images/pdf/temp_files/Alerts__Memos/20200427_CDSS_IPC_Interim_Protocol_Update.pdf
Dental Hygiene SDHA: https://www.sdha.ca/wp-content/uploads/2020/04/SDHA-COVID-19-Pandemic-IPC-Interim-ProtocolMay3.2020.pdf
Summary of required PPE:
Treatment to be completed in the operatory with dental staff (Dentist/Dental Assistant/Hygienist/Float)
Low risk (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/High risk (AGP - aerosol generating procedure)
- NIOSH approved N95 or KN95 equivalent fit-tested DDS/DA documented (fit test with documentation of style and size within the last two years)(reuse-use level 2 or 3 mask over top with face shield) (N95 info here )
- Face shield or protective eye wear googles (goggles can replace face shield when using a dental dam)
- Cap or Bonnet
- Fluid resistant cuffed gown or lab coat
- Gloves (to cover gown or coat cuffs)
- Gown or barrier for patient
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
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