We are taking steps to help all our members who are currently working in the dental practice.
We want to ensure that everyone is safe in the workplace amidst these uncertain Covid times. We expect that there has been new changes in most practices returning to work and we will try to help as best we can to update you as anything further changes.
Guidelines for each State regarding PPE (Personal Protective Equipment) may vary but we have compiled some resources and links to provide as much information as we can for each of the States.
The health and safety of every member is important. Each State has established guidelines of when PPE is to be used and what types of PPE are required and recommended.
Colorado Springs PPE
- Non-Aerosol generating procedures (NAGP): Any dental procedure that does not produce aerosolized particles. These include exams, hand scaling, simple extractions, or orthodontic procedures.
- 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.
CDC guidelines: https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html
Colorado PPE table: https://cdaonline.org/wp-content/uploads/2020/05/PPE-Guidance-Poster-050420.pdf
CODH ( Colorado Dental Hygiene Association) : http://codha.org/covid-19/
ADHA return to work: http://codha.org/wp-content/uploads/2020/05/ADHA_TaskForceReport.pdf
ADHA hygiene guidelines: https://www.adha.org/resources-docs/2016-Revised-Standards-for-Clinical-Dental-Hygiene-Practice.pdf
CDC Using PPE: https://www.cdc.gov/coronavirus/2019-ncov/hcp/using-ppe.html
IPAC: https://www.cdc.gov/mmwr/PDF/rr/rr5217.pdf
CDC IPAC: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html
Colorado Public health:https://data-cdphe.opendata.arcgis.com/datasets/colorado-covid-19-positive-cases-and-rates-of-infection-by-county-of-identification
Niosh N95 info:
https://www.cdc.gov/niosh/topics/respirators/
https://www.osha.gov/SLTC/etools/respiratory/index.html
https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/index.html
Summary of required PPE:
Treatment to be completed in the operatory with dental healthcare provider (DHCP)
Low risk: NAGP - Non-aerosol generating procedure includes:
ortho retainer checks, hand scaling, prophy, recall exam
- Level 2 or above
- Face shield or protective eyewear
- Gloves
- A lab coat or gown
- For x rays or photos eye protection OR face shield
Mod/High risk AGP - aerosol-generating procedure include:
Restorative, endodontic, ultrasonic scaling, surgical periodontal hygiene, ortho de-bonding/banding
- Level 3 or NIOSH-approved N95 filtering facepiece respirator or higher
- Face shield
- Protective eyewear
- Gown or lab coat
- Gloves
- Booties and bonnet (but NOT for ortho new bonding)
High Risk - NO treatment in a general dental office
Disinfecting treatment rooms for all procedures: Follow ADA & IPC standards
- Level 2 or above
- Protective eyewear or goggles
- Face shield
- Gloves
- Gown
Reception area:
Front desk Staff (Administration staff/Treatment coordinator/Manager)
- Level 1 mask minimum or cloth mask
- Protective eyewear or a clear barrier/plexiglass separation
- Patients and visitors to wear masks at all times
Staff screening patients
- Level 2 mask
- Gown or lab coat
- Eye protection
- Face Shield preferred
Disinfection of Reception area: Follow ADA & C IPC standards
- Level 2
- Protective eyewear
- Face shield
- Gloves
AGPs should ideally take place in an AIIR.
Information about Airborne Infection Isolation Rooms (AIIRs):
- AIIRs are single-patient rooms at negative pressure relative to the surrounding areas, and with a minimum of 6 air changes per hour (12 air changes per hour are recommended for new construction or renovation).
- Air from these rooms should be exhausted directly to the outside or be filtered through a high-efficiency particulate air (HEPA) filter directly before recirculation.
- Room doors should be kept closed except when entering or leaving the room, and entry and exit should be minimized.
- Facilities should monitor and document the proper negative-pressure function of these rooms.
Airborne infection isolation rooms – Single-patient rooms at negative pressure relative to the surrounding areas, and with a minimum of 6 air changes per hour (12 air changes per hour are recommended for new construction or renovation).
Air from these rooms should be exhausted directly to the outside or be filtered through a high-efficiency particulate air (HEPA) filter directly before recirculation. Room doors should be kept closed except when entering or leaving the room, and entry and exit should be minimized.
Facilities should monitor and document the proper negative-pressure function of these rooms.
Air changes per hour: the ratio of the volume of air flowing through a space in a certain period of time (the airflow rate) to the volume of that space (the room volume). This ratio is expressed as the number of air changes per hour.
Optimize the Use of Engineering Controls and Indoor Air Quality
- Optimize the use of engineering controls to reduce or eliminate exposures by shielding HCP and other patients from infected individuals. Examples of engineering controls include:
- Physical barriers and dedicated pathways to guide symptomatic patients through triage areas.
- Remote triage facilities for patient intake areas.
- If climate permits, outdoor assessment and triage stations for patients with respiratory symptoms.
- Vacuum shrouds for surgical procedures likely to generate aerosols.
- Reassess the use of open bay recovery areas.
- Explore options to improve indoor air quality in all shared spaces.
- Optimize air-handling systems (ensuring appropriate directionality, filtration, exchange rate, proper installation, and up to date maintenance).
- Consider the addition of portable solutions (e.g., portable HEPA filtration units) to augment air quality in areas when permanent air-handling systems are not a feasible option.
Pennsylvania PPE guidelines
- Non-Aerosol generating procedures (NAGP): Any dental procedure that does not produce aerosolized particles. These include exams, hand scaling, simple extractions, or orthodontic procedures.
- 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.
PA Pennsylvannia Dental Association https://www.padental.org/Online/Membership/COVID-19/Online/Membership/COVID19.aspx?hkey=1f174b4f-e7c0-4506-8826-66b3206270e3
Covid Updates http://www.padental.org/covid19
Pennsylvannia Guidelines updated May 8/20 https://www.porh.psu.edu/wp-content/uploads/Guidance-on-COVID-19-for-Dental-Health-Care-Personnel-in-Pennsylvania.pdf
CDC guidelines: https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html
Pennsylvania Dental Hygiene https://pdhaonline.org/
Department of health https://www.health.pa.gov/topics/disease/Pages/Coronavirus.aspx
ADHA return to work: http://codha.org/wp-content/uploads/2020/05/ADHA_TaskForceReport.pdf
ADHA hygiene guidelines: https://www.adha.org/resources-docs/2016-Revised-Standards-for-Clinical-Dental-Hygiene-Practice.pdf
CDC Using PPE: https://www.cdc.gov/coronavirus/2019-ncov/hcp/using-ppe.html
IPAC: https://www.cdc.gov/mmwr/PDF/rr/rr5217.pdf
CDC IPAC: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html
Standards of practice https://www.cdc.gov/hicpac/recommendations/core-practices.html
Niosh N95 info:
https://www.cdc.gov/niosh/topics/respirators/
https://www.osha.gov/SLTC/etools/respiratory/index.html
https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/index.html
Summary of required PPE:
Treatment to be completed in the operatory with dental healthcare provider (DHCP)
Low risk: NAGP - Non-aerosol generating procedure includes:
ortho retainer checks, hand scaling, prophy, recall exam
- Level 2 or above
- Face shield or protective eyewear
- Gloves
- A lab coat or gown
- For x rays or photos eye protection OR face shield
Mod/High risk AGP - aerosol-generating procedure include:
Restorative, endodontic, ultrasonic scaling, surgical periodontal hygiene, ortho de-bonding/banding
- Level 3 or NIOSH-approved N95 filtering facepiece respirator or higher
- Face shield
- Protective eyewear
- Gown or lab coat
- Gloves
- Booties and bonnet (but NOT for ortho new bonding)
High Risk - NO treatment in a general dental office
Disinfecting treatment rooms for all procedures: Follow ADA & IPC standards
- Level 2 or above
- Protective eyewear or goggles
- Face shield
- Gloves
- Gown
Reception area:
Front desk Staff (Administration staff/Treatment coordinator/Manager)
- Level 1 mask minimum or cloth mask
- Protective eyewear or a clear barrier/plexiglass separation
- Patients and visitors to wear masks at all times
Staff screening patients
- Level 2 mask
- Gown or lab coat
- Eye protection
- Face Shield preferred
Disinfection of Reception area: Follow ADA & C IPC standards
- Level 2
- Protective eyewear
- Face shield
- Gloves
AGPs should ideally take place in an AIIR.
Information about Airborne Infection Isolation Rooms (AIIRs):
- AIIRs are single-patient rooms at negative pressure relative to the surrounding areas, and with a minimum of 6 air changes per hour (12 air changes per hour are recommended for new construction or renovation).
- Air from these rooms should be exhausted directly to the outside or be filtered through a high-efficiency particulate air (HEPA) filter directly before recirculation.
- Room doors should be kept closed except when entering or leaving the room, and entry and exit should be minimized.
- Facilities should monitor and document the proper negative-pressure function of these rooms.
Airborne infection isolation rooms – Single-patient rooms at negative pressure relative to the surrounding areas, and with a minimum of 6 air changes per hour (12 air changes per hour are recommended for new construction or renovation).
Air from these rooms should be exhausted directly to the outside or be filtered through a high-efficiency particulate air (HEPA) filter directly before recirculation. Room doors should be kept closed except when entering or leaving the room, and entry and exit should be minimized.
Facilities should monitor and document the proper negative-pressure function of these rooms.
Air changes per hour: the ratio of the volume of air flowing through a space in a certain period of time (the airflow rate) to the volume of that space (the room volume). This ratio is expressed as the number of air changes per hour.
Optimize the Use of Engineering Controls and Indoor Air Quality
- Optimize the use of engineering controls to reduce or eliminate exposures by shielding HCP and other patients from infected individuals. Examples of engineering controls include:
- Physical barriers and dedicated pathways to guide symptomatic patients through triage areas.
- Remote triage facilities for patient intake areas.
- If climate permits, outdoor assessment and triage stations for patients with respiratory symptoms.
- Vacuum shrouds for surgical procedures likely to generate aerosols.
- Reassess the use of open bay recovery areas.
- Explore options to improve indoor air quality in all shared spaces.
- Optimize air-handling systems (ensuring appropriate directionality, filtration, exchange rate, proper installation, and up to date maintenance).
- Consider the addition of portable solutions (e.g., portable HEPA filtration units) to augment air quality in areas when permanent air-handling systems are not a feasible option.
Comments
0 comments
Please sign in to leave a comment.