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.
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.
- 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.
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/
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
Illinois Public health
Illinois dental hygienist association Does have a link on their site directly if they want to temp
Includes: Fox VAlley//Winnebago/Chicago/Springfield/McHenry county/Southern Illinois
Illinois Licensing Requirements
Refer to ADHA for guidelines
MDHA https://massdha.org/
Covid resource https://www.massdental.org/Member-Resources/Practice-Management/Coronavirus/Hygienists
Pennsylvania PPE guidelines
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
Tennessee Dental Association https://www.tndentalassociation.com/member-center/COVID-19
Tennessee Department of health https://www.tn.gov/health/cedep/ncov.html
Tennessee Dental Hygienists Association
Regarding PPE
the ADA Return to Work Interim Guidance Toolkit
https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html
Engineering Controls
- When possible, install barriers/partitions between employees and patients
- Use local exhaust ventilation to capture and remove mists or aerosols generated during dental care
- Use directional airflow to move air from employee occupied areas, to unoccupied areas
CDC guidelines: As of August 28, 2021
https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html
This update includes:
Provides a section for routine delivery of care during the pandemic and a second section
for delivery of care recommendations for patients suspected or known COVID-19
- Reminder for DHCP of transmission risks outside of patient care areas.
- Clarification on engineering controls for open bay operatories, reprocessing treatment areas between patients, and alternative disinfection methods
New Guidance from the CDC in Dental Settings - updated August 4, 2020
The CDC Guidance for Dental Settings During the COVID-19 Response has been updated. Most recommendations in the updated guidance have been rearranged for clarity and are not new. Recent updates include:
- How to respond to SARS-CoV-2 exposures among dental healthcare personnel (DHCP) and patients, and guidance on physical distancing.
- The definition of fever changed to either a measured temperature ≥100.0°F or subjective fever to align with CDC’s Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings.
- In areas with moderate to substantial community transmission, during encounters with patients not suspected of SARS-CoV-2 infection, CDC recommends that DHCP:
- Wear eye protection in addition to their facemask to ensure the eyes, nose, and mouth are all protected from exposure to respiratory secretions, including those where splashes and sprays are not anticipated.
- Use an N95 respirator or a respirator that offers an equivalent or higher level of protection during aerosol generating procedures.
- Added language that protective eyewear (e.g., safety glasses, trauma glasses) with gaps between glasses and the face likely do not protect eyes from all splashes and sprays.
It is unknown at this time how COVID-19 may permanently change infection control practices in dental health care settings. CDC continually assesses emerging scientific evidence for developing policies, guidelines, and recommendations. You can find the most up-to-date information about infection prevention and control practices on CDC’s COVID-19 page. This is an emerging, rapidly changing situation, and CDC will update this guidance as additional information becomes available.
ADHA return to work: http://codha.org/wp-content/uploads/2020/05/ADHA_TaskForceReport.pdf
ADHA hygiene guidelines: ADHA guidelines update as of July 7, 2021
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
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