This policy has been created based on multiple updated sources from within the dental and medical professions and direct feedback from all members of the Gentle Dental practice. It outlines modifications to our normal procedures that we intend to employ once dental practices can be reopened once the COVID-19 pandemic peak of infection has subsided.
It is not known at this time whether these procedures are temporary or whether they will become a permanent feature of the way dental practices must be run to ensure patient and staff safety in the future. The worldwide COVID-19 pandemic is still being evaluated and studied and policies and recommendations are likely to change in line with new scientific evidence over time.
We would like to thank all of our patients for their patience and forbearance doing this long period of practice closure and for their understanding and cooperation whilst we implement new measures at the practice.
It is our intention for all staff members to return to work on Tuesday 26th May unless an extension to the current lockdown recommended by the government or professional bodies. The Gentle Dental team will spend three to four days preparing the practice for reopening and practising updated procedures before patients return to the practice.
It is envisaged that the practice will reopen to normal patient treatments commencing Monday 1st June.
We would of course like to continue providing necessary dental care to all of our patients in the safest possible environment. We therefore respectfully request your full cooperation with any new or modified procedures at the practice.
Our clinicians and front office coordinators will be contacting patients with ongoing treatment and confirming appointments to continue with current courses of treatment during the second part of May. Our patients with ongoing or delayed courses of treatment will be prioritised in the first three months of opening.
We will request that all patients who are returning to The Gentle Dental Practice for treatment update their standard Medical and Dental Questionnaire (MDQ) via the links below.
https://www.cognitoforms.com/GentleDental1/MedicalAndDentalQuestionnaire
This includes a new, more detailed, section regarding your recent activity which will allow us to assess your level of risk for coronavirus infection before you attend the surgery.
Our normal cross-infection control protocols at The Gentle Dental Practice against all previously known pathogens are already woven into all clinical activity carried out at the practice. It should be remembered that the dental practice is already a very clean environment compared to public areas and it is not possible for us to control sources of infection outside the dental practice.
There have been multiple suggestions from many sources as to how the risk of transmission of COVID-19 can be reduced in a dental clinical environment. Some of these are straightforward and some of these are patently impractical when carrying out fine and detailed dental procedures.
We have collectively evaluated all of these and feel that the following measures will reduce risk to an acceptable level at the practice. Please be assured that all of our clinical staff will also be complying with these procedures to reduce the risk of cross infection in both directions.
https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk-from- coronavirus/
We would like to eliminate waiting times in reception as much as possible so that you are not near other patients. Accordingly, appointments will be staggered so that patients do not arrive or leave at the same time as other patients as far as we are able to manage.
o Thoroughly wash your hands for 30 seconds with the antiseptic hand wash provided
o Carry out a dilute (0.2%) chlorhexidine gluconate antiseptic mouthwash 30 second mouthwash and gargle. This has been shown to rapidly kill the virus and reduce any viral load even if you are asymptomatically infected. Our clinical staff will be carrying out the same process at each session.
o Our use of our normal high-volume suction reduces aerosol production by over 90%.
o Use of dental rubber dam which in the practice is routine further reduces bio-aerosols by a further 30-90%
o Our regular facemasks filter approximately 60% of remaining airborne particles.
o FFP2 and FFP3 masks filter 94% and 99% respectively of airborne particles in both directions (patient to clinician and clinician to patient).
We therefore feel that our normal dental procedures can be carried out with minimal risk with use of high-volume suction, dental dam and FFP2 and, in high aerosol generating procedures such as hygienist visit for periodontal treatment, FFP3 masks as appropriate.
At the time of writing there are approximately 2786 confirmed cases of COVID-19 infection in Surrey out of the local population of over 1,190,000 (less than 0.24% infection rate), 26113 confirmed cases of infection in greater London (0.28% infection rate) and approximately 5,000 confirmed deaths (0.06% death rate) in the Greater London area with a population of approximately 8.9 million.
https://coronavirus.data.gov.uk/#regions
This means that the vast majority of our patients are otherwise healthy without coronavirus infection and we would like to be able to provide normal dental care for these patients in as normal an environment as possible while bearing in mind our responsibilities to mitigate risks of infection spread as far as is practically possible.
This policy will be constantly reviewed and updated as necessitated by circumstances over time.
If you have any questions regarding this policy or about your dental care at The Gentle Dental please do not hesitate to contact us on hello@thegentledental.co.uk or on 0208 224 7562.
Yours sincerely
Dr Ali Rifai
BDS (Lond) PgCert MClinDent (Implantology)
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