CDC gives webinar on Dental Care during COVID-19
Guidance on resuming non-emergency dental care
by KEVIN KUO DDS, MMSc | June 3, 2020
On June 3 at 2 pm, the CDC gives dental-specific guidance for dental practices when resuming non-emergency dental care. The webinar was approximately 1 hour long. Recordings can be found on the CDC website or here.
SUMMARY of presentation:
Michele Neuburger, DDS, MPH, a dental officer at the CDC, gives general dental care recommendations. They mirror the CDC guidelines seen previously on their site.
Alberto Garcia, MS is a mechanical engineer. He gives recommendations on operatory air filtration and circulation.
“Clean-to-(less-clean) airflow (e.g. reception desk -> waiting area, work desks -> patient chairs)”
“Increase filtration efficiency to the highest level compatible with the HVAC “
“Investigate increasing outdoor air percentage in HVAC supply air “
“Limit the use of demand-controlled ventilation“
“Consider using portable HEPA air filtration unit“
“Consider the use of upper-room ultraviolet germicidal irradiation (UVGI)”
“Allow a 15 minute wait period after patient leaves and before beginning the room cleaning and disinfection process”
Marie A. de Perio, MD, FIDSA, a medical officer at the CDC, gives recommendations on PPE.
Dr. Perio recommends tier PPE use depending on the risk of exposure—more PPE with certain procedures.
“For procedures likely to generate splashes: gloves + eye protection + gown (or protective clothing) + surgical mask”
“For aerosol-generating procedures: gloves + eye protection + gown + N95 or higher level respirator (instead of surgical mask)“
“For patients with suspected or confirmed COVID-19: gloves + eye protection + gown + N95 or higher level respirator”
Megan Casey, RN, BSN, MPH, CIC, a nurse officer at the CDC, gives recommendations on international respirators.
She gives guidance on how to look for legitimately imported respirators
She does not recommend ear-loop KN95s
SUMMARY of Q&A:
How the industry is preparing for 2nd wave of COVID-19?
Prepare dental practices with proper PPE, especially with shortages. Start treating patients with the most need first.
Any documented case of COVD-19 transmission at a dental office?
There are no confirmed cases of transmission reported to CDC thus far.
How is the CDC investigating the risk of COVID-19 transmission in dental settings?
CDC is continuing to evaluate and provide information.
What are aerosol-generating procedures in dentistry?
There is no complete list yet. Most known procedures include ultrasonic scalers, handpieces, air-water syringe, air polishing, and air abrasion devices.
What face masks can be used if not using N95?
Use the highest level of surgical mask available.
Fit testing?
OSHA requires a respiratory protection program by employers. This includes medical evaluation, training, and fit testing. Initial fit testing is still required. CDC understands that fit testing may not be possible during emergency scenarios. Thus, N95 masks can still be used without proper fit testing. They recommend N95 masks over other masks if possible. CDC also state that surgical masks with face shield is an acceptable alternative.
Re-using N95?
Times of crisis may require extended use and re-use.
Different methods to decontaminate N95 respirators?
CDC summary on respiratory sterilization can be found on CDC website.
Can ear-loop KN95 protect providers?
NIOSH and CDC do not recommend KN95 masks with ear-loops.
Does waiting 15 minutes in between patients apply to all procedures?
The 15-minute wait is more applicable for splatter and aerosol-generating procedures.
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