Dental hygiene an essential service

Now that we are in a stricter provincial lockdown to halt the spread of COVID-19, some of us wonder what businesses are open and what services we can access. Dental hygiene appointments are among those services that many people are so unsure about.

Yes, dental hygiene appointments are allowed

The good news is that dental hygiene services are open. Above the author wears Personal Protective Equipment (PPE) Dental hygiene is a regulated health profession, which the provincial documents have listed as a health service that is open during this lockdown. Scaling and root planing/debridement (the part of the appointment where we scrape the tartar buildup off your teeth) are regulated health acts. Science has shown over the years that the act of debriding teeth helps to treat and prevent gingivitis and periodontitis a more severe form of gum disease which has been linked to many overall health concerns including heart disease, stroke, diabetes, dementia, and aspiration pneumonia to name a few.

Why is this different from the first lockdown?

Much of the confusion lies in the fact that dental hygiene was closed in the lockdown imposed from March to July of 2020. There are a couple of reasons for this difference.

In March 2020, the mysterious COVID-19 virus was very new and we had little to no scientific evidence to make decisions about infection control protocols, in-office procedure protocols, public health compliance, etc. Consider that we had pandemic protocol recommendations in place … but they were written well before anyone could have guessed what kind of a “bug” we would be up against. 

In dentistry a lot of our procedures create aerosols. Using drills, polishers, ultrasonic scalers — even spraying the teeth with a mix of water and air pressure — all these procedures force tiny particles into the air. These stay suspended for some time, depending on the size of the particle being created.  

While elective dentistry was shut down, the regulatory Colleges that govern it were at the drawing board coming up with a reopening plan to keep Ontarians safe in dental and dental hygiene offices. They had to consider the little bit of science we then had to determine the recommendations for pre-screening clients, building ventilation and air flow, PPE requirements, office traffic and scheduling, aerosol production and settle time.

What to expect at your appointment

Every office is different, but the Barry’s Bay Dental Hygiene Clinic (BBDHC) has made many changes. The most notable ones can be determined in the first few seconds of your appointment. Instead of the homey, comfortable reception area that used to be unlocked and welcoming all the time, the door now remains locked, with a screening station just inside the door. The waiting room is now the your car, as clients get waved in by the dental hygienist once she is ready to screen them and take them back to the operatory (the room where they will have their treatment completed).  

The dental hygienist looks different too. Instead of wearing the traditional scrub outfit, she now greets you looking more like an astronaut. (Brooke is pictured wearing PPE) With an isolation gown, face shield and mask over her scrubs, and her hands covered with non-latex gloves, it may be hard to tell she’s smiling and happy to see you, but she is!

The operatory has changed too … now the walls are bare, without pictures or decorations for aerosols to settle on. A large sliding door seals the room once you walk in to trap potential aerosols and keep our office air flow controlled.

At the end of an appointment your dental hygienist will no longer escort you to the front desk, but instead will point you in the right direction so that she can quickly ‘doff’ her safety gear, wash, and apply the required gear to revisit the reception area and help you check-out. 

Kaylee disinfecting surfaces (above)

And while in the reception area, don’t worry about bumping into a neighbour or friend. The operatory must stay sealed for a minimum of fifteen minutes after your appointment so a thirty minute space is booked between each client coming into the Clinic. This allows the required fifteen minutes for the operatory to be closed up, then time to clean and disinfect the operatory, start reprocessing the instruments that were used, and prepare for the next client.

An important question

The million dollar question has been, “Can I use your bathroom?” The answer: Yes, but please leave the door open after so we know it needs to be disinfected before it is used next. That’s right, the bathroom gets disinfected after each use.

What about the stay-at-home rule?

Another question that’s been asked lately is, “Am I allowed to travel there? I’m supposed to stay at home.” This is where the messaging gets confusing. You are allowed to travel outside of your home to access health services. So you are absolutely allowed to travel for a dental hygiene or dental appointment. For those clients who prefer, BBDHC can email a customized letter for you to carry to and from your appointment explaining your reason for travel, although it is not required. If you would like one, just ask when confirming your appointment. We are happy to provide it.

Are the clinic employees safe?

The last question to be addressed today is: do we feel safe. All three employees of the BBDHC have been asked this question, as dental hygiene tops the list of at-risk professions for contracting airborne illnesses. With the infection control protocols, safety measures, and pandemic protocol that we have in place and use with every client every day, we absolutely feel safe at our work and we feel it’s necessary to continue to provide our services in these challenging times. It is more important than ever to be practising preventive health care.

marcia-rutledge-rdh

About the author: Marcia Rutledge is an independent dental hygienist  who opened Barry’s Bay Dental Hygiene Clinic in 2010 and has been providing dental hygiene services to the community since. Preventive dentistry is Marcia’s passion.

photos Facebook/Barry’sBayDentalHygieneClinic

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