First do no harm: the prevention of any disease is both fundamental and essential. The corona virus is one of many pathogens our office has equipment and procedures in place to prevent that exceed all governmental guidelines. Keep in mind that public health policies target flattening the curve of COVID-19; our office is focused on zero transmission. Although adding safeguards does increase cost, allowing any patient to become infected from a preventable disease is not an option in this office. Because there are some unknown aspects to the virus responsible for COVID-19, our office has targeted known regulations set for a more virulent airborne pathogen, Ebola.

As anyone could be an asymptomatic carrier of the corona virus, all patients are assumed to be contagious. No patients are allowed in the building with a mild temperature or without a face mask and are being prescreened by answering a litany of questions that would identify someone of high risk. There is a Dyson air purifier fan set at the maximum volume that blows perpendicular to the opening of the front door as one enters. The front door is locked at all times to prevent an unscreened person from entering. The reception area has been repurposed as a donning and doffing anti-room: a sealed area locked on both sides. Patients that were screened for entry now disinfect hands, put on a paper suit, booties, and gloves before entering the other side of the anti-room indicated by a blue/green line on the floor. Masks are worn at all times inside the building except when seated in the patient chair. As soon as the patient removes their mask, they are asked to rinse with both hydrogen peroxide (to kill virus) and chlorhexidine (to kill bacteria).

Our office HVAC unit is equipped with a Guardian system which uses UV and peroxide to disinfect all recirculating air. The HVAC is oversized for the square footage of the building to allow for more restrictive return filters. The supply vents are directional so that regular HVAC recirculating air does not flow directly over patients. Airborne infection isolation room (AIIR) equipment is in place in every treatment room to address the concern inherent with providing dental care: a mask can’t be worn while dental care is being provided. This equipment uses 2-feet diameter supply and return ducts that are directed to move approximately 15 air changes per hour in the treatment room while providing a negative pressure in the room and directs air from treatment rooms to be vented outside the building while minimizing the loss of heating/cooling. As a fail-safe, air purification units specified for the appropriate square footage of the room with HEPA filters and UV are placed in each treatment room.

When dental care is delivered, either rubber dam isolation with high speed and volume suction is used with an assistant or a Xuction unit is used to evacuate over 90% of the aerosol generated. There are motion activated hand sanitizer, soap, faucets, and paper towel dispensers in all treatment rooms to reduce the chance of cross contamination. Double surface disinfection is used: all surfaces cleaned and sprayed, then wiped with an all-purpose germicide after being left for the appropriate time followed by misting the surface with 95% ethyl alcohol. The restroom fan is a quiet 150 cfm fan that clears the air in the restroom every 2.25 minutes. Before each restroom use bleach is added to the toilet and after each restroom use the room is closed for at least 35 min to allow for 15 air changes. Light switch, soap, faucet, and paper towel dispensers in the bathroom are all motion sensor activated. Policies and procedures are in place to ensure patients keep a social distance of 6 feet at all times. Our team uses PPE that exceed the recommended guidelines. Your safety is of the utmost concern. With all the new protocols in place more time is needed for each appointment and treatment is still currently being prioritized based on patient needs to keep everyone safe. We thank you for your understanding with the limitations in scheduling as we continue to ensure your safety.

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