STATE AFFILIATE OF THE AMERICAN DENTAL ASSISTANTS ASSOCIATION
I hope you had the opportunity to view the ADAA live Facebook webinar on June 17th, 2020. It was phenomenal with so much information being shared. Presenting was Tija Hunter, Sherrie Busby, Robynn Rixse and Sarah Stream.
I certainly can’t repeat everything that was said but I would like to share some specific topics that were discussed and you can review each of them via: CDC, ADA, OSAP, OSHA and ADAA.
As of May 19, 2020 the CDC and ADA published information in both English and Spanish on staying safe when returning to work. Everyone who enters your office should be screened – not just patients. This includes the mailperson, supply company sales reps, FedEx - - yes, everybody. There is a Screening Form available upon request that can give you assistance if needed. Temperatures of 100.4 or higher should be turned away and 100 or above for teens.
What do we do when we walk out of the office at the end of the work day? Get in our car, stop at the grocery store, start a load of wash before starting dinner. All outside clothing should be removed before leaving the office. Everything that could be laundered should be left at the office, even our socks. If not we can contaminate our car and everything that is touched. Shoes should stay at the office or wear booties. Follow the OSHA laundry protocol. Head coverings are also recommended along with shoe coverings.
Masks are a must and don’t become complaisant. Cover the nose! Earrings are also a source of contamination.
It’s important to stay hydrated when wearing masks. You are breathing your own carbon dioxide and anxiety and high blood pressure can form. It can be detrimental to an assistant with COPD.
If a mask becomes damp, wicking will develop and not be affective past that point.
An N-95 mask should be fit tested but it isn’t always possible. The N-95 provides the most protection when working with aerosols. If an N-95 is not available to you, use a #3 mask and over lay with a face shield.
There is controversy about allowing a room to rest 15 to 25 minutes before disinfecting, allowing aerosols to drop.
I hope this has given you some things to think about. Please be safe………
Linda Kihs, CDA, EFDA, OMSA, MADAA
Tija Hunter, CDA, reminds her peers that rushing back to work, no matter how much you miss your patients and income, is not a good idea until some things are corrected in dental practices.
By Tija Hunter, CDA, EFDA
Apr 23rd, 2020
I’m so tired of being off work due to COVID-19. Can’t we just go back to work and stop this madness?
No! We can’t go back to work for a couple of reasons.
We have some pretty strict infection control practices in dentistry, but do we follow them like we are supposed to? Many times, when I visit an office to perform an assessment, (part of my job is to help offices become compliant in infection control), I see many things that are not quite right. When I see this I always go back to: you don’t know what you don’t know! This means offices do not intentionally do anything wrong, they just haven’t been trained in proper infection control.
Sometimes when I visit offices, staff members tell me, “I just had OSHA (Occupational Safety and Health Administration) training, and we didn’t learn any of this.” I tell them, “No, because infection control isn’t OSHA.” Many confuse the two, but they’re very different. Like the name, OSHA is occupational safety, meaning it is there to protect workers—you! Infection control has a broader range because it protects both you and your patients—the public! When you use proper infection control and sterilization techniques to clean surfaces and instruments, you do not have to worry about spreading this virus. Note I say “properly.”
Also, COVID-19 spreads mainly through airborne particles, such as coughing and sneezing. It also spreads through aerosols such as those seen in dental offices when using a handpiece or ultrasonic cleaner.
What about our personal protective equipment (PPE)? Is it enough? Can we do anything differently? I believe our PPE is going to come under fire in the dental profession during the next few months. I believe what we wear will be significantly different in order to protect ourselves post-COVID-19.
What about those waterlines? Even if your office is seeing only emergency patients, offices aren’t using many of their operatories, therefore, leaving the water in the lines leads to stagnation. Right before you begin seeing patients again, you’ll need to shock your dental unit waterlines to ensure there is no biofilm buildup in the lines. If you aren’t shocking regularly, this should become part of the infection control protocol for your office and should be done quarterly, but especially now that ops have been unattended for a long time. If you don’t know the protocol, email me at firstname.lastname@example.org and I’ll be happy to help!
What we need to do right now is simply stay home! I realize this is a crazy time and most of us need our jobs. However, we need to heal as a nation and throughout the world. I beg you to listen to the warnings and not go into work. I hope your practices are seeing only emergency patients and that none of you are going in your offices due to fear of losing your jobs.
We’re still learning about this virus! There is no vaccine (as of this writing), and we’re just beginning to experiment with vaccines and drug treatment. But, what about the next round? Many predictions believe there will be another outbreak this fall. While we still don’t know all of the changes that are coming post-COVID-19, our dental practices can keep a watchful eye out to make sure we stay on top of things!
Want to learn more about infection control in the dental office? Now is the perfect time to visit the website for the Organization for Safety Asepsis and Prevention at osap.org and educate yourself.
Tija Hunter, CDA, EFDA, CDIA, CDSO, CDSH, MADAA, is a member and current vice president of the American Dental Assistants Association (ADAA), where she holds the honor of Master. Tija is the editor of Dental Assisting Digest and contributes to Dental Economics magazine. She is the director of the Dental Careers Institute, a dental assisting and dental continuing education program, and the author of seven continuing education study courses. She is an international speaker and a certified trainer in nitrous oxide in several states. Tija was named one of the Top 25 Women in Dentistry by Dental Products Report magazine in 2015. She can be reached at email@example.com.
More than one donning and doffing method may be acceptable to your facility. The method listed below is recommended by the CDC. Good information as a reminder, especially at this time.
Gather your PPE
Use hand sanitizer or wash with soap and water for 20 seconds
Put on isolation gown and tie at the neck and waist.
Put on the N-95 respirator or face mask.
Perform a user skill check.
Put on face shield or goggles.
Use hand sanitizer or wash with soap and water for 20 seconds.
Remove and discard your gloves. For the glove-in-glove method.
Dental practices around the country are overwhelmed with questions regarding the unknown. Being out of work with bills to pay can certainly be cause for anxiety and concern.
The love that is showing up in generous acts around the world though is testimony to the power of empathy of our humanity. Each day when the growing numbers of those who lost their battle against the virus are announced, we shed a tear and grieve for those families. As you say your prayer each night, remember hospital workers, emergency response teams, truck drivers; and the clerks who keep the shelves stocked as best they can. Mail carriers, internet technicians and all the others who put their lives on the line each day so we can be cared for, fed and connected. Those prayers and thoughts of gratitude promote hope, faith and love.
Many of you were counting on the Oregon Dental Conference for obtaining your continuing education credits for the year. Don’t forget about the continuing education available to you online:
American Dental Assistants Association (ADAA)
Dental Assistant National Board (DANB)
to name a few.
Stay strong and hold to the intention that you will receive exactly what you need. Fuel it with faith and positive thoughts and then let your creativity and action take you towards that goal.
Blessings to all ~
Due to the coronavirus outbreak, it appears we may experience a higher than normal demand for infection control products such as masks, goggles, and face shields among other items.
However, this should not cause us to be more lax about how we use a mask or for saving them and using them on multiple patients. A common misuse of facemasks, is after a procedure, placing it around the neck or under the chin and even taking it off and placing it into a gown pocket with the intention of reusing it again. This act requires the health care worker to touch the outside of the contaminated mask with either their bare hands or gloves. Now contaminates on the mask are in contact with the skin on the neck or chin of the dental team member. Masks should be removed and discarded after each patient by only the ties, bands or loops, along with the exam gloves.
Beginning with the initial 1978 American Dental Association published document, every series of ADA and Centers for Disease Control and Prevention infection control guidelines for dentistry has included recommendations for wearing face masks as key components of personal protection against airborne pathogens. The 1991 Occupational Health and Safety Administration Bloodborne Pathogens Standard also included a regulation stating: “Masks in combination with eye protection devices, with solid side shields or a face shield, shall be worn whenever splashes, spray, spatter, or droplets of blood or other potentially infectious materials may be generated and eye, nose, or mouth contamination can be reasonably anticipated.”
Specific features should be evaluated when selecting a mask:
it should not come into contact with the wearer’s nostrils or lips
has a high bacterial filtration efficiency rate
fits snugly around the entire periphery
does not cause fogging of eyewear
is made of a fabric that does not irritate skin or induce an allergic reaction
is comprised of a material that does not collapse when worn or when wet
is easy to put on and remove
Wet masks should be changed every 20 minutes when challenged during procedures that generate heavy levels of spatter and aerosols, after 60 minutes in non-aerosol environments and certainly after each patient. Keep in mind, no mask can filter out 100% of all aerosolized particles.
The American Society of Testing and Materials is the organization responsible for establishing criteria and testing methods to delineate performance specifications for face masks used in healthcare. Masks are generally classified into 3 types:
Level 1 masks are designed for procedures with low amounts of blood, fluid, spray and/or aerosol exposure. Common clinical examples include patient exams, operatory cleaning, impressions, lab trimming and orthodontic work.
Level 2 masks are ideal for procedures where moderate to light amounts of fluid, spray and/or aerosols are produced. Restoratives, prophylaxis, sealants, limited oral surgery and endodontic treatment.
Level 3 masks are designed for procedures with moderate to heavy amounts of blood, fluid, spray and/or aerosol exposure. High barrier protection is needed for procedures such as implant placement, crown preparation, and periodontal or complex oral surgery.
So lets all be safe – not sorry.
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