When you're just starting out, it's hard to envision where your business will be in a few years. But while your lease might seem like an afterthought now, it can carry a lot of weight if you ever decide to move, sell, or shut down your practice!
1. Navigating the Make-Good Clause in a Dental Lease
A make-good provision lays out how the landlord expects the property to be when the lease is over. If you don’t leave the space in the condition you agreed to, you’ll pay for it!
Examples of common make-good clauses include:
The tenant returns the building in its initial condition
The tenant strips the building down
A make-good clause can be bad news if your practice space is a fixer-upper and you plan to undertake major renovations. Years down the road, when it comes time for you to move on, you could be on the hook for the expenses of stripping the property or returning it to its original state.
Fortunately, there are ways to navigate this costly sticking point. Sometimes, all you need is to ask. Your best chance is if the landlord is eager to bring on a tenant long-term and you have leverage.
Of course, it won’t always be that straightforward, in which case, you’ll need to take other steps to offset those expenses.
Below is a list of actions you can take to stave off the potential pitfalls of a make-good clause if your landlord doesn’t get rid of it:
Agree to a maximum total expenditure so that you’re only paying a certain amount.
Don’t agree to undo any work you didn’t do. Make sure it’s written in the contract that you only have to pay to return the space in its original condition, not to make any additions or strip it bare.
Get a document called a “condition report” before moving in. This will document damage or changes that already exist before your tenancy begins. This way, you won’t have to pay anything that wasn’t your doing.
Be sure you're not paying your make-good provision fees months after your lease ends. Ask your landlord at the end of your term if there’s work they want you to do. Provided they answer “no,” ask them to release you from the clause.
2. Know the Difference Between Sublets and Assignments
Sublets involve transferring your lease’s rights and responsibilities to a third party (i.e., the right to access space and the responsibility to pay rent every month) without changing your original contract with your landlord. You’re responsible for any of the new tenant’s actions (e.g., if they miss rent, you’re stuck with the bill).
This option's a bit risky, but it's a whole lot easier to negotiate than an assignment. Sublets are ideal for sharing your practice space with another dentist or professional part-time, or on a temporary basis.
An assignment, on the other hand, entirely releases you from your obligations as a tenant and transfers those obligations to the new tenant. This option makes sense when you’re selling your practice or trying to move to a different location before the end of your lease. However, since you need the landlord's permission to assign your lease, you must talk to your landlord before making this arrangement with another professional.
To avoid any confusion, your lease should clearly state which scenarios allow an assignment to occur.
For example, your landlord might agree to get rid of the make-good clause because you sign a longer lease. Or, they might even end up paying for some of the improvements you make to the space.
Before signing a long lease, consider the following:
Are you confident in your practice and its long-term success?
How long do you plan on running your practice?
Does the lease require a personal guarantee?
Remember that a long lease can be rigid, so you should be 100% sure that the benefits outweigh the commitment!
Finally, know that the end of your lease doesn’t always spell the end of your business at that location. If you have a good deal on a great space, talk to your landlord about renewing the lease before the end of its term. However, renewal clauses should not be a substitute for negotiating good make-good and assignment clauses up front.
Securing a great lease from day one will help get your practice off on the right foot! Understanding these factors gives you a better idea of what to look for in a dental practice lease before you shake hands and start doing business.
Why Mouthwash Has the Potential to Reduce COVID-19 Transmissions
When people think mouthwash, they think of fresh breath and plaque removal. They don’t really think about the broader health benefits of swishing a mouthful of the minty, slightly-burning liquid.
However, the results of recent laboratory testing suggest that there are at least two types of mouthwash that could stop COVID-19 from replicating in a human cell.
The two types of mouthwash in question are Listerine and chlorhexidine. Listerine contains the active ingredients Eucalyptol (0.092%), Menthol (0.042%), Methyl salicylate (0.06%), and Thymol (0.064%). The latter, chlorhexidine, is only available in Canada and the United States by prescription.
According to the lab results, both mouthwashes only took a few seconds to disrupt the virus, even after they were diluted to resemble functional use.
Questions remain about the real-life efficacy of these findings. The study only replicated conditions found in the mouth, applying concentrations of the mouthwash and measuring the time it took to contact tissues. Real-world scenarios have yet to be tested.
For this reason, more studies are needed before anything is set in stone. However, the findings suggest a simple, straightforward method that people could use to protect themselves.
Other Mouthwashes Show Promise for Preventing COVID-19 Transmissions
Another mouthwash has the potential to help in the fight against COVID-19, that being Betadine. But unlike Listerine and chlorhexidine, this product couldn’t disrupt the virus without impacting the skin cells in the mouth, which offer a layer of protection.
Betadine contains Peroxyl and povidone-iodine, which are not found in the other two mouthwash products tested by researchers.
Mouthwashes Could Help Keep Dental Professionals Safe from COVID-19
Part of fending off COVID-19 is keeping yourself safe from the virus. While PPE and other safety standards help, they aren’t impenetrable. After all, your job revolves around being up close to your clients’ mouths day after day. Every added bit of protection is welcome.
By giving a patient (who has unknowingly caught the virus) Listerine or chlorhexidine, there’s now proof it might lessen the viral load and help offset the chances of you transmitting COVID-19.
And in keeping yourself safe, you keep your patients, staff, and surrounding community safe.
The hope is that people using these mouthwashes a few times per day would lessen transmissions. However, mouthwash alone cannot stop anyone from catching or transmitting the virus.
While other research had been performed to test other antiseptic mouthwashes’ abilities to disrupt COVID-19, these findings are unique. Previous studies only examined temporary transmission prevention, whereas the new study also examined antiseptic rinse concentrations, time of contact, and skin-cell killing traits that mirrored oral conditions.
Although Listerine and chlorhexidine aren't 100% proven to prevent transmission, it wouldn't hurt to encourage patients to use them.
The “new normal,” as we’ve taken to calling it, has changed the way that multitudes of people are doing work.
Those with non-essential office jobs have found themselves working from the comfort of their own home. They’ve become fluent in Zoom meetings and online chat functions.
Not to downplay their struggle, but these individuals have much less to worry about than other professionals ‒ particularly those of us in the dental profession, who are in the very-high-risk category for aerosol production due to drilling and cleaning processes.
Although teledentistry has come a long way, there's no way to clean your patients' teeth, perform fillings, or give someone a root canal without being in the same room.
This presents you and your staff with a distinct challenge. Yes, you follow detailed safety protocols and put your best foot forward...but unfortunately, there’s always the potential for danger, despite your eternal vigilance.
Which brings us to another issue: testing for COVID-19 in the dental practice.
When someone in your practice starts showing any symptoms, they must receive a COVID-19 test. This tends to cause a chaotic chain reaction.
First and foremost, your employee (or you) must now wait at home, isolated, for up to a week, waiting for results.
From patients to colleagues, anybody who's come in contact with the potentially infected party now must take the same necessary step. Appointments must be cancelled. Contact-tracing calls and emails must be made as soon as possible.
Despite your best efforts to contain the potential spread of COVID-19, by the time someone even feels symptoms, it may already be too late ‒ a chaotic chain reaction is ignited.
A Dentaltown article by Dr. Thomas Giacobbi discusses this topic in detail. Through his lens, we'll examine how to mitigate risk under our current circumstances.
How Can Dental Practices Control the COVID-19 “Chain of Chaos?”
To date, there is no clear timeline for the development of a safe, widely available vaccine for COVID-19.
As such, argues Dr. Giacobbi, dental practices take steps to make rapid, proactive testing available for dental employees.
Rapid testing for asymptomatic individuals has the potential to catch an infection before it is unwittingly spread amongst coworkers and patients. That makes for immediate peace of mind.
Is it a foolproof solution? Probably not. Yet, it’s still a sound approach that mitigates risk.
Catching the virus before asymptomatic spread, as Dr. Giacobbi writes, could successfully protect an entire community.
Rapid COVID-19 Tests Are Available in Canada
As much as accurate and helpful information is being shared during this time, plentiful misinformation makes the rounds. This notion rings doubly true with COVID-19 rapid testing.
Well, we’re here to confirm that rapid testing is approved for use in Canada.
Namely, Dr. Giacobbi cites the Abbott’s ID test. It’s a toaster-sized machine that generates results in 15 minutes. While there’s been a few reported false negatives, these outliers likely stemmed from a less optimal sample collection or timing.
We empathize with any practice sticking to a budget – but paying for these tests might be worth the investment.
Recently, Canada approved another test that produces results in 13 minutes. More available options will prevent backlog for the general population's test results.
Plus, it'll help to monitor your team in real-time, so they don't find out they're infected when it's too late.
Why Do Dental Professionals Need These Tests so Badly?
There’s no accounting for your patients. You can’t control their COVID-19 vigilance beyond your practice’s confines.
Plus, you’re exposed to more harmful bacteria and germs in a dental setting because you’re working with people’s mouths. Due to the equipment you use, highly volatile aerosols are produced and linger through the air far longer than regular saliva deposits.
Should You Test Your Patients as Well?
According to Dr. Giacobbi, some dental professionals have been offering tests to their patients. Aside from the fact that you may not be approved by your local health authority to deliver such testing, Dr. Giacobbi cautions against this idea for two reasons:
You may not be equipped to properly bill patients’ medical insurance for these tests.
By offering COVID-19 testing, you may attract sick people to your office who want an expedited diagnosis.
Dr. Giacobbi isn't 100% against the idea; it simply doesn't work for his practice. Provided you feel that you have the infrastructure to perform these tests, it might be a worthy venture.
We’re all facing this challenge together. We hope this kind of information will help your practice successfully weather the current COVID-19 landscape.
Sable Industries strives to provide premium quality products and services at value-driven pricing to our dental dealers and their clients. Contact us for more information.
COVID-19 has been challenging for almost every kind of business. The new risks, safety standards, and sense of duty associated with the pandemic have been stifling for everyone from plumbers to servers to retail managers.
But the above examples – and many other industries – don’t face nearly the COVID-19-related risks of a dental office.
As a dental professional, you're exposed to bacteria and germs in the form of dental aerosols on a daily basis, putting dentists and hygienists in the highest risk category for COVID-19 transmission. Not to mention you’re dealing with the same common obstacles that everyone else must deal with, such as social distancing and wearing PPE day in and out.
Since this crisis is entirely unprecedented, most throughout the dental sphere are doing our best to establish excellent practices to navigate these murky pandemic-laden waters.
Let’s discuss the five key takeaways on COVID-19 and dentistry from Dr. Smith’s firsthand experiences:
Lesson 1: Keep a Contingency Plan in Your Back Pocket
The first lesson provided by Dr. Smith stems from him scaling down his practice to emergency services only.
With shutdowns on the horizon and the need to flatten the virus's curve, Dr. Smith’s large practice needed to limit its considerable foot traffic. Otherwise, he would have been encouraging far too much person-to-person interaction and exacerbating the potential COVID-19 spread.
This decision presented a distinct challenge: his patients already found themselves waiting long for appointments, only to have them pushed back further.
Instead of merely telling his patients they were out of luck, Dr. Smith felt it necessary to implement a backup plan. He pointed patients toward his state dental society’s guidance.
The dental society provided Smith with reinforcements to help clients figure out how to receive dental care without his practice. As such, after informing his staff about his decision, he sent an email blast to his patient network to keep them abreast of these happenings.
Dr. Smith’s contingency plan saved him from plenty of undue stress while keeping things streamlined and hassle-free.
Lesson 2: Maintain a To-Do List for Your Practice
Now more than ever, as a leader in both the dental community and in your own neighbourhood, you must find your inner optimist.
With that said, the slowed-down foot traffic in your practice doesn't have to be a setback.
For instance, Dr. Smith used the time allotted by the lockdowns to do some proverbial housecleaning and side projects he’d let slide. Namely, the office received some much-needed repairs and touch-ups that the dentist was previously too busy to manage.
Creating a to-do list for these downtimes ensures a productive lockdown that helps your practice flourish instead of hindering it.
Lesson 3: Learn the Art of Flexibility
We already mentioned in the introduction about how the pandemic has presented the dental community with unprecedented circumstances.
There's no fixed solution, playbook, or magic bullet with all the answers. Thus, your flexibility and willingness to pivot and roll with the punches are absolutely critical. Whereas committing too much in one direction is a fool’s errand.
Dr. Smith tapped into his flexibility when he initially sent his staff home one week into the shutdown, paying them an average weekly wage. Eventually, he began laying people off so they could earn more through unemployment. Furthermore, he changed his PPP loan plan.
The doctor weighed his and his employees' needs by keeping his ear to the ground and keeping up with the various shifts in the fluxing landscape.
Lesson 4: Commit to Self-Care
Mental health struggles have been well-documented during the pandemic, with signs indicating a rough winter ahead.
After five weeks of dealing with the lockdown, Dr. Smith decided it was time to take a week off. This mental break from the office and gave his brain some breathing room paid dividends.
As dental care providers, it's all too common for you to prioritize others' wellbeing over yourselves. But to perform your duties at the level that you expect, you must focus on your own wellness.
Click here to read “A Selfcare Survival Guide for Busy Dental Professionals.” You’ll receive a detailed itinerary that doesn’t merely focus on physical and mental rest. It also prioritizes physical activity, stress reduction, and proper nutrition.
Lesson 5: Stay in Touch with Your Peers
The term “lockdown” isn’t known for its association with socializing and gathering in groups to freely exchange ideas.
Most importantly, though, as a dental professional, you must interact with your peers to stay sharp and informed about the latest industry developments.
Fortunately, we live in a world where these kinds of interactions don’t have to occur on a face-to-face basis.
For example, Dr. Smith increased his activity on the Dentaltown message board. This approach kept him well-informed about pandemic-related challenges. Receiving helpful feedback from his industry peers helped him make informed decisions and maintain his practice during this trying time.
Hopefully, these lessons have provided helpful insights into how you think you should run your practice during the pandemic. Sable Industries Inc. continues to serve the dental profession and dealer/distributor community during these trying times. We look forward to assisting you!
As a dental professional, your line of work has the potential to leave you more vulnerable to COVID-19 than many other professionals.
First, there’s the fear of what all people are dealing with: asymptomatic spreaders unwittingly putting you, your coworkers, and patients at risk during an appointment.
Beyond that, dentists, dental assistants, and registered dental hygienists are all in the very-high-risk category for aerosol production due to drilling and cleaning processes. Aerosols travel long distances, up to 20 feet, from their source. They also remain suspended long after your hypothetically infected patient leaves the dental chair.
Still, COVID-19 or not, your patients need your help, and you must earn a living. All you can do is protect yourself from the perils of dangerous risks like aerosols.
Naturally, the number one COVID-19 preventative measure for dental professionals is the correct use of PPE. For this notion to ring true, first and foremost, you require the most optimal equipment.
Securing Proper Dental PPE Equipment During COVID-19
Currently, many find it challenging to secure industry-standard PPE equipment, with dental practices scrambling to get back up and running amid the pandemic.
The surge in demand has far eclipsed the supply, causing high anxiety levels for dental professionals throughout the country.
Unfortunately, this looming issue has also led to an abundance of counterfeit products flooding the PPE market. Namely, knockoff N95 masks have resulted in multiple recalls.
They, too, cause problems with fit testing – a primary component of medical-grade equipment.
N95 masks are integral to dental professionals, and any discrepancies in how they are manufactured leave you open to some severe dangers.
While there are certified knockoffs on the market, there remains the need to ensure those masks have NIOSH's stamp of approval. These legitimate imitation models are known as KN95, for the record.
Regarding the rest of the substandard imitations that don't meet specifications, these counterfeits will lead you astray. For a mask to be medical grade, it requires several layers of nonwoven material (e.g., polypropylene).
Furthermore, there are rigorous design specifications for the size and number of particles that authentic N95 masks can block. They’re put through a steady stream of tests before being certified.
Why Must Dental Professionals Stick with N95 Masks?
For optimal protection against dental aerosols, there's nothing compared to the N95s. It's worth noting that surgical masks are an option for other healthcare workers to protect against droplets, splashes, or sprays.
However, N95 masks accomplish an almost suction-like facial fit, boasting a highly evolved filtration against submicron airborne particles.
The N95/KN95 classification verifies that the respirator defends against a minimum of 95% of minuscule (0.3 microns) test particles. When these masks/respirators are correctly fitted, they exceed the filtration of standard PPE.
With the heightened risks involved in dentistry, investing in reliable equipment is necessary. Even if you're worried about budgeting, prioritize your spending on PPE that most protects those in your practice.
Best Practices to Purchase Legitimate PPEs
Below, we’ve prepared a short list of suggestions to help keep counterfeit PPE out of your dental practice.
Tip #1: Be an Eternal Realist
Don’t get lured into promises of tons of inexpensive equipment with unrealistically quick delivery. Remember that supply chains are strained, reliable PPE won’t be cheap, and deliveries will be slower than usual.
Tip #2: Perform Your Due Diligence
If you’re looking for an alternative to your regular supplier, research the person or company carefully. Find out how the masks are being supplied. Keep an eye out for red flags, e.g., someone saying they represent a Calgary-based company, but they sell out of Nova Scotia.
Tip #3: Meet the Maker
Know where the product is manufactured, ensure the distributor is approved, and validate their documentation. It isn’t easy to forge all documentation (e.g., instruction manuals, certification). Peruse all documents to see if there’s a warning sign.
Hopefully, we’ve eased some of your PPE-related anxiety as you get your dental practice up and running during COVID-19. Sable Industries Inc. is open and here to support your business needs.
Research shows that up to 90% of children across the globe deal with untreated dental caries.
These youngsters face the potential for long-term and short-term consequences: worsening pain and discomfort that intensifies without treatment, and difficulties eating, sleeping, learning, playing if the problem persists. Left untreated, the circumstances can be severe enough to necessitate surgery.
These adverse outcomes are discouraging, since they’re easily preventable with proper education.
As such, there’s really no substitute for providing quality education on this growing issue. And since not all families in the United States and Canada have consistent access to dental care, this education often comes from nurses, teachers, and social workers.
However, there are two crucial caveats:
The information must be accurate.
It also must be consistent.
Recently, a first-of-its-kind study published in the journal BMC Oral Health assessed the effectiveness of childhood dental advice given to expectant parents and parents with toddlers by non-dental professionals (such as teachers, social workers) on children's oral health.
Alarmingly, these researchers’ findings suggest that this non-professional advice yields mixed results.
Effectiveness of Preventive Dental Programs Offered By Non-Dental Professionals
In this study, researchers analyzed five databases, seeking out quantitative studies that assessed the success of dental interventions by non-dental professionals. The interventions were focused on expectant mothers and mothers of toddlers.
All of the nine chosen studies measured the following results:
Outcomes and changes in the children’s teeth just before the age of five; and
Outcomes and changes of said children’s mothers at the same time.
The goal of this research was discovering if current mother-centric oral health programs are generating positive results. Researchers also wanted to discern the comprehensiveness of these programs, and whether they lack education that could be valuable to patients’ dental health.
The results were decidedly mixed. When the mother was guided by a well-rounded team of specialists (e.g., social workers, nurses, and dental professionals), the toddlers had fewer dental caries and extractions compared to toddlers with mothers not receiving guidance. The results were more positive when childhood dental advice was paired with free dental supplies such as toothbrushes, toothpaste, mouthwash, and interdental aids.
However, while the children of mothers with teams guiding them got off to a great start, these positive results don't continue after toddlerhood. Most of the mothers making use of these programs lacked a fundamental understanding of dental-related issues.
Additionally, there appears to be a lack of cohesiveness in dental education shared by non-dental professionals. Issues with accuracy and omitted details were both prevalent.
The Crucial Role of Dental Professionals
Despite a lack of statistical support, it is clear from the results that these programs do help many families who wouldn’t otherwise have access to care. However, it is also evident that such programs would benefit from greater involvement from dentists, registered dental hygienists, and other dental professionals.
As a dental professional, our success in enhancing these younger patients’ outcomes is predicated on how well we communicate with the non-dental professionals involved in their care. Dental professionals can provide accurate and viable information about dental hygiene best practices and preventative care that ensure families in these programs receive correct information and cohesive guidance.
Depending on where your dental practice is located, you’ve likely reopened — but notice that patients are hesitant to visit your practice in-person.
These fears aren’t unfounded. The CDC’s COVID-19 Infection Prevention Team warns that dental settings have unique characteristics that warrant specific infection control considerations. Being in an environment where instruments create visible sprays with particle droplets of saliva, blood, and microorganisms feels risky, even where case numbers are low.
Now, we’d be remiss in failing to mention how there haven't been any COVID cases connected to dental practices as of yet. But with surfaces potentially being contaminated for 3 hours, industry professionals need to find a way to treat clients who refuse to visit their offices.
What can fill this gap in dental care?
Increasingly, it looks like teledentistry might be the answer.
What is Teledentistry?
Teledentistry applies the same principles of telehealth, except with the scope only revolving around oral health.
This kind of care utilizes various technologies to provide dental care and education to treat patients remotely.
Through the following methods (and more), dental professionals can provide “tele-dental” services to their patients:
This can happen with either Skype, Zoom, or other video-chat technology, and it happens in real-time.
Store and forward
Patients store and send their health information via radiographs, photographs, video, digital impressions, and photomicrographs to their practitioners.
The practitioner looks at this information at a different time than when it's sent (so, it's not in real-time).
Remote Patient monitoring
Different dental practices can share information (usually through data processing services) to provide supportive care or direct care.
Mobile communication devices such as cell phones, tablet computers, and personal digital assistants (PDA) can help support dental care.
The Future of Teledentistry
Eventually, there will be a vaccine for COVID. At that point, fears over the virus will begin to subside. However, that doesn’t mean that teledentistry is only temporary.
Once you’ve shown patients the capabilities of teledentistry, it’s akin to opening Pandora’s box. Sure, there’s going to be instances where in-person visits are unavoidable. Yet research shows that patient success-rates are the same when they use telehealth compared to when they don’t.
Therefore, this convenient form of care doesn’t seem to come at the cost of quality.
There’s also the matter of general dental anxiety. Some patients fear oral care for reasons outside of the pandemic. Teledentistry provides these people with an option to avoid dealing with the stress of in-person visits.
It seems like teledentistry will remain a significant part of many practices, even when everything returns to "normal."
The Long-Term Benefits of Teledentistry
Let’s take a look at the benefits that clearly outline why teledentistry is here to stay:
1. Reducing Overhead Costs
Virtual consultations manage to mitigate potential miscalculations for appointment times. The nature of emergency treatments isn’t always apparent when only a phone call is involved, leading to dentists blocking off too much time. Similar missteps occur with more straightforward visits for prescriptions.
Knowing how long appointments streamlines that day and ensures time is being spent most efficiently. Plus, prescribing medications during virtual calls opens up chair-time to patients who need it.
2. Removing Geographical Limitations
Teledentistry can be a fantastic boon for people that live in communities with limited access to dental care. They can receive guidance and prescriptions to better their oral health while at home or in the office. That's a far more realistic option than driving 2 hours for a half-hour examination!
Moreover, it gives you a chance to expand your patient-base by offering routine care to people who usually can't access it.
3. Improving the Patient Experience
Many patients are incredibly busy with their work and family. Teledentistry will meet these people in the middle. They won’t need to block off big chunks of time to drive and sit around at the office on top of the appointment.
Other patients lack transportation, and teledentistry offers them an alternative to paying an expensive cab fare or bothering someone for a ride.
Teledentistry Will Revolutionize the Dental Industry
You’ll want to strike while the iron is hot with teledentistry because it’s not going anywhere — even when the pandemic is long gone. As technology advances and patients begin to expect more from their dental care, adopting this technology will be a primary component of any thriving practice.
As your dental practice begins to welcome patients again, their safety and that of your dentists, hygienists, and the rest of your staff is paramount.
With a heightened public awareness of cleanliness, sanitation, and safety, any hint of poor practices can damage your reputation. Furthermore, you can’t afford to put yourself, your team, and your community in harm’s way.
Unfortunately, many dentists aren’t protecting themselves or their patients from the potential infections that come with being exposed to those germs, particularly in the form of dental aerosols.
What Are Dental Aerosols? Are They Related to COVID-19?
The working definition of a dental aerosol is a solid or liquid particle in a gas, produced during many dental procedures, under 50μm in diameter (anything bigger is classified as splatter.) Dental aerosols are created when scalers, drills, and other high-speed equipment interact with saliva, blood, or plaque.
Although not all dental aerosols are harmful, these airborne materials can contain harmful bacteria and viruses, including COVID-19. Dentists who treat patients using aerosolization are at high risk of infecting themselves, their dental assistants, and others working at their practice.
It should then come as no surprise that dentists find themselves afflicted with respiratory infections more frequently than most, due to the perils of their environment. In addition to concerns regarding COVID-19, there is also proof of aerosols harbouring other cross-infection risks, including the common cold, sinusitis, pharyngitis, pneumonia, tuberculosis, SARS, influenza, and swine flu.
Moreover, harmful pathogens caused by aerosols linger in the atmosphere long after you’ve finished with your patients. In fact, contamination occurs most frequently due to the inhalation of infectious particles after they have settled on surfaces.
Another way aerosol contamination often occurs is when the evacuation system or dental unit waterlines are of poor quality or have been compromised in some way. This can result from water stagnation, inadequate cleaning, heating of your chair unit, and reservoir bottle contamination.
The health risks of aerosols vary between patients, depending on their saliva, blood, plaque, and mucus, and if there's any infection present.
Managing Aerosols at Your Practice
The perils of aerosols can be mitigated through proactive aerosol management measures, such correct fittings, appropriate level masks, high volume suction, and the use of products that protect the patient’s nasal passages. You and your team should adhere to a comprehensive infection-prevention plan the moment patients enter the practice.
Given that the risk level of a dental aerosol depends on a patient’s health, you should gain a full medical history of your clients. This means completing a thorough examination and making your patient rinse their mouth with a microbial mouth rinse before treatments.
Face masks, of at least ASTM Level 3, should be snugly covering your mouth and nose. Only use a mask for one appointment, switching to a new one for each patient.
Regarding treatment-based equipment, flush lines and reservoirs with a microbial evacuation system cleaner like Bio-Pure. Bio-Pure is a non-foaming, 100% natural cleaner that can be used anywhere there is organic waste and water, including plaster traps, cuspidors, and drains.
Dental aerosols are a major concern for infection control within dental care, especially in light of COVID-19. We hope that this advice will help you and your team feel safer and better prepared to face this post-pandemic world with confidence. Reach out to us to learn more about any of our EPA-compliant cleaning products.
Evaluate your office/practice and assess the surfaces and materials that comprise the space.
Light switches, doorknobs, and other regular areas will need extra attention paid for cleaning and disinfection to reduce the risk of spreading germs.
Now it’s time to execute on what you’ve developed.
To ensure optimal cleaning/disinfecting, thoroughly read the manufacturer's instructions for all products.
During any cleaning and disinfecting, ensure that you’re wearing gloves and other required personal protective equipment (PPE).
3. Maintenance and Revision
Continue to update your implemented plan based on evolving guidelines.
Also, keep an eye out for potential blind-spots you might have had during the development stage.
How to Properly Clean & Disinfect a Surface
People tend to conflate ‘cleaning’ and ‘disinfecting’ when they’re really two separate processes. One valuable source of information breaks down the dual-process in very straightforward terms:
For cleaning, your primary focus is the removal of germs, dirt, and impurities from surfaces. This way, you’ll mitigate the potential for infections to spread.
After cleaning is when disinfectant products do their best work. They kill the lingering germs on surfaces, thus further offsetting the possible spread of infection.
As has been established in the previous section, wear gloves and any other necessary PPE to keep yourself safe. Given that you’re working in a dental office, additional protective equipment should be considered.
Clearing Up the Confusion: Cleaners Versus Disinfectants
Cleaning can be performed with water and either soap or detergent.
Conversely, disinfectants are generally sprays, concentrates, and wipes—all of which can be employed in preventing COVID-19.
According to the EPA and CDC, following the product label instructions is a non-negotiable must. Doing so will keep you informed on how long you should leave products on the surfaces to successfully eliminate germs. There’s also the matter of rinsing the product so that you don’t ingest harmful chemicals. Plus, you want to keep those products out of the reach of children.
Something else to consider is that it’s been suggested not to overuse or stockpile both disinfectants and PPEs. Given the current circumstances and the need to combat COVID-19, you need to do your part in preventing shortages in the case of emergencies.
Lastly, you might experience a situation where the EPA's requested disinfectants aren't accessible. In this instance, those same guidelines establish other ways to disinfect surfaces that are equally effective at staving off COVID-19.
Click here for a list of CDC and EPA-requested disinfectants.
Other Crucial EPA & CDC Guidelines to Consider
Naturally, running a dental practice exposes you, your staff, and your clients to an array of excess germs compared to the average business.
Thus, measures must be in place to protect everyone who'll come into contact with your practice and the surrounding community. This means stringent social distancing rules must be maintained.
Furthermore, all practice staff should be wearing cloth face coverings and frequently washing their hands. Keep on top of federal, state, tribal, territorial, and local guidelines as they continue to evolve and shift in nature.
Adapting to the New Normal
These guidelines might seem a little bit intense, and something of a headache on top of everything else required to run your practice. After all, being successful in the dental industry requires in-depth focus and dedication outside of keeping your office COVID-proof.
However, maintaining these cleaning and disinfecting standards contributes to the greater good of society. All while keeping your practice safe. And eventually, at least until there’s a vaccine, these methods will slowly become second nature.
Above all else, you’ll find that these measures offer you tremendous peace of mind!
PPE, short for personal protective equipment, has always been important to dental professionals. It helps us protect ourselves and our patients from the spread of germs and disease. But with the COVID-19 pandemic this year, wearing PPE is more crucial than ever.
Healthcare professionals are now the most at-risk group for coronavirus as they work in close contact with patients. The challenges surrounding PPE use, as well as the risk of PPE failure is unfolding before our eyes.
As a result, PPE must be used vigilantly by all healthcare professionals, including dentists and dental hygienists.
But one side effect of PPE that isn’t often discussed is the severe skin damages it can cause – especially when preventative measures aren’t taken to combat it.
Here, we’ll highlight how the use of PPE can result in skin damage, how to minimize skin damage, and how your own dental practice can be proactive in mitigating the risk.
Types of Common Skin Damage While Using PPE
A new study on medical workers treating COVID-19 patients discovered that 42.8% of staff experienced serious skin damage linked to the use of PPE. These items included masks, goggles, face shields, and protective gowns.
The study consisted of 2,732 medical respondents. They were among the first healthcare workers fighting coronavirus in emergency departments, screening clinics, isolation areas, infectious branches, and as well as voluntary staff who wore PPE.
According to the study’s findings, 1,844 medical respondents experienced 4,735 skin injuries, equating to 2.6 skin injuries per respondent. Stage 1 injuries were registered by 81.1% of the respondents, 18.3% experienced stage 2, and 0.6% suffered from deep tissue injury.
Researchers discovered three main types of skin injuries relating to PPE: device-related pressure injuries, moisture associated skin damage, and skin tear.
Various factors increased the risk of skin damage. These include heavy sweating, longer daily wearing time, being male, and using grade 3 instead of grade 2 PPE.
Interestingly, skin injuries were more common in males than females, with 59.7% of men experiencing damage compared to 40.5% of women. Doctors were also more likely to suffer skin damage from PPE than nurses, with 51.9% of doctors experiencing injuries than 41.6% of nurses.
Skin injuries from PPE were also more common in the following groups:
Those wearing grade 3 PPE compared those wearing grade 2 (88.5% versus 21.0%)
Those using PPE longer than four hours than those with daily use time equal to or less than four hours (47.3% versus 18.7%)
Those older than 35 than those younger than 35 (46.3% versus 41.2%)
Those with considerable sweating than those without considerable sweating (91.3% versus 17.8%)
Avoiding Skin Damage When Using PPE
The same study also concluded that the treatment of skin injuries relating to PPE was insufficient.
Only 17.7% of respondents applied prophylactic dressings and lotions that protect the skin. Medical staff and managers overlooked skin protection during the early stages of the coronavirus pandemic, and respondents received no training or education in prevention.
To prevent damage to the skin when using PPE, dentists and hygienists are advised to use preventative methods such as prophylactic dressings and lotions to avoid tear and injury. If you so become injured, these wounds must be treated immediately with hydrocolloid dressing, oil, or cream to ensure a quick recovery and to avoid infection when treating patients.
Preparing for PPE Skin Injuries During a Pandemic
That’s because medical staff and managers overlooked skin protection during the early stages of the coronavirus pandemic. As well as this, respondents received no training or education in prevention and didn’t know how to use dressings.
Of course, in the height of the pandemic, the risk of skin injury is unlikely to be a priority. But today, as dentists and dental hygienists prepare to reopen, we can and should be vigilant.
To reduce the risk of skin injuries and infection in wearing PPE, dental professionals should provide their staff with resources and training in skin protection; and protective items should be chosen and distributed to staff according to guidelines.