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FARMINGTON – What does social distancing and personal safety look like for dentists and patients during the coronavirus pandemic?

Regional dental care providers say they have implemented a series of changes and best practices to ensure routine cleanings and procedures can be done safely and to minimize the danger from a virus that can spread through airborne droplets.

Early in the COVID-19 pandemic, the American Dental Association was one of the first national health associations to recommend postponing non-urgent or emergency procedures to decrease the spread of the coronavirus and conserve essential personal protective equipment. By late May, when dentists and doctors were beginning to reopen for nonemergency services, the association released a list of safety procedures and recommendations to guide dental offices.

Some of the recommendations were already considered best practices in the field, but the pandemic and the association’s guidance have reinforced some of those practices, said Robyn Cole, a dental hygienist at Integrity Dental in Farmington.

She said Integrity Dental and many others have placed “barriers,” or plastic coverings, on surfaces and tools used during a patient’s visit. The replacement plastic sheeting should be on suction straws, equipment handled by the dentists and light handles. Those practices are included in the association’s recommendations.

Cole said one of the bigger changes her office has made is scheduling patient’s appointments for 25 minutes longer. This change is to allow extra time for safety precautions, such as cleaning between patients and ensuring patients do not cross paths with other patients.

“It’s to allow for social distancing, so to speak,” she said.

Sunrise Dentistry in Durango allows two patients in the waiting room at a time and has additional seating in the hall that is spaced 6 feet apart, said Carolyn Chandler, the front office manager at Sunrise. Chandler said the dental clinic also removed its carpet and installed hardwood floor and removed cloth furniture in favor of plastic furniture that can be wiped down.

“We’re trying to do our best to keep everyone safe and keep everyone healthy,” Chandler said.

The American Dental Association’s guidelines say patients should be screened for COVID-19 symptoms before entering the office. Both Sunrise Dentistry and Integrity Dental said they have implemented temperature checks and symptom screening questions before a patient is allowed into the buildings.

Cole said the lengthier appointments have meant dental offices are not able to see as many patients each day as they were able to pre-pandemic.

“The profit is not there when you do all of this,” she said.

Dentists are also required to wear more personal protective equipment than before. For many procedures, dentists and staff members are wearing a full gown, an N95 mask, a face shield and hair bonnets.

“It’s very, very hot for us,” Cole said. “It’s very difficult to take everything on and off.”

Sunrise Dentistry also has a Sentry Air System to extract air from the area where dentist Dr. Dale Strietzel works on a patient. The system pulls in 350 cubic feet of air and aerosols per minute and is used when the dentist is drilling or handling mercury.

Federal support for clinicsIn a health care landscape becoming dominated by corporate models, dentistry has not escaped the trend. According to a 2020 review, the dental field has moved toward an increasing number of dental support organizations, or corporate dental practices.

In two letters to the U.S. House of Representatives and Senate in mid-July, the American Dental Association urged Congress in the next coronavirus relief package to pass additional financial relief for smaller dental practices facing economic struggles and low profits.

The association asked Congress to include tax credits for small dental practices buying additional personal protective equipment and making office safety improvements to meet new public health standards.

While dental practices were allowed to apply for early rounds of the Paycheck Protection Program loans, the association is asking Congress to allow more flexibility in how small dental offices could use that money. It argues small businesses should be allowed to use the loan money to purchase personal protective equipment and to allow 501(c)(6) organizations, typically a membership-based business group, to apply for the loans, too.

Offices are busyDespite any coronavirus concerns, most patients seem ready to schedule routine cleanings and dental procedures. Many offices in Durango cited busy schedules this week.

Cole said only about 10% to 15% of Integrity Dental’s patients seemed hesitant to come in. Often after explaining all the safety procedures, patients’ worries were lessened, she said. If patients are seeking emergency and urgent services, they are often more willing to come in.

“You can’t out-wait the pandemic if you’re in pain,” she said.

Chandler also said patients have expressed concern when calling to schedule a cleaning or dental procedure.

“They have asked what are we doing to protect them,” she said. “But after explaining everything, most of them have kept their appointments.”

Cole recommended concerned patients educate themselves about the American Dental Association recommendations and ask their own dental care provider if they have implemented the changes.

Cole said she can understand patients might be nervous about coming in or frustrated about having to wait outside and having their temperatures checked, but she wished they could see all of the added work the dentists, hygienists and staff members do to protect them.

“Don’t stop going in for dental care,” she said. “That’s never the answer.”

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