Dental offices were among the first businesses allowed to resume operations in May after being asked to close for non-emergency services in March. Guidelines from the state Dental Board offer a roadmap but each office is figuring out what works best for them and what services they're comfortable providing.
At Montgomery Dentistry, Michael W. Hull, DDS, says there was a lot to consider before reopening this week. His office with five staff was closed for almost two months with a few exceptions for emergencies.
"There were a lot of things - trying to weigh out when we could reopen, when we felt it was safe," he says. "Once they felt like we could reopen, it was a matter of, can we get the right protective equipment in place to do this in as safe a way as possible?"
As he speaks, Hull's voice is muffled by layers of masks. All employees are wearing N95 masks when in the office, only removing them for lunch. On top of that, Hull and the dental hygienists add a standard surgical-style mask that's discarded after each patient, and a plastic face shield.
COVID-19 is spread through droplets and vapor. Dental procedures and equipment produce a lot of aerosolized particles, hygienist Kathy Mettey points out.
"We're trying to minimize that. I have an ultrasonic cleaner that I use on patients that need it, it's just a deeper clean. Nobody's using those right now because it creates a lot of aerosol. Dr. Hull's fine with us using the polish, some offices are not polishing because of that same reason."
Editor's note: To be clear, the office is not using the high-aerosol producing equipment.
Mettey's wearing a cheery purple disposable button-front jacket but says the office is trying to get gowns to offer more coverage. There's some talk about wearing hairnets, too, because of the air particles.
Getting the necessary PPE to open wasn't easy, Hull says. "Our normal vendors were completely out of the things we needed to get and so it became a matter of calling around other dentists and other vendors to try to find the right protective equipment. Yeah, it was very difficult."
Hull says he does believe he has enough supplies to remain open and it appears suppliers are catching up with demand. "The pulse that I'm getting is that we'll be able to continue to get the things that we need."
Magazines no longer adorn the waiting room and there's no one to read them anyway. Appointments are spaced further apart and patients call when they arrive and are told when to enter the building. Plexiglass barriers separate the reception desk. Patients answer health screening questions prior to their appointment and again upon arrival and have their temperature taken.
Also new is a hydrogen peroxide rinse that must be swished for a minute before a procedure to kill any bacteria or viruses that may be in the mouth.
Mettey says she had a lot of emotions about returning to work - nervousness, excitement.
"Getting back to a new norm is good and a routine is good. Being with people is good. There is apprehension but we have to move forward. We're all taking a risk but I feel like we're doing as much as we can to protect that for the patient and for us."
Hull says he wouldn't be operating if he didn't feel it was safe. "I think I speak for everyone in the dental community - everyone I know - we're doing our absolute best to ensure everyone's safety. I think we wouldn't be operating - at least the way I operate my practice is I wouldn't do anything that I wouldn't be comfortable doing myself. I think the procedures we have in place, the screening we have in place, and the equipment that we're using is to ensure everyone's safety."
He respects that patients have to use their own judgement about whether they're comfortable coming to the office. He says the reaction from patients has been mixed in terms of people feeling comfortable about going into the office. Some people are postponing appointments but others are still showing up.
May 15, 2020 - This story has been updated to correct that magazines have been removed and are not still available as previously suggested, and to clarify the office is not using high-aerosol producing equipment.
