Covid And Beyond – A New Standard Of Care

As we begin a new era in infection control, the Center for Disease Control has started the process of setting up new guidelines to keep you as the patient and us as the dental team safe. The guidelines, however, keep being modified as the medical community and scientists find out more about how this nasty virus behaves. As these procedures and guidelines evolve, we understand the goal is to mitigate risks, as well as prepare for any other devastating diseases that may happen in the future. As these guidelines and procedures change, we will be sure to keep you and all our patients informed.

We have worked hard to stay on top of things in this uncertain environment and go beyond the new standard of care, as we always have done. The AIDS epidemic of the 90’s caused the CDC to develop very stringent guidelines for blood-borne pathogens, which have proven effective in medical and dental environments. The CDC is in the process now of developing and recommending similarly stringent guidelines for aerosol- borne pathogens such as the COVID 19 virus. Going forward, we do anticipate that this will become the ‘new normal’ in dental care to protect both our patients and our team. While this will require extra measures for safety, we are prepared and are already implementing many of the anticipated protocols, as well as establishing extra procedures to meet this new reality.

In public spaces all over the country and the world, the past 2 months have seen many changes on how we are now allowed to interact with each other. We still can’t go into a restaurant for a sit-down meal, or even sit down in a coffee shop for a cup of coffee. Grocery shopping has been an adventure, as well.

Many things have also changed literally overnight in the medical and dental professions, in terms of how we now interact with and treat our patients. Thankfully, the extra steps we already take in our office to meet a higher level of care have better prepared us for adapting to these events. Because of this, we have resumed our office’s full-time schedule. This includes our hygiene department.

In light of this emerging crisis, and being guided by the CDC, the American Dental Association, the Colorado Dental Association, Mercy Regional Medical Center, and the San Juan Basin Health Department, here are the changes you will see in our office as we move forward in this new normal:

• Our waiting room is now basically a ‘virtual’ waiting room. When you enter the office, we will require you to wear some type of facial mask. We will only allow one or two people at a time in the waiting room, separated by social distancing of 10 feet or more. We may also ask you to wait in your car, in which case we will text you when we are ready to take you to the operatory.
• You will be asked several questions regarding symptoms of COVID. We will also take your temperature with an infrared-type device aimed at your forehead (the same used in hospitals). Any patient with a temperature of 100.4 or more will be sent home and asked to reschedule once their fever and any related symptoms are gone.
• You will no longer find magazines or any articles that you can touch in our office that could become a transmission vessel.
• There is hand sanitizer at the front desk for your convenience. We will also ask that you go into the restroom and wash your hands upon entering the space.
• You will see that our assistants and hygienists wearing more PPE (personal protective equipment) garb that they will change frequently. You may not recognize us. (I am not sure our new patients will ever realize that I have a mustache!) We will be wearing higher level masks, face shields and for some procedures we will wear surgical gowns, caps, and shoe covers.
• Throughout the office, you will see two Ozone generators going 24/7, as well as our negative ion generators. These control the quality and movement of the air and remove pollution, kill bacteria, viruses, and mold. As you walk through the office, you will smell our mixture of aroma therapy oils, designed to not only relax you but also disinfect the area.
• Before you sit in one of our dental chairs, we will mist your face with a very mild, nontoxic, safe and natural solution of hydrochlorous acid, which kills bacteria and viruses. We will also ask you to swish with our ultra-purified, ozone generated water, spit it out and then drink some. (I have written several research papers on ozone in dentistry and have been using it in the office for over 20 years in many of my procedures, including hygiene care with our ultrasonic scaler. I will write more on the value of ozone for health soon.
• We will also have you swish and swallow a pump of all-natural Biocidin, an antiviral and antibacterial product that has been proven in the scientific literature. (In light of my research, this company also produces a toothpaste and mouth rinse that we sell and have been favorites of our team and patients, as well as many other natural health care practitioners all over the world.)
• We will be installing extra oral high-speed suction equipment that will either hover in front of you or be attached to a rubber dam holder or our standard cheek retractors. This is to prevent any excess aerosol contamination and keep the area as sterile as possible.

What you will not see is how we disinfect the office, including anything you may touch such as door handles, pens, restroom, etc. You will not see how we “fog” and disinfect the dental operatory before you come in, and after you have left. You will probably not see how we process and sterilize the instruments, or how thoroughly we disinfect everything from the hoses to the keyboards of the computers. You will never see how we monitor our sterilizers for effective sterilization of the instruments and handpieces. You will never see the rigorous training my team goes through, as a new employee or during our yearly official training program. You will never see the discussions we have about emerging science, and changes in the standard of care in our monthly meetings and since recently, our daily morning huddles. And you will never see how much time we really put into keeping you safe by thoroughly researching articles and identifying what leading offices and hospitals are doing across the nation.

What we do hope you have noticed is the dedication that our team has to you, our patients. They have been there and at the ready, every day since this crisis started. I am very proud of this team, who have consistently put our patients first as we stayed open seeing emergencies when other offices were closed, and to help relieve Mercy Regional Medical Center’s emergency room by being on-call for their dental emergencies

Going beyond the standard of care. Keeping you safe and keeping ourselves safe. This is what first responders do!

We are proud to do this for you, our patients, and for our community.

Sincerely,

John A. Rothchild, DDS, FAGD, MAGD, IMD, DAAPM, DIDIA