COVID-19 INFECTION CONTROL

You will find a lot of resources here for dentistry. This page is constantly being updated as new information is available so be sure to check back often for new content.

At a minimum the dental practice should be following guidance from their State Board, state government requirements, and Centers for Disease Control (CDC).  

Learn more about COVID-19 Safety Management Program

Practices that are providing patient treatment must continue to follow Standard Precautions, which includes use of personal protective equipment, good hand hygiene, sharps safety, proper sterilization procedures, and disinfection of all items that could be contaminated with a dental patient’s body fluids.

Get a free COVID-19 Safety Checklist

Preparing your practice for change in treatment hours
If you have shortened your work week or are temporarily closing your practice, then there are  suggestions for equipment and other items you may want to consider preparing for non-use. See recommendations.

Disinfectants Effective Against COVID-19
For COMMERCIAL/HOSPITAL-LEVEL DISINFECTANTS: SafeLink has consulted with manufacturers of some of the most commonly used products in dental practices and dental labs for disinfecting. What we learned was that not all disinfectants are effective in inactivating the COVID-19 virus. We are not recommending any particular disinfectants to use since there are so many out there. It is best to contact the manufacturer of that product to confirm whether or not it is effective against COVID-19. Follow the manufacturer’s instructions for use for your particular application. See Disinfectants for use against SARS-CoV-2

Dental Practice Staff Safety - Employee Protection
For healthcare workers who are treating patients known to be infected with COVID-19, the CDC recommends use of the N95 respirator as a face mask. Also protect your eyes, wear gloves, and gown.  CDC recommends use of disposable gowns rather than washing them, but due to shortages washable items may be more practical.  Washing your hands is critical to practicing standard precautions. 

Patient Screening
If you determine that patient screening needs to be implemented, then consider screening patients when they call in for an appointment as well as when patients arrive for a scheduled appointment. Daily decontamination of waiting room furniture and furnishings is advisable.  Maintain the 6' physical distancing between patients in the lobby area as well as between your front office staff and the patient as they sign-in. Get HIPAA training and compliance. 

Learn more about Managing Risks of Coronavirus COVID-19 in a Dental Practice Setting

CDC Resources:

Coronavirus Disease 2019 (COVID-19)

Postpone Non-Urgent Dental Procedures, Surgeries, and Visits

Coronavirus Disease 2019 (COVID-19) Infection Control

Healthcare Professionals FAQs

Prepare to Care for COVID-19: Get Your Practice Ready

Other Resources:

Public Health Department

State By State Recommendation Regarding Dental Care During COVID19 Spread

Get Coronavirus Poster for the Dental Practice

Get virtual safety training & assessment. 

Why is assessing compliance so vital and how often do I need to train my staff?

Top Five Safety Compliance Issues All Businesses Should Know

OSHA Compliance Solutions for the Dental Practice

Get an OSHA Consultant

Contact SafeLink Consulting

HIPAA Employee Need to Know:

The COVID-19 pandemic has brought to the forefront the need to protect patients and workers through the use of personal protective equipment (PPE). 

Until this pandemic which has created shortage of PPE, employers have been able to protect their workers with masks, gloves, gowns and safety eyewear or face shields.  The CDC and FDA have reacted to the shortage by allowing the use of alternatives to the N95 respirator.

Health & Safety Manual options specific to dentistry

OSHA requires employers to protect their workers first through the use of engineering and administrative controls so these steps are even more important now.  Employers must assess the hazards and implement controls to eliminate or minimize the hazards before requiring the use of PPE.  This PPE is even more important now due to the method of transmission of COVID-19 through coughing, sneezing, and even talking within close proximity.  Now that there is a shortage and there’s a pandemic, the PPE is well-respected and considered a necessity. Get Virtual Safety Training + Assessment.

Learn More:

COVID-19 and OSHA Guidance on N95 Respirators

Top OSHA and FDA Updates on Mask and Respirator Shortage

CDC Resources:

Symptoms to watch for in Infected Person

Epidemiologic Risks

Understanding the Difference - Surgical Mask and N95 Respirator

CDC FAQ About PPE Equipment

Strategies for Optimizing the Supply of N95 Respirators

OSHA Resources:

OSHA website for healthcare workers

U.S. Department of Labor Issues Temporary Enforcement Guidance for Respirator Fit-Testing in Healthcare during COVID-19 Outbreak

FDA Resources:

N95 respirator 

FDA list of authorized emergency-use respirators for HCP

Enforcement Policy for Facemasks and Respirators During the Coronavirus Disease (COVID-19) Public Health Emergency Revised April 2020

Other Resources:

Contact SafeLink Consulting for assistance

Take online course: Employee Health & Safety Training for Dental Clinical Environment

Once we get through this current situation there will be a new normalcy that will exist. Infection Control will remain in the forefront.

The pandemic of COVID-19 has created real challenges and uncertainties for dental practices.  Some practices are continuing to provide essential and emergency services and others are waiting to re-open their practices.  One thing for sure is that at some point during this pandemic, dental practices have had to ensure that their infection control procedures and policies are working to protect their workers and their patients. 

So what will be the long term impact of COVID-19 on infection control? The Long Term Impact of COVID-19 on Infection Control in the Dental Practice to learn more about how you can apply the latest CDC, OSHA, and FDA policies relating to the COVID-19 safety concerns to your practice now and in the future. 

Dental practices must ensure that their infection control procedures and policies are working to protect their workers. Here you'll find some helpful Q&A from SafeLink Consulting's Webinar: Long Term Impact of COVID-19 on Infection Control in the Dental Practice held on April 16, 2020. 

Get a Health & Safety Manual for Dentistry

Contact SafeLink Consulting for assistance in developing your Risk Mitigation Policy, writing your safety compliance program, or training  your staff on patient and worker safety including CDC / OSHA / HIPAA / EPA guidelines and requirements.  SafeLink's consultants are ready to help!

Learn more about the Long-term Impact of COVID-19 on Infection Control in Dental Practices

Get a customized OSHA Health & Safety Manual for your dental practice

Manage your OSHA compliant Health & Safety Manual securely online

Workplace safety training is a major requirement of most of OSHA’s standards. 

Employers must communicate workplace hazards to employees and instruct them on how to protect themselves from injury or illness.  Workplace safety training should include all company safety policies. 

Learn more about Virtual Safety Training for Dentistry

If you plan to do training for your dentists and staff, it is recommended that you use OSHA's information published on protection of workers from the coronavirus along with information from the Centers for Disease Control.  Stress the need to continue to practice Standard Precautions. 

Get virtual safety training & assessment. 

The objectives of safety training are:

• To avoid and reduce injuries and illnesses of employees by providing appropriate information concerning the physical and health hazards that could be present in the dental practice.
• To reduce property and/or environmental damage caused by dental operations, instructional activities or hazardous materials/chemicals used.
• To comply with all applicable OSHA standards and any applicable state safety requirements.

Most importantly workplace safety training helps ensure workers go home safe to their families.

Training must be conducted by individuals knowledgeable about the subjects of the training.  Information and materials provided by outside sources can be used in the training along with videos, online courses, or webinars, however, the training must be specific to the dental practice.  For instance, when emergency action planning is being covered, it’s important to discuss the location and use of the emergency equipment in place in the practice along with evacuation and severe weather gathering places.

Get a professional safety trainer.

Always document the training activities.  The Training Register should contain the date and time of training, name and qualifications of the trainer, subjects covered, names and signatures of attendees.  Retain these records for your Bloodborne Pathogen training for a minimum of three (3) years. Other training records should be retained according to your policies, however, as a Best Practice it could be three (3) years.

Why is assessing compliance so vital and how often do I need to train my staff?

In the Centers for Disease Control’s 2016 Summary of Infection Prevention Practices in Dental Settings, CDC recommends appointing an Infection Prevention Coordinator who performs frequent inspections of the infection control practices.  Assessing these practices more than annually provides an opportunity to close the gap more frequently on unsafe infection control practices.  This goes for all of the safety policies. 

Learn more about Virtual Safety Assessment for the Dental Practice

Other Resources:

Infection Prevention Coordinator's Responsibilities for the Dental Practice

Proper Removal of PPE for Infection Control

How to Achieve OSHA Compliance for the Dental Practice

Health & Safety Manual Options

Each course provides up to one hour of AGD PACE Program credit provided for FAGD/MAGD. Participants must include their AGD # when taking this quiz to ensure credits are reported to AGD. This activity has been planned and implemented in accordance with the standards of the Academy of General Dentistry Program Approval for Continuing Education (PACE) through the joint program provider approval of SAFELINK CONSULTING, INC. SAFELINK CONSULTING, INC. is approved for awarding FAGD/MAGD credit. AGD ID# 327654. 

ABOUT THE SPEAKERS:
Mary Bartlett has been providing risk management consulting to SafeLink Consulting’s client since 1991. Her passion for helping business owners provide a safe workplace and a quality product are evidenced by her enthusiasm for these subjects as a presenter and consultant. In addition to consulting, Mary has contributed to, quoted, and authored numerous educational materials in national publications. Mary takes pride in providing accurate and the most up-to-date information to her clients and co-workers. Her clients have benefited from her knowledge and experience in dealing with both OSHA and FDA inspectors. Mary has been recognized nationally for her dedication and contributions to worker safety and quality assurance.

Gary Morgan, CDT, CQA/ASQ has been guiding businesses in implementing OSHA compliant employee health and safety programs since 2005. Gary received training in FDA quality systems requirements because of a desire to improve his own dental device manufacturing company. This experience has provided a unique understanding that enables him to help companies integrate compliance in a way that not only mitigates risk but also benefits the business. Gary became a Certified Dental Technician in 1991 and in 2015 obtained his Quality Auditor certification from the American Society for Quality. He performs safety and quality audits throughout the U.S and internationally.

There are steps that should be taken for temporarily closing and reopening your practice.

Protecting Patients and Staff When Resuming Your Dental Practice

Suspending Operations - Temporary Closure
If you are preparing your practice for changes in treatment hours and have shortened your work week, are temporarily closing your practice or are considering what to do to re-open your practice, then there are steps that should be taken for equipment and other items in your practice. Get help in developing your COVID-19 Safety Management Program

Safety Actions When Resuming Your Dental Practice

Here are some suggestions for equipment and other items you may want to consider in this preparation:

• Autoclave - check with manufacturer's recommendations for preparing for inactivity (for Midmark equipment see information available online);  also refer to these instructions for steps to take to prepare the autoclave for use upon re-opening.
• Notify your spore culture testing lab that this testing will be on hold and document in your spore culture test results log the date that the unit became inactive.  When re-opening, run the spore culture strip with your first sterilization run to ensure it is operating properly.
• Vacuum pump and air compressor - follow the manufacturers' recommendations for preparing for inactivity and for re-activating this equipment.
• Waterlines - follow the instructions provided some of the leaders in this industry such as ProEdge for preparing waterlines for inactivity and then re-using them.  Links below take you to the ProEdge information as well as another dental maintenance company that offers some information on this topic.
• Amalgam separator should be inspected on last operational day and the final inspection indicated on the inspection log.  Upon re-opening, inspect the separator and document the inspection.
• Have all biohazard waste and sharps disposed of according to state hazardous waste laws.  Notify the biohazard waste company upon inactivation of their service and when you need to resume the service.  Do not leave biohazard waste or sharps in the practice when the facility is unattended. 
• Collect all personal monitoring badges or dosimeters from staff; return to staff upon re-opening.
• Prior to closing and prior to re-opening, disinfection and cleaning of treatment rooms, sterilization, and common areas are critical.  Perform a thorough cleaning of these areas using a disinfectant referenced below.  Ensure that full personal protective equipment is worn during this cleaning.  If you have been using a log to sign off on daily disinfection, then indicate on the log the date the treatment room use was discontinued.
• Turn off, disconnect, and replace gas cylinder cap on oxygen and nitrous oxide cylinders; ensure cylinders are secured.  Identify with tag the full, partially full, empty status of the cylinders so when re-opening, it's apparent which cylinders to re-connect.
• Turn off emergency oxygen cylinders and store securely.  Inspect this cylinder and prepare for emergency use when re-opening.
• Unplug equipment that can be unplugged and doesn’t need to have the electrical source when the office is unoccupied such as toaster ovens, microwaves, ultrasonic equipment, etc.  
• Remove all food and perishable items from refrigerators.
• Follow your state regulations regarding retention of controlled drugs so they are secured during this period.  Secure your crash cart in a locked room if possible. 

Recommended Protocol for Waterline Maintenance If You're Suspending or Limiting Care

Dental Fix Protocol for DentaPure Cartridges

Resuming Operations - Other Re-opening Considerations
Many re-opening issues were pointed out above with the closing procedures.  Here are some other items  you also need to consider:

• Conduct an inventory of all critical items such as PPE, sharps containers, sterilization pouches, chemical indicators, etc.
• Check expiration dates on anesthetic carpules;
• Check expiration date on battery in AED;
• Check expiration dates on items in your First Aid Kit;
• Ensure all certifications for x-ray equipment are current, as well as the individual staff certifications as required by your state;
• Properly train all staff on CDC infection control guidelines, use of PPE, and OSHA health and safety requirements; document all training

Infectious Disease Preparedness & Response Plan for the Dental Workplace

Long Term Impact of COVID-19 on Infection Control in the Dental Practice

CDC Resources:

Prepare to Care for COVID-19: Get Your Practice Ready 

Other Resources:

Get a free COVID-19 Safety Checklist

Get a professional safety trainer

How to Achieve OSHA Compliance for the Dental Practice

Contact SafeLink Consulting

Watch Intro Video - Top 5 Safety Compliance Issues Employers Need to Know:

Learn more about other safety topics:

Top Five Safety Compliance Issues All Businesses Should Know

New TB Guidelines, Compliance & OSHA's Inspection Criteria

3 Steps to Warding Off the Flu in Your Workplace

Dental Laboratory Resources:

COVID-19 and Safety Protection Guidance for Dental Laboratories

Dental Lab 3D Printing of Medical Devices, COVID19 Swabs & PPE

Managing Risks of the Coronavirus in the Dental Laboratory Setting