Training, PPE buys underway ahead of dental reopenings in West Virginia

CHARLESTON, W.Va. — Dental workers across West Virginia were among the many professionals dealing with the specifics of how to resume services safely as the Mountain State began to reopen businesses and other locations in the coronavirus pandemic.

Starting Thursday, dental practices were permitted to fully reopen with a whole list of other outpatient healthcare service providers after being limited for weeks to only emergency procedures. This means that people can now visit their general dentist for routine teeth cleaning and other dental services such as invisalign braces. It is important that people visit their dentist regularly in order to prevent dental health issues and maintain their bright smile.

However, the West Virginia Board of Dentistry set May 11 as the earliest possible reopening date after established protocols from the West Virginia Dental COVID-19 Task Force had been fully implemented.

Dr. Vince Veltri

Dr. Vince Veltri, board president and a dentist in Clarksburg, said the protocols, which included input from the American Dental Association and the Centers for Disease Control and Prevention, were designed to protect employees and patients while easing anxiety.

“The anxiety is real. It’s normal. It’s something that’s going to be around for a little while as we adjust to the new normal, but I think we’ll be able to move past this in a good way,” Dr. Veltri said on Friday’s MetroNews “Talkline.”

Required steps included in-office training on new protocols covering pre-appointment COVID-19 screening processes, in-office patient registration procedures to limit contact, reception area preparation strategies, chairside checklists and staff protection strategies.

For dental hygienists, social distancing was not possible, said Carly Scala, spokesperson for the West Virginia Dental Hygienists’ Association.

Carly Scala

“We are dealing with saliva. We’re dealing with aerosols that elevate the risk of exposure to coronavirus for dental hygienists and the patients as well,” Scala told MetroNews.

Aerosols are suspended solid particles or liquid droplets in the air which medical professionals have said can be one of the main ways the novel coronavirus is spread.

Availability of personal protective equipment, PPE, was an issue.

“People are scrambling for masks just to go to the grocery store let alone dental professionals in their professional setting,” said Scala who works in Charleston as a registered dental hygienist after relocating in November.

Before any reopenings, “We want to make sure that all dental offices are making sure that they’re stocked up with enough equipment. We want to make sure that everybody’s ready to go back to keep themselves and patients safe.”

Dr. Veltri agreed.

“There are several offices around the state who are prepared (with PPE), but there are a good amount, if not more than that, who are scrambling a bit,” Veltri said.

The Board of Dentistry had PPE vendor information posted on its website.

Specific COVID-19 questions could be sent to wvcovid19dental@gmail.com.

Scala said any reopenings were ultimately up to individual dentist office owners and operators.

“Just because they’ve said, ‘May 11th, you can reopen,’ doesn’t mean you have to and it doesn’t necessarily mean you should,” Scala said.

“The Board of Dentistry recommended that dentists use their best judgment on how much PPE is needed to start up and we need to make sure that those items are available.”

Recommendations from the Board of Dentistry also included suggested informed consent forms for staff members and patients.

The staff form, as proposed by the Dental COVID-19 Task Force, required signoffs on several statements including the following:

– I understand that COVID-19 has a long incubation period and carriers may not show signs or symptoms and still be contagious.

– I understand that dental procedures create an aerosol which is one way that COVID-19 can be spread.

– I understand that due to the characteristics of dental procedures there is an inherent risk of potential contraction of COVID-19 simply by being present in a dental office.

“No members of the dental staff should be made to work against their will if they do not feel the environment to be safe,” the West Virginia Board of Dentistry guidance indicated.

Workers with safety concerns were advised to file a complaint directly with the board.

Pre-screening of patients was to include repeat questions about recent travel and possible COVID-19 symptoms along with in-office temperature checks.

“If we can check all those boxes, we’re going to see the patient. If we can’t check all of them, we’ll kindly ask the patient to reschedule,” Dr. Veltri said.

The patient informed consent form included the following passage: “Despite our careful attention to sterilization, disinfection and use of personal barriers, there is still a chance that you could be exposed to an illness in our office, just as you might be at your gym, grocery store or favorite restaurant.”

It concluded with a question.

“Although exposure is unlikely, do you accept the risk and consent to treatment?”

Scala said, in general, hygienists were ready to get back to work if adequate protections were in place.

“We love our patients. Everybody needs a paycheck and we want to make sure we’re taking care of our communities and their oral health,” Scala said.

“But we also want to make sure that we’re able to do it for the long term. We don’t want to get sick that first week we go back just because we didn’t have the right mask or we didn’t have the proper gowns to wear.”

Overall, Dr. Veltri said anxiety about COVID-19 was understandable.

“I think it’s very similar to the AIDS situation and hepatitis and some of the other things we’ve had to worry about in the past that have made our PPE and infection control standards in dentistry what they are today and we just need to continue to evolve with that,” he said.





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