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18/03/2020

Dental Precautions for our Dentists About coronavirus

 Because the coronavirus can stay alive on surfaces for 24 hours+, it is important to keep all surfaces clean and sanitized. While this pertains to the waiting room, the bathroom and the front desk, it is particularly important to disinfect the operatory as frequently as is feasible.
Common cleaners such as 0.1% sodium hypochlorite, 0.5% hydrogen peroxide or 62-71% ethanol have all been shown to be effective.
Recommendations for Dental Practice:
1- Dentists should take strict personal protection measures and avoid or minimize operations that can produce droplets or aerosols.
2- The 4-handed technique is beneficial for controlling infection. 
3- The use of saliva ejectors with low or high volume can reduce the production of droplets and aerosols
 
Evaluation of Patients:
There should be a prominent sign directing the patient to use a hand sanitizer from a non-touch dispenser stand and to rigorously rub their hands for 20 seconds.
Anyone who is coughing should be given a mask.
1- During the outbreak of the virus, establish precheck triages to measure and record the temperature of every staff and patient as a routine procedure. ask patients questions about the health status and history of contact or travel.
2- Patients and their accompanying persons are provided with medical masks and temperature measurement once they enter the hospital. 
3- Patients with fever should be registered and referred to designated hospitals. If a patient has been to epidemic regions like Chin, Italy or any other country within the past 14 d, quarantine for at least 14 d is suggested.
4- Records the temperature of the patient and staff as a routine work
 
Oral Examination: 
 1- Preoperative antimicrobial mouth rinse could reduce the number of microbes in the oral cavity 
 2- Procedures that are likely to induce coughing should be avoided 
 3- Aerosol-generating procedures, such as the use of a 3-way syringe, should be minimized as much as possible. 
 4- Intraoral x-ray examination can stimulate saliva secretion and coughing. Therefore, extraoral dental radiographies, such as panoramic radiography and cone beam CT, are appropriate alternatives during the outbreak of COVID-19.
Treatment of Emergency Cases:
 1- Rubber dams and high-volume saliva ejectors can help minimize aerosol 
 2- Face shields and goggles are essential with use of high- or low-speed drilling with water spray
 3- If a carious tooth is diagnosed with symptomatic irreversible pulpitis, pulp exposure could be made with chemo mechanical caries removal under rubber dam isolation and a high-volume saliva ejector after local anesthesia; then, pulp devitalization can be performed to reduce the pain. The filling material can be replaced gently without a devitalizing agent later 
 4- After treatment, environmental cleaning and disinfection procedures were followed. Alternatively, patients could be treated in an isolated and well-ventilated room
 5- If a tooth needs to be extracted, absorbable suture is preferred. For patients with facial soft tissue contusion, debridement and suturing should be performed. It is recommended to rinse the wound slowly and use the saliva ejector to avoid spraying.
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