10:52 AM

Lessons from the Pandemic: What COVID-19 Is Teaching Us About Infection Prevention and Control

By Julie Hawley, PhD, CAE, Director of Analytics and Evaluation, DentaQuest Partnership for Oral Health Advancement and Kathy Eklund, RDH, MHP, Director of Occupational Health & Safety, The Forsyth Institute

Dental providers are among the professions at the highest risk of exposure to COVID-19. So, to us, it came as no surprise that a recent DentaQuest Partnership for Oral Health Advancement provider survey revealed one overwhelming area of need: information and guidance on infection prevention and control.

Keeping patients and staff safe is always a concern for dental professionals, but in recent times the profession has not faced that challenge during a pandemic — let alone in a pandemic caused by a virus that transmits so easily. The novel coronavirus has required us to make substantial changes in the way we provide care. And it has required us to lean on each other to learn, act and improve together.

The DentaQuest Partnership and the Organization for Safety, Asepsis and Prevention (OSAP) — the leading organization addressing infection prevention and control in dental settings — collaborated with national experts to produce several resources to help dental offices deliver care in an environment that minimizes infection risk. They have helped providers stay open, reopen safely and ensure patients can still get the oral health care they need.

So, what have our collaboration and conversations with front-line providers taught us about infection prevention and control? We offer three lessons.

1. Communication Is Critical

We’ve seen that clear, concise and consistent communication with both patients and staff enables dental providers to establish new safety protocols while avoiding the kind of confusion that can lead to safety lapses. If everyone understands the changes, the risk of infection is lowered.

This starts with staff, but quickly extends to patients. When patients are anxious and unsure about the new processes, explaining the changes in a simple and straightforward way establishes trust and increases compliance. The DentaQuest Partnership and OSAP worked together to develop information on Dental Patient Care in the Era of COVID-19, available in English and Spanish. We also designed our Patient Guide for Visiting the Dentist to help prepare patients for what to expect, making them aware of the concrete steps providers are taking to ensure their safety.

2. Many Changes Are Here to Stay

Leaders and dental providers are implementing several policy and care-based changes, largely to help control infections, that are already influencing the way the industry will look going forward.

In fact, 93% of dental providers anticipate long-term changes due to COVID-19. A report released in May called Dental Care’s New Normal shares results from the previously mentioned May 2020 survey of dental providers. In the report, providers list some of the key practices they think are here to stay, such as:

  • A shift toward telehealth technologies, which enables providers to engage in more patient outreach, reinforce healthy behaviors, provide education and explore minimally invasive treatment options. This also provides the opportunity to triage and direct patients to appropriate care — without the risk of infection.
  • A pathway redesign, with an increased focus on the use of non-aerosol generating secondary care treatments that reverse or slow the progression of active diseases. For example, secondary treatments for carious lesions may include silver diamine fluoride, temporary restorations with glass ionomers or atraumatic restorative treatments.

When implementing and evaluating new infection prevention and control protocols, it’s clear that we cannot view them all as short-term fixes or band-aid solutions. Many of the changes we’re seeing now, like the transition toward teledentistry and minimally invasive treatments, could and should remain after the pandemic. As an added incentive, the changes could help providers feel less vulnerable when future events — e.g., subsequent waves of COVID-19 or other emerging pandemics — are more likely to affect patient utilization and cash flow.

3. Guidance Will Continue to Evolve

Although some changes are likely here to stay, others change by the day. We are constantly learning and adapting as public health officials and disease control experts learn more about COVID-19. There are constant updates from a variety of sources — the Centers for Disease Control and Prevention (CDC), the Occupational Safety and Health Administration (OSHA), the American Dental Association (ADA), the American Dental Hygienists’ Association (ADHA) and state dental boards and health departments. All are offering important safety information for dental providers.

To help aggregate the information, the DentaQuest Partnership and OSAP released — and updated at the end of August — a guide on Best Practices for Infection Control in Dental Clinics during the COVID-19 Pandemic. This 20-page document pulls together the latest guidance and offers practical resources for dental practices as they implement new safety standards. It includes, for example, checklists for providers around PPE, a list of infection control topics to discuss with staff, screening logs and information for patients. We’ll continue to update the information in the coming weeks and months.

Read other blogs in our Lessons from the Pandemic series.

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