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Dentists struggle with new infection control

 


Although her daughter’s condition did not rise to emergency levels, Amanda Weisher was convinced that the six-year-old child would need immediate medical attention. Rosie had two permanent teeth gushing into her mouth and her infant’s teeth were congested, but the dentist couldn’t see her.

This issue could have been easily addressed during the child’s regular dental checkup. However, except for emergencies to reduce the prevalence of COVID-19, the visit was postponed because thousands of Georgia dentists were ordered to close their business.

“It was really frustrating,” said Alpharetta’s mother. “I was worried.”

»Complete coverage: Georgia Coronavirus

Dental staff in clinics differ significantly from the day before COVID-19, as dental clinics across Georgia are now reopening, and families like Weishars are trying to supplement skipped cleaning and routine procedures. May pick you up. For example, it may be natural for a dentist to look like a spacesuit and for a dental hygienist to remove plaque using only hand tools. The barriers that delimit the treatment area can be replaced by walls that help prevent cross-contamination of the patient.

However, throughout the United States, and dental offices such as Georgia, are not immediately ready to meet even the minimum requirements and stringent infection control procedures set by the Centers for Disease Control and Prevention.

“This is beyond us,” he said. Dr. Likith V. Reddy, Clinical Professor of Texas A & M Dentistry in Dallas, Director of Residency Training, Oral Surgery and Maxillofacial Surgery. “I don’t know if I can meet the standards, but I’m sure nothing will be 100% fully prepared.”

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Dentists are one of the few healthcare providers who have worn masks and gloves when treating patients for decades, but they also work in environments that are at the highest risk of exposure to infectious diseases such as coronaviruses. .. This is the result of all the procedures that are actually done in the dentist’s clinic, and devices such as drills, ultrasonic scalers, and water-water syringes spout spatters and droplets from the mouth into the air and onto clothing and other surfaces This is because aerosol is generated when you do.

Up to 3 weeks ago Georgia Dental AssociationRepresenting thousands of dentists in the state letter To the Governor’s Office expressing concern that most members are unable to meet the CDC’s minimum requirements.

The fear that industry leaders in other states have reiterated is that dentists may be subject to disciplinary action and may lose their license if they are found to violate new requirements. That is.

“It’s a time like never before.” Dr. Alan R. Furness, Deputy Dean of Patient Services at Georgia Dental College at Augusta University. “We are all trying to get the information, read all the information that comes out, and make appropriate and responsible decisions.”

Minimal standard care requires that the dental clinic provide adequate and appropriate personal protective equipment, especially N-95 mask, gown, disposable glovesTo protect dental personnel from blood and other body fluids. However, in many offices there is a lack of supply and most cannot find equipment that prioritizes hospitals treating COVID-19 patients.

It will also financially strain more than 4,200 dental clinics in Georgia and employ 27,800 people, including 5,859 qualified dentists, dental hygienists, laboratory technicians and front desk personnel.

“The costs will be astronomical,” said Dr. Robert Lee, a former Atlanta dentist who treats patients in former Omaha in southern Georgia and Omaha in a neighboring county in Alabama. “They suggest that all patients wear (new) gowns and all employees wear gowns.”

As a result, many dentists will likely have to see one-quarter of the patients they see before the new guidelines, Lee said. He recently applied to help dental clinics keep costs down Industrial alcohol license As a result, he was able to produce up to 5,000 gallons of hand sanitizer per day, a shortage throughout the United States.

Meanwhile, as dentists reduce their visits, there is growing concern that patients may not have access to necessary procedures and may be at risk of serious complications. For example, patients who skip cleaning and are susceptible to periodontal disease may face complications of heart disease, diabetes, stroke, or pregnancy.

Lady, who is also the director of the Oral Surgery Residency Program at Baylor University Medical Center in Dallas, notices that a small increase in emergency room patients with tooth abscesses causes emphysema and restricts the airways. It was

He imagines those cases will increase as patients struggle to find a donor.

Tedious and time consuming

Some say that it is reasonable to expect dentists to adapt to new regulations over time.

A set of workarounds may reduce the risk of exposure in many dental clinics, industry leaders say. For example, a transparent shield, rubber dam, or dome can be placed around the patient’s mouth to contain spatter from the aerosol.

“The costs will be astronomical. They suggest that we wear (new) gowns for all patients and all employees for gowns.” — Dr. Former Atlanta Dentist, Robert Lee

Dental hygienists can also use old-fashioned hand appliances to clean their teeth. The equipment can be disinfected after each use Dr. Amerian D. Thorns, Director of Continuing Education at the Texas A & M School of Dentistry in Dallas.

Sones acknowledges that, as with other practitioners, it can be difficult for some dental hygienists to apply an ultrasonic scaler to a tedious and labor-intensive manual instrument.

“Some people may be worried and you’ll want to use those ultrasonic scalers,” she said. “But perhaps in the next few years, we’ll need to use them to a minimum.”

In Georgia, some dentists say they have been dealing with infectious agents for many years and are in a position to determine appropriate actions to protect patients and staff.

Dr. Las Anderson, a Kennesaw dentist reopened on April 27, said his office had autoclaves to disinfect and sterilize all surfaces of the treatment room and a medical waste system to kill bacteria. Said.

Despite precautions, Georgia dentists were ordered to close restaurants, bars and nail salons, he said. “We have a restaurant open,” he wrote in response to a question from the Atlanta Journal Constitution. “They don’t sterilize forks and knives. Not all surfaces. Nail salons do the same.”

Rosie’s mother, Amanda Weisher, agrees to some extent. Why is a liquor store considered a must-have business, but not a dentist?

Fortunately, Rosie was evaluated by a local dentist and was able to assure her that everything was fine in less than 5 minutes.

“Don’t worry,” he told her, pointing to Rosie’s baby’s tooth. “She’s okay, wiggle on her.”