Many of us are wondering “what is COVID-19?” and “What is its impact on dentistry”?
For many in the dental industry, this has lead to the question of “what is the future going to look like”?
Well, we don’t have a crystal ball, but lets break it down, because the challenge of COVID-19 in dentistry, although significant, is pretty simple in its context. First off, lets start off with the virus.
A novel coronavirus is a new coronavirus that has not been previously identified. The virus causing coronavirus disease 2019 (COVID-19), is not the same as the coronavirus that commonly circulate among humans and cause mild illness, like the common cold.
Do you know why COVID-19 has that name? We didn’t either, so we checked. Its CO for “Corona” Vi for “Virus” D for “disease” and 19, because it was first named in 2019.
The covid-19 virus has three anatomical features of note. The first are the “spear” proteins, these are the “keys” that help it pick the lock of a human cell, in the case of COVID-19, these spears “pick the lock” of the cells of your upper respiratory tract. Once inside the cell, the virus uses its RNA, combined with your cells building blocks and replicates itself. This kills your host cell in the process. The third anatomical feature of note is the viruses lipid (or fat) outer membrane. No, its not overweight, but this membrane is important, because of the fat. This is why soap and water is effective in killing it!
Why does “dentistry” provide such a problem in the context of COVD-19?
One word – aerosols.
Virus are transmitted one of three ways, this is known as the “ADC’s” of virus transmission, Aerosol, Droplet or Contact. Droplet and contact precautions are straight-forward, we all know them, cough-etiquette, hand hygiene, physical distancing, don’t touch your face, that sort of thing. Aerosol precautions are much more complex however. And the way we generally practice dentistry in North America didnot consider pandemic aerosol virus risk. Until now.
What’s a aerosol?
Well we create them in dentistry, as most of our operations use tools that take the little bits of saliva, and blood that’s in your mouth, turn it into really small droplets, and throw them out into the world. Pretty gross, but a long-time known hazard, one by which dentistry has always taken serious precautions with. When these aerosols are created, if the patient is COVID-19 positive, research shows that they take the virus with them.
Where do they go?
Well anywhere really, they bob along in the air currents, moving throughout the practice, and contaminating everything. Yuck. Studies show that they can hang around for up to 2-hours, generally getting up to no good and causing a ruckus. Along the way, they encounter our wives, our husbands, our sons and daughters, and our grandparents…..
We assume…
- Community transmission i.e. its here in Kelowna
- You can shed virus, i.e. be “catchy” and not show any symptoms, which means we cant fully screen out patients that have it (no quick test)
- Its a very scary bug, especially so if you or a loved one falls into a vulnerable category
This makes it a big problem.
At Care Dental we moved quickly to address the problem. We moved offsite our patient screens, and triage. We devised with Health Canada guidance, a 4-layer approach to airborne infection containment and elimination. The culmination of which is we had an engineer build BC’s first in a dental setting CSA-Z8000-18 Health Care Facilities compliant Airborne Infection Isolation Room (AIIR). We now can use the same tools that advanced Canadian Hospitals use to control and remove the bug. We rewrote our infection control protocols, and delivered suitable PPE to our patients and team alike. We wrote a book, that’s right a book, we gave that book to UBC. We fit our respirators, and conducted hours of zoom training on all the new stuff with our team. Like the Navy Seals, we drilled, we did dry-runs, all in a virus free location, so that we could work out all the kinks before you showed up on Day one. We were proud, and we came together like a family, stronger than ever.
We are really proud to pioneer this. Not just during COVID, but next year during flu-season as well. A bug, is a bug, is a bug, and you cant put a price in safety.
Care Dental, the dentist that we hope our teams and patients will look forward to safely visiting.