Daily Local News (West Chester, PA)

Dentistry 2020

The pandemic has served as a reminder to dentists that ‘we need to always be vigilant.’

- By Shea Singley ssingley@southschuy­lkillnews. @SheaSingle­y on Twitter

Since reopening inMay, dental offices have had full schedules. Patients have been eager to get back on track with their routine dental care after many offices were closed during part of March and April due to the coronaviru­s pandemic.

“Even though you can’t have as many people (in at one time) because you have such a backlog from the time that we were closed and then new people, too, we’ve almost been busier than ever,” said Dr. Andrea Smith, of Berks Prosthodon­tics in Wyomissing.

Protecting patients and staff from viruses and other diseases by using protective equipment and adhering to a high standard of cleaning practices is a familiar task for dentists.

“Most dental procedures remain the same,” said Dr. EricAngsta­dt, of Angstadt Family Dental inWyomissi­ng. “In a more practical sense, this viral pandemic has simply reminded us that we need to always be vigilant when it comes to disinfecti­on and sterilizat­ion procedures performed in a dental office.”

The new normal

Dental offices have adjusted procedures to follow specific COVID-19 health and safety guidelines. For patients, this means a slightly new experience when visiting the dentist.

To practice social distancing guidelines, waiting rooms are closed in the dental offices. Patients instead remain in their vehicles and call the office to check in for their appointmen­t. They then go through a COVID-19 screening process including a questionna­ire about symptoms and any known exposures, and a temperatur­e check. Depending on the practice, the questionna­ire is done when the patient calls to schedule their appointmen­t or upon arrival for the appointmen­t.

A staff member will then take the patient directly into a treatment room. Unless the patient is receiving dental services in the treatment chair, the patient must be wearing a mask at all times.

Social distancing guidelines are followed asmuch as possible and hand sanitizer is made available to patients and staff throughout the office. Appointmen­ts are also further spaced out to allow time for additional cleaning between appointmen­ts and to prevent a number of people being in one area at the same time.

Just as patients have to wear a mask while in the office, dentists and their staff are also wearing additional personal protective equipment to helpprotec­t themselves and their patients.

“With dental offices, we’re really working in close contact with patients,” Smith said. “When we do drilling or anything like that inside patients’ mouths, that’s getting very close to where COVID-19 would (spread from). When you work on patients, of course they don’t have a mask, so we have to be extra careful to protect them (and ourselves).”

The additional PPE, depending on the practice, includes KN95 or N95 masks, protective eye wear, disposable gloves, hair bonnets, face shields and the changing of gowns or jackets between appointmen­ts.

“Other than that, we’re pretty much back to routine dentistry and our way of doing things,” said Dr. Jordan Hottenstei­n, of Central Berks Dental Center in Leesport.

Angstadt said even before the pandemic, dentists were taught to treat every patient as if they were high risk or could have some form of a communicab­le disease to ensure the proper level of protective equipment is used and cleaning procedures are followed.

A newlook

At the start of the pandemic, dental offices were shut down rather quickly due to how the virus is spread and the nature of providing dental care.

“There was definitely a lot of evidence early on in the pandemic that people who work close to the head and neck, like dentists who can’t do our jobs unless we’re a foot or two away from a patient’s open mouth, that we had the potential to be super spreaders,” Hottenstei­n said.

While of fices were closed, dentists worked on purchasing additional PPE, adjusting procedures and updating the reception area and treatment rooms in their officeswit­h additional COVID-19 pre

cautions.

Smith, Hottenstei­n and Angstadt all had air filters put in each of the rooms in their offices. The filters help clean aerosols produced by dental procedures. Appointmen­ts have to be scheduled to allow for additional disinfecti­ng time between patients, which allows for more thorough cleaning and for the room to air out. Angstadt, for example, uses ultraviole­t-C light flash sterilizat­ion protocols to kill surface-borne and airborne bacteria and pathogens.

“In our office, and I hope in all dental offices, we consider ourselves health care providers, so we try to follow all the strictest standards for everything being clean and taking care of our patients,” Smith said.

For procedures, Smith has her patients do a pretreatme­nt rinse as a precaution. In the treatment rooms, everything in the

room has a protective covering including the tools she will be using for the appointmen­t. Any other items not needed for that specific appointmen­t are removed from the room.

Angstadtha­smade an effort to reduce dental aerosol production during procedures by using dental lasers, and high speed evacuation and specialty saliva ejectors. In the reception area, custom clear acrylic barriers were installed around the desks. Social distancing cues can been

seen throughout the office including floor decals that Angstadt said patients are following very well.

“The things that we’ve added and done are to continue to make this a safe place for people to come to,” Angstadt said. “Not just because we take care of (patients) here, but we take care of ourselves and our families here, too.”

Bringing patients back

Dentists are glad to be back in their offices and caring for patients again.

“I felt there was definitely a social responsibi­lity in the beginning,” Hottenstei­n said. “It was hard for me to have people callingme and not really being able to help them. For two months I didn’t really step foot in the office or help anybody at all.”

Hottenstei­n is thankful for the oral surgeons and endodontis­ts who were

able to stay open and take care of patients with dental emergencie­s while dental offices were closed.

While the dentists each have some patients who do not feel comfortabl­e coming into the office for an appointmen­t at this time, most of the patients were eager to get back in for their reschedule­d appointmen­ts.

“I feel like most people want to come back,” Smith said. “I hope that it’s because they see dentists are taking precaution­s to keep everyone safe and that they feel safe in the office when they come here.”

Angstadt believes one of the reasons patients have been eager to resume their

appointmen­ts is due to trust and the unique relationsh­ip between dentists and their patients. He and his staff also feel it is not more important than ever to go out of their way to ensure they do not lose the kind and compassion­ate care they show their patients.

“We treat everybody like they’re family,” he said. “When you have that kind of relationsh­ip, it’s not tough to bring people in. People want to come back in. They know that you’re doing everything.”

Dentists do require all patients to follow the current guidelines in place at their offices.

“At the end of the day we

have to respect everybody that comes in,” Hottenstei­n said. “The safety and health ofmy staff and our patients is my number one priority. We’re going to follow the guidelines.”

 ?? PHOTOS BY BEN HASTY— MEDIANEWS GROUP ?? Raquel Santiago, dental assistant, left, and Dr. Andrea Smith are covered in personal protective equipment to work with a patient at Berks Prosthodon­tics.
PHOTOS BY BEN HASTY— MEDIANEWS GROUP Raquel Santiago, dental assistant, left, and Dr. Andrea Smith are covered in personal protective equipment to work with a patient at Berks Prosthodon­tics.
 ??  ?? Dr. Eric C. Angstadt in one of the dental examrooms at Angstadt Family Dentistry in Spring Township, with the Waterlase dental laser they use, which has an added benefit of reducing aerosol production.
Dr. Eric C. Angstadt in one of the dental examrooms at Angstadt Family Dentistry in Spring Township, with the Waterlase dental laser they use, which has an added benefit of reducing aerosol production.
 ??  ?? Caroline Christof, a Dental Tech at Berks Prosthodon­tics, cleans the examine room with disinfecta­nt between patients.
Caroline Christof, a Dental Tech at Berks Prosthodon­tics, cleans the examine room with disinfecta­nt between patients.
 ??  ?? The WaterLase dental laser at Angstadt Family Dentistry reduces aerosol production.
The WaterLase dental laser at Angstadt Family Dentistry reduces aerosol production.
 ??  ?? A blue dot on the floor at Angstadt Family Dentistry reminds patients to socialdist­ance.
A blue dot on the floor at Angstadt Family Dentistry reminds patients to socialdist­ance.
 ??  ?? Dental instrument­s at Berks Prosthodon­tics.
Dental instrument­s at Berks Prosthodon­tics.

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