Modifications of emergency dental clinic protocols to combat COVID-19 transmission

Robert Hollinshead Long, Tyrous David Ward, Michael Edward Pruett, John Finklea Coleman, Marc Charles Plaisance Jr, Robert Hollinshead Long, Tyrous David Ward, Michael Edward Pruett, John Finklea Coleman, Marc Charles Plaisance Jr

Abstract

During the COVID-19 pandemic, incidence rates for dental diseases will continue unabated. However, the intent to prevent the spread of this lethal respiratory disease will likely lead to reduced treatment access due to restrictions on population movements. These changes have the potential to increase dental-related emergency department visits and subsequently contribute to greater viral transmission. Moreover, dentists experience unique challenges with preventing transmission due to frequent aerosol-producing procedures. This paper presents reviews and protocols implemented by directors and residents at the Dental College of Georgia to manage a dental emergency clinic during the COVID-19 pandemic. The methods presented include committee-based prioritization of dental patients, a multilayered screening process, team rotations with social and temporal spacing, and modified treatment room protocols. These efforts aid in the reduction of viral transmission, conservation of personal protective equipment, and expand provider availability. These protocols transcend a university and hospital-based models and are applicable to private and corporate models.

Keywords: COVID-19; dentistry; emergency.

Conflict of interest statement

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

© 2020 Special Care Dentistry Association and Wiley Periodicals, Inc.

Figures

FIGURE 1
FIGURE 1
Emergency Clinic Triage Committee (ECTC) triage table. This multidisciplinary committee included all departments and specialties. Collectively, departmental representatives developed these necessary standards to ensure that all respective patients received appropriate care and limited provider exposure. All procedures were evaluated by the committee to determine severity and priority, with a list of examples procedures appropriate for each diagnosis. High‐speed handpieces were used at provider discretion. However, this was not a determining factor in determining patient priority. Patients were treated based on disease severity, and appropriate treatment modalities were used as needed
FIGURE 2
FIGURE 2
Screening workflow. Level 1 screenings are phone interviews. Level 2 are pretreatment physical follow‐ups in a triage room. Level 3 requires a predetermined treatment room with designated dailyproviders wearing N95 masks and using modified treatment and PPE protocols
FIGURE 3
FIGURE 3
Temporal spacing through team rotations. Three selected teams placed on a 3‐week cycle. Each team provides dental care for 1 week and is then placed in self‐quarantine for 2 weeks

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Source: PubMed

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