DENTAL CARE SERVICE IN ERA NEW NORMAL

Summarized by Annisaa Sittatunnikmah 

Dental Therapist

 

PROLOGUE

From the webinar international conference on handling non-communicable diseases on Wednesday 2nd September  2020 in cases of Dental Care Service in Era New Normal which presented by Prof. DR. drg. Diyah Fatmasari, MDSc  we could know that dental care is important to do, so we can prevent dental and oral health problem because oral diseases  is a major public health problem globally and the most wide-spread non-communicable disease that caused by several factor such as sugar, diet, behavior, and also bad habit. We also know that oral and dental health is an integral part of body health, that the mouth is the main entrance of bacteria and viruses into the body so people should care about their oral hygiene because it’s affect to their body health.

 

SUMMARY

Indonesia is now facing a new era normal due to covid-19 pandemic, we all have to comply with covid-19 prevention protocols. Not only as a citizen but also as a dental health worker such as dentist, dental therapist and also dental hygiene who have direct contact patient espesially to their oral, we have a high probability of being exposed to covid-19. This means dental health workers as a victims that should prevent it with knowing about dental care service in era new normal also apply it in their clinical pactice.

Here, what we got from the webinar about dental care in era new normal :

A.     Preparation For Dental Care

1.      Changed of practice fasilities by added facilities to reduce dental aerosol. Aerosol suction and exhouse van is needed, also changed room setting for clinical area

2.      Use sandard operating procedure for health workers and admitting patients. Workers safety use lavel 3 personal protective equiopment

3.      Do clinical practice if only for patient by appointment, limited number of patienrs and for emergency dental cases.

4.      Standartd operating procedure patient care for precautions by fill the informed consent, prelimenary check include body temperature, traveling history, contact with patients covid history.

B.     Dental Clinical Facilities

Requirements that must be carried out regarding management in the dentist's office:

1.      Zoning settings.

2.      Signage arrangement (sign / groove).

3.      Patient volume adjustment.         

4.      Air flow regulation must be achieved at least 12 ACH with clean air position enter from behind the operator and assistant (back to the patient's head) and the direction of the outflow of air is placed below, approximately 20 cm from the floor.

5.      Using HVE dental suction (with the exhaust stream attached to the dental unit), make sure the HVE suction strength exceeds 100 cfm and funnel shape effective suction.

6.      Use of rubber dam.

7.      Use of a wall separator at the consultation table.

Additional facilities as a conditional recommendation require related attention

management in the dentist's office:

1.      Use of portable HVE.

2.      Use of UV-C lamps

C.    S.O.P Health Workers

1.      The type of APD depends on the main duties and functions (main tasks and functions) :

a.       Level 1: assistant in the waiting room

b.      Level 2: janitor

c.       Level 3: dentist and assistant in the dental unit room

2.      Donning APD is a technique to put on or use ADP

3.      Doffing APD is a technique to remove APD.

4.      All stages of donning and doffing should be installed on the walls of the APD donning and doffing room.

5.      The technique of removing APD is very important for health workers to understand because when removing APD, there is a high risk of infection from the microorganisms attached to the APD. 

APD donning step :

a.       surgical scrub clothes

b.      Wash hands

c.       Head cover

d.      Masks

e.       Inner gloves

f.       Disposable gown / hazmat suit

g.      Outer gloves

h.      Glasses or face shield

i.        Fasten the hazmat suit

j.        Boot or shoe cover

6.      APD doffing stages (always wash your hands using 70% alcohol between each stage)

a.       Outer gloves

b.      Shoes with shoe covers or boots

c.       Disposable gown / hazmat suit

d.      Glasses or face shield

e.       Masks

f.       Head cover

g.      Inner gloves If there is no special room for removing APD, then APD and gloves are removed in the dental unit room. Meanwhile, removing the face shield / goggle / face shield and mask is done outside the dental unit room.

D.    S.O.P Admitting Patient

1.      Check body temperature

2.      Traveling history

3.      Selected case

4.      Minlimal aerosol

5.      Quick dental care

E.     S.O.P Patients Care

What health workers should do before treath a patients are :

1.      Check body temperature

2.      Their travering history

3.      Contact with covid patient history

What health workers should remember are :

1.      Do clinical practice if only for patient by appointment, limited number of patienrs and for emergency dental cases.

2.      All patients are suspect to be OTG so health workers should be aware

3.      Room and instrument sterilization after patients changed

4.      When patient have cough, give oral medicine

5.      Prefer to rapid test or swab

F.     Informed Consent

Standartd operating procedure patient care for precautions by fill the informed consent. Compulsary for dental cre with risk such as extraction, filling and scalling.

 

CONCLUSION

Dental care is important to do, so we can prevent dental and oral health problem because oral diseases  is a major public health problem globally and the most wide-spread non-communicable disease that caused by several factor such as sugar, diet, behavior, and also bad habit. We also know that oral and dental health is an integral part of body health, that the mouth is the main entrance of bacteria and viruses into the body so people should care about their oral hygiene because it’s affect to their body health.

Indonesia is now facing a new era normal due to covid-19 pandemic, we all have to comply with covid-19 prevention protocols. dental health workers as a victims that should prevent it with knowing about dental care service in era new normal also apply it in their clinical pactice.