Safety

Before Coming to Work:

• Take a daily temperature. Do not report to work if you or your close family members are experiencing symptoms of illness (fever, cough, difficult breathing….)
• Remove watch, rings and leave at home
• Tie hair up and keep nails clean/short
• Avoid extra accessories
• For male team members, present clean shaven to allow for proper mask fit
• Place cell phone in a Ziploc bag that you can discard at the end of the day
• Bring work clothes in a washable or disposable bag
• Practice appropriate use of personal protective equipment (PPE) prior to caring for a patient

At work:

• Change into scrubs/work attire including work shoes as soon as you arrive
• Use PPE as appropriate for each clinical situation
• Leave all clutter out of patient treatment rooms
• Avoid using the desks, phones, computers and work related items of another employee
• Clean telephone handset after use
• Discourage use of cell phone at work
• Food/lunch items to be placed upstairs in the staff lounge (non-clinical area).
• No eating or drinking in patient areas, sterilization room or office laboratory.

After work:

• Wash hands and arms with soap
• Remove scrubs/work attire and place in washable/disposable bag
• Clean work shoes and leave at the office
• Wash hands and put on clean clothes
• Sanitize phone, glasses, keys etc. – Wash hands again

At home:

• Be mindful not to cross-contaminate
• Immediately remove shoes, clothes
• Wash scrubs/clothes in washing machine with detergent and hot water
• Shower immediately with soap and water before touching anything (including close contact with your loved ones)

Before a patient arrives for an appointment, every effort is made to:

• Filter patients during booking and at time of confirmation for any special precautions they may require
• Screen patients for any symptoms or history of illness or contact with an infectious individual
• Reschedule patients who show any signs of a cough or fever or who describe any concerning warning signs of illness
• Instruct patients to call ahead and reschedule their appointment if they develop symptoms of a respiratory infection as their appointment time approaches

To promote social distancing:

• Prioritize high risk patients (immunocompromised or vulnerable) with appointment times that will see less contact with other individuals
• We are spacing out our booking schedule to limit the number of people in our waiting area
• Patients are asked to not bring extra family members to their appointment with them unless absolutely necessary (parent-child, translator, physical assistance required etc.). Escorts may be asked to wait in their car to limit the number of people in the waiting room
• Utilize a virtual waiting room, whereas patients remain in their vehicles/outside the office until they are contacted via cell phone to enter the office.
• Consider virtual appointments where appropriate – treatment planning consultations, post-op discussions etc.
• Send patients documents (such as new patient forms and medical history forms) electronically to complete prior to appointment time

Safety Measures taken upon arrival:

• Visual alerts at the entrance door advising patients of the COVID-19 risk and advising patients not to enter the office when ill
• Alcohol-based hand rub (ABHR)is available in the waiting room
• Tissues and waste receptacle available for use
• Visual alerts to remind patients about proper hand hygiene and how to use tissues/elbows to cover nose/mouth when coughing or sneezing

Patients are:

• Asked to phone from their vehicle upon arrival for their appointment
• Patient will be screened for possible fever, cough or symptoms of illness
• Patient will be telephoned to enter the office when their treatment provider is ready for them
• We welcome patients to wear homemade masks in common areas of the office. Patients are to wear masks before and after treatment. If our PPE stock allows, we will distribute masks to patients upon entry.
• Patients are asked to not bring food or drink into the office. This includes the reception area.
• Upon entry, patient is asked to perform hand hygiene with available alcohol-based hand rub (ABHR)
• Patient will be assessed for respiratory symptoms and fever (with a non-contact digital infrared forehead thermometer)
• If fever (>100.2 F) or respiratory symptoms are present, the patient is advised to seek medical attention and their appointment will be rescheduled

• If a treatment room is not immediately available, patients will social distance in the waiting room.
• The number of chairs in our waiting room has been decreased to facilitate social distancing
• We have removed clutter and high-touch surfaces that could lead to crosscontamination. This includes magazines and children’s toys.
• We ask parents consider bringing small toys/items to entertain their children.
• Our children’s toy area has been converted to a family-waiting area.
• Our waiting room, bathroom, door handles, tables, light switches, front desk… are frequently cleaned and disinfected.

We will adhere to the usual and transmission-based precautions in our operatories but with greater attention to detail to ensure that procedures are followed consistently and correctly.

We have team members whose sole focus is sterilization, disinfecting and cleaning.

Hand hygiene is performed by staff

• Before and after all patient contact, contact with potentially infectious material and before putting on and removing personal protective equipment, including gloves.
• Hand hygiene is performed after removing PPE to ensure there was no transfer of pathogens during the removal process.

Personal Protective Equipment

• The clinical team will wear PPE appropriate for each clinical encounter. This will include masks, gloves, gowns, hair covers, eye protection, face shields and shoe covers.
• Fit-tested N95 masks, eye protection and face shield may be used when performing or present for an aerosol-generating procedure.
• Only unused or clean PPE will be allowed outside of the operatories.
• Clinical team members will ensure PPE is donned and doffed in proper sequence and proper location when entering and exiting an operatory.
• Eye protection and masks to be worn throughout the office. Aerosols can stay in the air for several minutes.
• Reusable PPE, such as clinician/patient protective eyewear, to be cleaned and disinfected between patients.

• All operatories have been converted to negative pressure treatment rooms.  A 25 air changes/hour (ACH) exhaust system has been installed to allow effective airborne contaminant removal.
• All operatories have been closed off with doors.
• Patients may pre-rinse with a peroxide mouthwash for 60 seconds
• Restorative treatment will be performed whenever possible with rubber dam ( often referred to as “the raincoat” with kids)
• High Volume Evacuator will be functioning during treatment especially when aerosols are generated
• We will reduce the amount of water spray while still having a coolant effect
• Minimize the number of people in the treatment room. Any additional staff entering the room to wear proper PPE.
• Look to only dismiss patients when the front desk staff and waiting room can accommodate them.

• Ensure environmental cleaning and disinfectant procedures are followed consistently and correctly
• If a non-aerosol generating procedure is performed, cleaning and disinfection of the operatory will be conducted without delay, as per standard procedures
• If an aerosol generating procedures is performed, cleaning and disinfection of the operatory will be delayed an appropriate amount of time to allow aerosol droplets to fall. The operatory will remain unoccupied during this delay.
• All non-disposable medical items are cleaned and sterilized according to manufacturer’s instructions for use and strict infection control guidelines
• All one-use items are discarded properly

SAFETY MEASURES after YOUR VISIT:

• Patients perform hand hygiene before leaving
• Encourage the use of credit (possibly by phone) or debit cards, e-transfer to encourage social distancing with front desk
• Review of estimates and insurance forms can be carried out via phone call or virtual meeting or sent in the mail
• Patients are asked to inform office staff if they experience any symptoms of COVID-19 within 14 days of their appointment.

AT the end of the DAY:

• Extra cleaning of all areas of the office including washing of floors in preparation for the next day.

YOUR SAFETY, AS WELL AS THE SAFETY OF OUR TEAM MEMBERS AND FAMILIES, IS OF OUR UPMOST PRIORITY