Dental practices taking extra COVID-19 safety precautions

Face masks and social distancing have become part of our daily lives during the COVID-19 pandemic, but there are some places where its not possible to wear a face mask or maintain at least six feet from other people.

One of those places is the dentist's office where dentists, hygienists and dental assistants are often inches away from their patients, patients who cannot cover their faces because masks would prevent access to their teeth.

Gabby Baffoni of Cape Girardeau needed a filling in one of her upper molars for more than a month. She had been scheduled for a filling in late March, but when the coronavirus outbreak began to spread, many dental practices, including hers, temporarily closed or postponed all non-urgent procedures such as cleanings, fillings and routine checkups.

Baffoni's appointment at Bennett Family Dentistry, 989 N. Mt. Auburn Road, was rescheduled for last week, a few days after the end of Missouri's "stay at home" order was lifted and businesses, including dental offices, began to reopen.

"I wasn't sure what to expect," Baffoni said, admitting she was somewhat concerned about potential coronavirus exposure.

"The first thing I noticed when I arrived was that there were a couple of people in protective gear outside and they seemed to be letting one person in at a time," she said. "Personally, I felt better seeing there was clearly a protocol in place. It took a little longer to get inside the building, but I was happy to wait."

Entry screening processes at dental practices such as Bennett Family Dentistry is one of several additional safety protocols area dentists have initiated as part of their reopening last week. Many practices have added additional sanitation and screening processes that take place before patients are brought into exam rooms.

"They sanitized my hands and took my temperature and then went through screening questions, asking if I had a cough, a fever or other symptoms," Baffoni said. "I definitely got the sense the protocols were as much for the employees as they were for the patients, and that made me feel good knowing they were trying to keep everybody safe."

Indeed, Dr. Ross Bennett said his staff went through two days of safety training last week before resuming patient visits. Staff members are also screened daily with temperature and symptom checks and if patients arrive with a temperature or other symptoms, they leave through a private door without entering the treatment area.

"Not only does this protect our staff, it also protects other patients as well," Bennett said.

The American Dental Association has issued guidelines for dentists, orthodontists and other oral health providers recommending they use "the highest level of personal protective equipment available (PPE) when treating patients to reduce the risk of exposure." That includes goggles and face shields in addition to face masks and gloves dentists have commonly used for decades.

Bennett said in some ways his practice is exceeding recommended safety protocols. "Until they have better protocols, more testing or a vaccine, our stances will be to follow the guidelines and there are several areas we've decided to exceed them," said Bennett who began practicing with his father, Dr. Michael Bennett, in 2007.

"For instance, our patients will swish with either hydrogen peroxide or povidone iodine," he explained. "While this step is not required, research indicates it can kill the virus which decrease the likelihood of an infected patient spreading it."

Because COVID-19 is an airborne virus, Bennett and other dental practitioners are mindful of the mist of "aerosol" produced by certain dental instruments.

"What we do generates an aerosol spray a lot of times," said Dr. Byron Aden who has been practicing in Cape Girardeau since 1990. "That's something we have to be aware of."

Aden said he and his staff are being "as overt as we can be" about sterilization and disinfection at his practice at 2857 Independence St. "And we're almost as gowned up as if we have hazmat suits on."

Aden and Bennett have closed their waiting rooms in order to minimize opportunities for patients to come into contact with staff members and with each other. For now, Aden said, "patients wait in their cars." However, he said, that might not be an ideal situation during hot summer months.

"This reminds me a lot of when HIV AIDS began in the 1980s," Aden recalled and said that was around the time dentists and office assistants began wearing gloves and masks.

Dr. Alyssa Ruopp Baker is one of Cape Girardeau's newest dentists, joining her parents, Drs. Patrick and Janet Ruopp, at Ruopp Family Dentistry, 1818 Broadway, in 2018.

"It's been an interesting time for our profession," she said. As at other practices, hers is adhering to coronavirus safety guidelines recommended by the American Dental Association and the Missouri Dental Association as well as the Centers for Disease Control and Prevention.

"We've been reaching out to our patients through text, email, Facebook and our website explaining some of the changes we've made," she said. "For instance, we're now screening patients and taking temperatures on everyone in the building, staff included."

Calling it "the new normal," Baker said patient screenings, additional sanitation measures and PPE protections "will be here for quite some time, at least until we have more definitive answers."

Baffoni agreed.

"Even if it calms down a bit, I think some aspects of the extra protections will remain," she said. "I actually thought about that as I was going through my wellness screening, especially as I watched people in gloves and masks. It made me wonder if this is what it will look like in medical facilities going forward. It also made me think maybe we should have been doing this all along."

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