In January 2020, The University of Texas Health Science Center at Tyler partnered with St. Paul Children’s Services, as part of the 1115 Waiver, to improve dental care for underserved populations. This initiative is led by dentist Adriene Haire, DMD. Dr. Haire sees pediatric dental patients for prevention, maintenance and treatment. In light of the pandemic, UT Health Science Center, with the aid of the occupational medicine faculty and residents, have furthered their collaboration with St. Paul’s clinical staff to continue infection prevention and occupational health best practices despite COVID-19 challenges.
Ashiq Zaman, chief resident of the occupational medicine residency program explains, “Fit testing of retrofitted N95 masks were conducted for St. Paul clinical staff and brief trainings were provided with respect to proper donning and doffing and how to perform a user seal check.” Residents also assisted in worksite walkthroughs at St. Paul’s clinic to identify potential hazards and determine best practices for worker/patient safety.
“One of the major challenges dental offices face is the control of aerosolized particles,” said Kevin Moore, assistant professor of occupational health sciences at UT Health Science Center’s School of Community and Rural Health. “These particles can stay suspended in the air for long periods of time like fog or smoke.” Some particles may be able to travel as far as 20 feet. It is believed that there is some degree of aerosol spread of COVID-19, so limiting the release of aerosols is critical.
Steps to controlling aerosols include:
- Limiting aerosol —generating procedures
- Using aerosol capturing devices at the source of generation
- Increasing ventilation rates and improving the efficiency of air filtration to help remove particles from the air
- Separating treatment areas from office areas and break rooms
- Use of personal protective equipment (including respirators) to help protect workers
With direct guidance from the State of Texas and the Occupational Safety and Health Administration (OSHA), dental clinics must comply with the 1910.134 respiratory protection standard. This standard requires clinics to abide by specific procedures.
- Procedures for selecting respirators
- Medical evaluation
- Fit testing
- Procedures for proper use of respirators in routine and reasonably foreseeable emergency situations
- Training of employees in the respiratory hazards to which they are potentially exposed during routine and emergency situations
- Training of employees in the proper use of respirators, including putting on and removing them, any limitations on their use and their maintenance (dependent on type of respirator required)
- Procedures for regularly evaluating the effectiveness of the program
The collaboration between UT Health Science Center and St. Paul Children’s Services to develop health and safety best practices, provides a model for all dental clinics to follow. Tim Ochran, vice president of safety, health, environmental and risk management, reminds us, “this is not just an intervention, but an ongoing process in changing times.” While St. Paul is just one of many dental service providers in the East Texas region, UT Health Science Center is uniquely positioned to provide these health and safety services to others in the community.
To learn more about the challenges faced by dental practices during the COVID-19 pandemic, you can attend a live webinar scheduled for: June 18, 2020 from noon until 1:00 p.m.
At the time of the webinar, please copy this link into your browser: vod2.netnet.org. Using an Internet Explorer browser is highly encouraged.