Covid - 19
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Philip Friel Advanced Dentistry - Blog

Covid 19 Update

7th October 2020

Following the lockdown and the suspension of dental services, I am delighted that we have been able to recommence our dental services in Hyndland.

 

Dental clinics are extremely clean and hygienic environments, however, we have taken some additional steps in the clinic to enhance this even further, to further protect our patients and our team. I have included an introduction to some of these below such that you will be aware of these steps when you visit the clinic.

The patient and staff journey is different as a result of COVID. Any changes are in line with the best evidence and best practice. It will come as no surprise that we are as advanced as we can possible be in terms of the safety of the environment.

Communication

The whole team is available as always via telephone and email. Given the need to ensure we have control of who is in the clinic at any given time, we would encourage patients not to attend the clinic without an appointment.

Appointments

Appointments are available and can be scheduled either by telephone or via our new online booking option on our newly updated website.

Prior to attending a scheduled appointment, you will be sent confirmation of your appointment, together with a link to complete a medical history, together with a specific COVID questionnaire.

This allows our patients to complete the required forms on their own devices at a time that suits their schedule. In addition, it reduces the risks of cross contamination if patients use our clinic Ipads. This is a very efficient system and one that is working very well to date.

We are unable to allow patients into the clinic without completion of the COVID questionnaire for obvious reasons as this would then potentially allow entry to the clinic for a patient who was potentially high risk. This would then expose our team and other patients to infection. The COVID questionnaire must be completed by each patient prior to every appointment regardless of how recently they have attended. Again, I understand this can seem onerous, but again, it is for everyone’s safety.

For any patient who does not wish to complete these forms online, they can be emailed for patients to complete and then scan back to the clinic digitally. Please note, we are unable to accept paper copied of these documents.

Paper free environment

We have been working for some time towards making PFAD a paper free clinic for both efficiency and environmental reasons. I am delighted that we are now in this position which has clear benefits in terms of reducing the potential risk of infection transfer. This means that appointment reminders, patient communications, treatment estimates and post operative instructions will be communicated this way for all patients.

We would be grateful for any feedback on these processes and as ever will look to improve this wherever we can.

Attending the clinic

When you have made an appointment, we will ask you to travel to the clinic as normal. When you are in the vicinity of the clinic, please call our reception team, who will advise if you can enter the clinic. The reception team are ensuring that there are not too many patients in the clinic at any one time to ensure distancing, therefore please bear with them if there is a request to wait before entering the clinic. The reception team are working extremely efficiently in this aspect to keep everyone safe.

Patients should attend alone where possible and also without any unnecessary items, for example shopping bags, newspapers and such like, again to reduce the risk of cross contamination.

When you arrive at the clinic, we would ask that you do so wearing a mask and retain this in position until asked by the dentist, hygienist or nurse to remove this. You will note some changes as you proceed through the patient journey and I detail these for you below.

On entering the vestibule, there is an umbrella stand for umbrellas to be stored if required. Our COVID patient information is clearly displayed for information and there is an automatic alcohol gel dispenser. All patients are asked to use this.

The clinic secure entry door remains in order to control when patients can enter the building.

On entering the waiting area, you will note that some chairs are not in use. Please choose a free chair and relax until called through to the dental surgery.

Our coffee machine and water dispenser are not in use at the moment. In addition, we have removed our magazines from the waiting area to prevent cross contamination. We have replaced the magazines with a digital magazine portfolio which is accessed by simply by photographing the QR codes on display at reception.

Our reception team are protected with transparent screens and will also wear visors and/or masks. There are additional alcohol gel dispensers on reception and throughout the clinic.

We would ask patients to refrain from using the toilet if at all possible, but the facilities are available if required.

Appointments and payments can be made as normal behind the protective screens. Please note we will not print out appointment cards – these can be easily emailed for inclusion into a diary.

Infection control

Our clinic is an extremely clean environment and always has been. You will note some additional features together with some upgrades as detailed below, to make this even more so.

  • Cleaning: Our clinic is cleaned every morning from 5 am-7 am by our cleaning team who have worked as part of our team for 10 years. In addition to this, you will note all door handles and patient contact areas being disinfected regularly throughout the clinic.
  • Distancing: You will note floor markings throughout the clinic to ensure that we are as distanced as we can be. Please observe distancing in the clinic at all times.
  • Ventilation: We have always has negative air pressure ventilation in the clinic. This has been serviced and upgraded during lockdown to facilitate the maximum ‘air changes per hour’ that we can achieve. Apologies if you do feel and hear this, but it is there for all of our safety.
  • Windows: In some cases, we may also work with our surgery windows open to further increase ventilation and air changes.
  • Antiviral Air filtration: In reception and in all surgeries, you will see our antiviral air filtration units. These are in addition to the other ventilations mentioned above. These units are on constantly and filter and purify the air with laser detection for foreign particles to ensure our air is as clean as possible.
  • Alcohol gels: In addition to asking patients to use alcohol gel before entering the clinic. In addition to this, you will be asked to use alcohol gel when leaving the treatment room – this is again to reduce the risk of infection spread, if for example a patient removes a denture or touches a tooth with a finger that is then used to open a door.
  • Masks and visors: Our teams will all be wearing a visor and masks together with hats on occasion for safety. In addition to this, disposable aprons are worn for routine appointments. Please bear in mind, its still the same team underneath all of the additional PPE requirements.
  • Enhanced PPE: For procedures requiring the use of the high speed drill, both dentists/hygienists and assistants will be wearing enhanced PPE. This includes FFP3 respirators and disposable scrub gowns. This is essential for the safety of the team and to allow us to carry out aerosol generating procedures or AGP’s. The use of all of these additional protective measures is not easy for us, but we are all getting used to it. As such, once a procedure is commenced using this enhanced PPE, we will try to work through the required treatment without any delay.
  • Fallow time: Following an AGP procedure, the surgery is left fallow for a period of time and after this, the room cleaned on all surfaces including floor mopping.
  • Pretreatment mouth rinse: Depending upon the procedure being undertaken, you may be asked to rinse before treatment with Orawise mouthwash in the surgery. This is a specific antiviral mouthwash which is shown to reduce viral load in the oropharynx, thus potentially reducing the risk of particle transfer during an AGP.
  • Antiviral chlorate spray: In addition to our rigorous detergent and alcohol cleaning of our surgeries, we have also introduced an antiviral chlorate spray that all surgery surfaces are cleaned with after every patient. Again, an additional step to ensure everyone’s safety.
  • Bubbles: Finally, the whole team are working in strict ‘bubbles’ to ensure the same people work together at all times such that any highlighted exposure to COVID can be contained. We are still the same team that we were before, you just may not see everyone that you are used to seeing throughout the surgeries on this basis.
  • Telephones: Given the ‘bubbles’ and reducing movement between surgeries, there can be an additional need for inter surgery calls if for example, equipment is needed in another surgery. The required item would then be left outside of the surgery to prevent a team member from another surgery having to enter the room.

My apologies for the length of this information piece, but I am sure you will read it as further reassurance of everything that has been going on behind the scenes to keep everyone safe in the clinic.

The team are all working as hard as ever to ensure that everything is kept as normal as possible for all of our patients. We are all happy to be back in the clinic and completely comfortable with the set up that we have to ensure everyone’s protection as part of an exceptional and highly trained team.

I would like to thank you for taking the time to read this. We are happy to discuss any aspect further at any time.

Finally, thanks to all of our patients who have got in touch to offer their support and appreciation for everything that we are trying to do. Its not easy for anyone, but the support means the world to the team.

With best regards,

Dr Philip J Friel
BSc(Hons,MedSci) BDS (Glas) MFDS RCS (Edin) MRCPS (Glas)
GDC Reg: 77637

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