To ensure that dental health professionals and their patients are not exposed to the risk of contracting COVID-19, the Department of the Interior and Local Government (DILG) enjoins all local government units (LGUs) to see to it that dentists within their areas or jurisdiction wear personal protective equipment (PPE) and that their clinics follow all the health and safety standards prescribed by the Department of Health.
"The nature of dental operation requires close proximity of a dentist and a patient. Kaya lalong dapat magsuot ng PPE ang mga dentist para sa kanilang kaligtasan at ng kanilang mga pasyente," DILG Secretary Eduardo M. Año said.
The DILG Chief said that the dynamics of the dental treatments and services and the inevitability of close exposure to human orifices, namely the nose and the mouth, expose dentists to high risk of infection.
In an Advisory issued to all Local Government Units, Año said governors and mayors must require oral health professionals in their respective jurisdictions to comply to the Philippine Dental Association (PDA) Interim Guidelines on Infection Prevention during the COVID-19 pandemic which guides dentists in their operations in the 'new normal.'
"Amid our country's efforts against the spread of COVID-19, we cannot ignore other serious concerns that need to be addressed, including dental health. The DILG recognizes that oral health is just as important and is part of overall health," he said.
Meanwhile, DILG Spokesperson and Undersecretary Jonathan E. Malaya said that the PDA guidelines provide the precautionary steps that dental clinics should take, such as patient screening, preparation of dental facility team, and standard layers of defense against COVID-19 which includes waste management of hazardous wastes.
"As the economy and establishments open up, the DILG counts on the LGUs to properly regulate the dental health sector in their localities in line with their duty to promote health and safety. Mahalaga ang oral health sa kabuoang kalusugan ng mamamayan," said Malaya.
Scheduling of patients
For patient appointments, the PDA recommends doing a two-phase triage. First, dental clinics must screen cases over the phone to determine the urgency of care, to find out the area of current residence, and possible contact with confirmed COVID-19 patients. Patients should be informed of treatment options and infection control protocols in the clinic.
Second, during the appointment, a questionnaire checklist for possible symptoms and contact exposure will be filled out by a patient who will sign informed consent on treatment options and waiver forms. A scheduled appointment is advised except for emergencies. This makes possible the scheduling of patients apart to give enough time for the disinfection of work areas.
Prior to a face-to-face consultation, PDA advises dentists to conduct an inventory of their PPE supplies and only schedule an appointment with patients according to PPE's availability.
Clinics should have printed reminders for patients to wear masks, avoid touching the face, do hand sanitization, observe cough etiquette, and maintain physical distancing.
Control of air flow in a clinic
It is recommended that dental clinics frequently renew indoor air either by opening the windows or using mechanical ventilation to allow air exchange. The intent is to bring aerosolized air down to be siphoned out of the operatory.
However, the clinic staff's responsibility that infected air to be delivered out should be sterilized so as not to infect other individuals where contaminated air is blown out.
The PDA guidelines further advised dentists that patients who need to undergo aerosol-generating procedures should be required to present a valid test result not more than five days old of RT-PCR (Reverse transcription-polymerase chain reaction) COVID-19 used and approved by the Department of Health.