We will never forget the impact of Covid-19 to our communities, friends, and businesses. Whilst we may have had some dark times throughout the period we can rejoice that we have been able to add some new vocabulary such as P.P.E! Many of us have been busy with zoom meetings, home-school classes and waiting in a queue outside the supermarket on our 'name day'.
Not all of us are microbiologists who can tell the difference between two viruses under an electron microscope, but we can probably pick out a corona virus in a line-up of usual suspects. Our new skills abound, we have figured out how to make hot cross buns without yeast, and how to fly a kite without invading social distancing. We Bermudians have it down!
As Bermuda becomes more confident and begins to cautiously ease restrictions it is a breath of fresh air to be allowed out of the house. We can reconnect with friends and family at a distance. We can start to find some shadow of what we previously thought was normal. But it can’t be normal. Not yet. Maybe not for 2-3 years according to some experts.
Some things that seemed normal will need to change. Some changes will feel restrictive, and some will be so obviously good we will wonder why we waited until a pandemic to initiate them. At one point in time airplanes had smoking sections - until that changed, and then we all wondered why they were ever there in the first place.
And so dentistry has to change. As the island moves into Phase 2, the Bermuda Dental Board has decreed that Dentistry is locked in Phase 1 for an additional 2 weeks until June 1st at the time of writing.
Dentistry is a bit of a special case. Throughout the years the profession had to respond to various out-breaks of water borne infections, blood borne viruses, and other hazards. Over time our dentists have adapted and augmented our armaments of protection within our practices. Already we purify our own water, our compressed air comes from medical grade oil free compressors. Our operatory walls, ceilings, and floors are of very specific construction to meet radiation safety standards. Doorways are carefully placed to facilitate line of sight but to avoid x-ray exposure. We no longer use traditional silver fillings which contain heavy metals, in favor of modern alternatives. And who can forget our iconic glass enclosed dual stream central island sterilization bay.
Now we have Sars-Covid-19 causing trouble which has resulted in an almost global suspension of dental services due to aerosols. We never had to worry about this before, but this particular virus can live and spread in very tiny water particles called aerosols, and modern dentistry produces aerosols. This is a serious challenge that we must address to keep our patients and our staff safe.
At SmilesInc. we made some changes. First, we checked that we didn’t have any air-conditioner intakes in the operatories as that could spread aerosols through the air-conditioning system (we didn’t!) Next, we added some very stylish and amazingly functional doors. One to separate the clinical and reception areas, and others to close off the operatories. Yes, love it or hate it, all our operatories now have doors! Independent continuous running HEPA 13 filters have been installed throughout the office and in each operatory. These are special filters that are able to clean aerosols from the air – sounds like we are surely getting closer to controlling those pesky aerosols! For the icing on the cake our most technically challenging modification was to make each dental operatory a negative air facility.
What is a negative air facility? It is normally found in hospitals that treat patients with infectious diseases but is beginning to find a home in some dental offices. First you must create positive pressure by adding clean air into a sealed room. Then you create suction to out compete that positive pressure to create negative pressure. The whole thing must be done in a controlled manner, within set parameters which needs to be checked by an independent engineer. The result is that airborne contaminants within the room are diluted, inactivated, and safely exhausted whilst the negative pressure prevents any particles from being able to leave the room. So, with the help of some very inventive local partners we were able to bring the same technology from hospital isolation wards into the dental office.
Now that we have made it safe to function, you will notice that we have also made changes to keep us current with the requirements for social distancing that you will find anywhere else. Bear with us as we must perform pre-appointment screening - so we will need to ask you some questions over the phone before you come in. You will be offered hand sanitizer when you arrive and before you leave the office. And we will ask you to please wear a mask for your appointment. You might notice some of the personal protection equipment (P.P.E.) we are wearing looks a little weird, please don’t be frightened of us!
Currently under Phase 1 regulations, dental offices are closed to all but emergency treatment which cannot be treated with antibiotics over the phone and must be done without creating aerosols. The plan to move to Phase 2 on June 1st will allow us to re-open with minimal aerosols. Finally, we can start to address a wider range of dental issues, however some procedures will still not be possible until we move to Phase 3 which has yet to be announced.
Unfortunately, we will not be sending our appointment email reminders for the time being. All previously scheduled appointments will have to be rebooked and you will receive a phone call with a new date and time.
Thank you for being understanding and we look forward to seeing you again soon!