Last week I had the pleasure of speaking to Kathy Nahrwold, President of Absolute OSHA Consulting, a highly experienced OSHA consultant.

We continue to hear many concerns from our clients and across industry in regard to infection control. As a result, we wanted to bring you important thought leadership on the matter.

Here is a summary of my conversation with Kathy.

Where Are We Today?

There are not going to be a lot of changes right away.  Likely for two reasons:

1. We are still learning about the virus.  How it transmits, how if effects people, etc.
2. There is a heavy bureaucracy involved between CDC, OSHA, FDA, ADA, State Departments of Health, Dental Boards, etc.

At present, the CDC has not made any changes.  The current CDC alert level is 3 – avoid non-essential travel and the recommendation to use Level 3 masks for oral health professionals remains.

Interim CDC policies still in place for treating emergency patients.

That said, Kathy urges all to be prepared.  It’s time to take OSHA and infection control more seriously if you haven’t previously. 

Tactical Guidance & Recommendations (in no order):

1. Continue to look to the CDC, ADA and state associations for guidelines when returning to work.  Changes are occurring every day.
2. Make sure to wear appropriate PPE. If not available, then offices may not be able to return to work.
3. Get MSDS sheets updated.
4. Employees cannot wear uniforms to work or home from work.  
5. Organize a team meeting to discuss a deep cleaning plan for the office.  Consider things like:
   1. Waiting room couches and chairs (upholstery), remove beverage stations from waiting rooms at this time, social distancing in the waiting room area, and install a hand sanitizer station.
   2. Front desk employees should have PPE at their disposal.
   3. Clean chairs, lights, cabinets, etc.
   4. Countertops and exposed inventory in operatories.
6. Update policies and procedures to reflect today’s realities:
   1. What to do with patients suspected of having COVID-19. 
   2. Defer to hospital setting if you suspect someone is ill.
   3. In calling to confirm, move ill or exposed patients out on the schedule.
   4. Should the office scan patients for a fever? Medical histories become very important. Do you have a fever?  Have you recently been in contact with someone with COVID-19? 
   5. Update Employee policies, like stay home if sick…
7. Appoint someone as the office infection control coordinator responsible for ensuring that employees are following protocol for PPE, Sterilization, etc.
8. Plan to spend more time cleaning between patients. Our scheduling will need to reflect the appropriate time to clean & disinfect all operatories properly, process instruments and don new PPE.
9. Get caught up on other OSHA requirements like HEP B vaccine to employees that have not had it yet.  CDC highly recommends that employees receive a flu shot each year (not mandated for employer to cover costs if any). In time we may have a COVID-19 vaccination.
10. Flush all dental unit waterlines, shock treat and then test.  They have been idle (stagnant) for a long time and therefore the accumulation of biofilm will be much greater.  The unknown still exists as to if the COVID -19 can be transmitted thru DUWL.

Final Thoughts & Looking Ahead

1. Kathy opined that she doesn’t know how this will affect the design or use of hand pieces.  There could be redesigns coming in the future to mitigate aerosol.
2. She could see the requirement increase for masks from Level 3 to N95 for oral surgery and/or maybe a respirator mask for restorative treatments.
3. Kathy considered that guidance may later include the use of disposable gowns to be disposed of after each patient (not daily).

I hope this helps answer some of your questions. If you have additional questions, please reach out to Kathy directly ((260) 705-6257 or kathy@absoluteoshaconsulting.com) or visit her website.

Last week I had the pleasure of speaking to Kathy Nahrwold, President of Absolute OSHA Consulting, a highly experienced OSHA consultant.

We continue to hear many concerns from our clients and across industry in regard to infection control. As a result, we wanted to bring you important thought leadership on the matter.

Here is a summary of my conversation with Kathy.

Where Are We Today?

There are not going to be a lot of changes right away.  Likely for two reasons:

1. We are still learning about the virus.  How it transmits, how if effects people, etc.
2. There is a heavy bureaucracy involved between CDC, OSHA, FDA, ADA, State Departments of Health, Dental Boards, etc.

At present, the CDC has not made any changes.  The current CDC alert level is 3 – avoid non-essential travel and the recommendation to use Level 3 masks for oral health professionals remains.

Interim CDC policies still in place for treating emergency patients.

That said, Kathy urges all to be prepared.  It’s time to take OSHA and infection control more seriously if you haven’t previously. 

Tactical Guidance & Recommendations (in no order):

1. Continue to look to the CDC, ADA and state associations for guidelines when returning to work.  Changes are occurring every day.
2. Make sure to wear appropriate PPE. If not available, then offices may not be able to return to work.
3. Get MSDS sheets updated.
4. Employees cannot wear uniforms to work or home from work.  
5. Organize a team meeting to discuss a deep cleaning plan for the office.  Consider things like:
   1. Waiting room couches and chairs (upholstery), remove beverage stations from waiting rooms at this time, social distancing in the waiting room area, and install a hand sanitizer station.
   2. Front desk employees should have PPE at their disposal.
   3. Clean chairs, lights, cabinets, etc.
   4. Countertops and exposed inventory in operatories.
6. Update policies and procedures to reflect today’s realities:
   1. What to do with patients suspected of having COVID-19. 
   2. Defer to hospital setting if you suspect someone is ill.
   3. In calling to confirm, move ill or exposed patients out on the schedule.
   4. Should the office scan patients for a fever? Medical histories become very important. Do you have a fever?  Have you recently been in contact with someone with COVID-19? 
   5. Update Employee policies, like stay home if sick…
7. Appoint someone as the office infection control coordinator responsible for ensuring that employees are following protocol for PPE, Sterilization, etc.
8. Plan to spend more time cleaning between patients. Our scheduling will need to reflect the appropriate time to clean & disinfect all operatories properly, process instruments and don new PPE.
9. Get caught up on other OSHA requirements like HEP B vaccine to employees that have not had it yet.  CDC highly recommends that employees receive a flu shot each year (not mandated for employer to cover costs if any). In time we may have a COVID-19 vaccination.
10. Flush all dental unit waterlines, shock treat and then test.  They have been idle (stagnant) for a long time and therefore the accumulation of biofilm will be much greater.  The unknown still exists as to if the COVID -19 can be transmitted thru DUWL.

Final Thoughts & Looking Ahead

1. Kathy opined that she doesn’t know how this will affect the design or use of hand pieces.  There could be redesigns coming in the future to mitigate aerosol.
2. She could see the requirement increase for masks from Level 3 to N95 for oral surgery and/or maybe a respirator mask for restorative treatments.
3. Kathy considered that guidance may later include the use of disposable gowns to be disposed of after each patient (not daily).

I hope this helps answer some of your questions. If you have additional questions, please reach out to Kathy directly ((260) 705-6257 or kathy@absoluteoshaconsulting.com) or visit her website.

Last week I had the pleasure of speaking to Kathy Nahrwold, President of Absolute OSHA Consulting, a highly experienced OSHA consultant.

We continue to hear many concerns from our clients and across industry in regard to infection control. As a result, we wanted to bring you important thought leadership on the matter.

Here is a summary of my conversation with Kathy.

Where Are We Today?

There are not going to be a lot of changes right away.  Likely for two reasons:

1. We are still learning about the virus.  How it transmits, how if effects people, etc.
2. There is a heavy bureaucracy involved between CDC, OSHA, FDA, ADA, State Departments of Health, Dental Boards, etc.

At present, the CDC has not made any changes.  The current CDC alert level is 3 – avoid non-essential travel and the recommendation to use Level 3 masks for oral health professionals remains.

Interim CDC policies still in place for treating emergency patients.

That said, Kathy urges all to be prepared.  It’s time to take OSHA and infection control more seriously if you haven’t previously. 

Tactical Guidance & Recommendations (in no order):

1. Continue to look to the CDC, ADA and state associations for guidelines when returning to work.  Changes are occurring every day.
2. Make sure to wear appropriate PPE. If not available, then offices may not be able to return to work.
3. Get MSDS sheets updated.
4. Employees cannot wear uniforms to work or home from work.  
5. Organize a team meeting to discuss a deep cleaning plan for the office.  Consider things like:
   1. Waiting room couches and chairs (upholstery), remove beverage stations from waiting rooms at this time, social distancing in the waiting room area, and install a hand sanitizer station.
   2. Front desk employees should have PPE at their disposal.
   3. Clean chairs, lights, cabinets, etc.
   4. Countertops and exposed inventory in operatories.
6. Update policies and procedures to reflect today’s realities:
   1. What to do with patients suspected of having COVID-19. 
   2. Defer to hospital setting if you suspect someone is ill.
   3. In calling to confirm, move ill or exposed patients out on the schedule.
   4. Should the office scan patients for a fever? Medical histories become very important. Do you have a fever?  Have you recently been in contact with someone with COVID-19? 
   5. Update Employee policies, like stay home if sick…
7. Appoint someone as the office infection control coordinator responsible for ensuring that employees are following protocol for PPE, Sterilization, etc.
8. Plan to spend more time cleaning between patients. Our scheduling will need to reflect the appropriate time to clean & disinfect all operatories properly, process instruments and don new PPE.
9. Get caught up on other OSHA requirements like HEP B vaccine to employees that have not had it yet.  CDC highly recommends that employees receive a flu shot each year (not mandated for employer to cover costs if any). In time we may have a COVID-19 vaccination.
10. Flush all dental unit waterlines, shock treat and then test.  They have been idle (stagnant) for a long time and therefore the accumulation of biofilm will be much greater.  The unknown still exists as to if the COVID -19 can be transmitted thru DUWL.

Final Thoughts & Looking Ahead

1. Kathy opined that she doesn’t know how this will affect the design or use of hand pieces.  There could be redesigns coming in the future to mitigate aerosol.
2. She could see the requirement increase for masks from Level 3 to N95 for oral surgery and/or maybe a respirator mask for restorative treatments.
3. Kathy considered that guidance may later include the use of disposable gowns to be disposed of after each patient (not daily).

I hope this helps answer some of your questions. If you have additional questions, please reach out to Kathy directly ((260) 705-6257 or kathy@absoluteoshaconsulting.com) or visit her website.