Dental offices prepare to reopen, share concerns about PPE supply

Dental offices across Minnesota are preparing to reopen on Monday, but visits will look different from before.

“A lot of practices are to help with social distancing, working to develop virtual waiting room where either patients wait in their car or in common areas where they can maintain good social distancing,” said Dr. Jim Nickman, the president of the Minnesota Dental Association.

He’s also a pediatric dentist at Metropolitan Pediatric Dental Associates.

“If you’re having a cleaning done, more of a routine visit, you’ll probably notice the staff are wearing gowns,” Nickman said. “Definitely wearing face shields, they may be wearing head coverings.”

They’re also looking at ways to improve airflow and filtration in the office.

Patients should expect to see fewer items in the waiting room and either plastic shields at the reception desk or receptionists wearing masks. Some practices may also have tape on the floor to guide traffic.

“We’ve really worked hard to streamline how a patient enters a practice, what happens during the dental visit and then on their exit out,” he said.

Nickman said is he concerned about the amount of personal protective equipment available. It was easy to acquire before COVID-19, he said, but now it’s become a struggle for some practices to find more supplies.

“The shutdown has been very helpful for practices to find suitable equipment, but you know that may be a reason that our care levels are not as high as they were before, too,” Nickman said. “Trying to preserve this until basically the supply chains have been reestablished and things go back to the new normal.”

“If we were to operate at the level we were operating at in February, I certainly couldn’t stay open as long based on what I’m able to obtain right now,” he said.

Carmelo Cinqueonce, the executive director of the Minnesota Dental Association, said they started surveying members on Thursday.

“Just to get a handle on how many days supply of N95, KN95 masks, gloves, face shields, surgical masks they may have in stock and inventory, and how confident they are in obtaining that,” he said. “Access to personal protective equipment is going to be the biggest challenge and hurdle going forward.”

The Minnesota Board of Dentistry is helping where it can. The state agency said it has now distributed nearly 30,000 N95 masks to offices around the state.

“It’s critically important these dental practices are able to return to some level of care and continue to be an important part of the community they serve,” Cinqueonce said.

He said if dentists treat a patient before there is an emergency, it can save a trip to the already burdened ER.

Cinqueonce doesn’t expect all dental offices to reopen right away.

“I think it’s going to be a yellow light on Monday and some practices may elect to push that out another week or so,” he said. “It’s going to be on an individual case-by-case basis what the dental practices feel prepared to do to re-enter.”

They urge patients to seek care.

“We’re very concerned about our patients,” Nickman said. “This is certainly not a time to put off unmet dental needs, it only gets worse as time goes on.”

His office plans to increase the number of patients they see throughout the month, taking every precaution.

“It’s a new reality and I think, as time goes, on it will become the expectation,” he said.

Bridgett Anderson, executive director of the Minnesota Board of Dentistry, released the following statement:

"Per the recent Executive Order that allows elective care to resume, the Minnesota Board of Dentistry has provided specific guidance on developing a facility plan as required. Dental clinics are required to develop this plan to mitigate risks for themselves and patients. Dental care is essential care and we are seeing a major increase in dental emergencies over the last few months throughout the state. Dental providers have been treating emergencies since day one of the pandemic response so they can help prevent patients from going to ER or hospitals to seek care. The plan will require strict guidelines, as even a dental root canal procedure produces aerosols and our plan helps the dentists and allied dental professionals mitigate risk while continuing to phase into care. The dental community needs to continue to address urgent needs and dental disease. Dental disease can be rapidly progressive when patients have an abscess or other urgent functional needs. Even periodontal disease can become urgent with high risk patients that have heart disease and diabetes. Patients need to gradually return to care in the safest environment and that can be achieved, but we are requiring that practices do their part in having a modified plan for engineering controls, administrative controls, and additional PPE considerations. Patient health and safety is at the forefront, along with provider health and safety. We are continuously pursing avenues for resource for PPE and testing for dental patients and providers."