I recently participated in a COVID-19 update webinar. The bottom line is that dentistry during the pandemic has proven to be very safe, with no known transmission of infection to a patient. While we are currently witnessing another surge in infections and PPE shortages, Dentistry is very safe. It also appears that vaccines are on the way and rapid testing may be available in the US in a few weeks. These would be very welcome developments.
As anyone who knows me or follows our Blog, I spend a fair amount of time studying the latest information available on COVID-19. In 32 years of private practice, I had never missed a day of work due to illness, so I was a little distressed when back in March, we had to close our practice for three months. We plan for contingencies, but I never expected anything quite like this.
At Markiewicz Dental, we responded quickly and aggressively to modify our office and implement protocols which allow us to provide exquisite dental care in an environment safe for both our patients and team members. Our patients have noticed:
Data suggests that American’s overall dental health suffered due to the shutdown. Dentistry is Essential Health Care and we need to ensure we can safely provide the dental care needed to maintain our patients dental health.
Since the pandemic began in the Spring, we have learned a great deal about controlling virus transmission. At Markiewicz Dental we are well prepared to provide the exquisite dentistry our patients expect and continue to do it safely.
So, what did we do?
Did you ever hear of the Swiss Cheese Model? James Reason developed the model to help explain risk management. In the Swiss cheese model, safeguards against failure are modeled as a series of barriers, represented as slices of Swiss cheese.
The holes in the slices represent weaknesses in individual safeguards and continually vary in size and position across the slices. The more layers, the less the chance of the holes aligning and thus greater safety.
At Markiewicz Dental, we added multiple layers of safeguards to ensure the safety of our patients and team members.
- We have remodeled our office and upgraded HVAC systems to meet ventilation guidelines including adding Negative Pressure Treatment Rooms
- We have installed Medical Grade HEPA air filtration with UV-c sterilization in our treatment rooms and added HEPA filtration throughout the office
- We have enhanced our disinfection protocols including electrostatic fogging to assure your safety
- We Screen every person entering our office including Team Members
- We have adjusted appointments to accommodate social distancing
- Masks are required while in our office
Why so much attention to air quality?
1. COVID-19 is a respiratory virus. Its primary mode of transmission is through the air, from person to person. Universal masking greatly reduces the spread of respiratory infections. If you wonder how masks work, this NYT piece is a great visual.
2. “Cleaning the air” helps create a safe environment.
I believe the cleanest air we breathe all day is in our office, especially in our treatment rooms. We have relied upon several scientists for the information needed to develop our protocols. Here is a snippet of a video featuring Dr. Joseph Allen of Harvard explaining “air cleaning”.
As mentioned in the video, the goal is “refresh” the air in a room through a combination of fresh air and air filtration. The number of times the air is “refreshed” is known as the Air Exchange Rate. The greater the number of air exchanges per hour, the healthier the air in a space.
A 2013 study showed the average exchange rate for schools and homes in the US is <1 per hour, creating environments where respiratory infections spread quickly and easily. Studies also indicate that as the air exchange rates increase, the chance of respiratory infection transmission declines. Better air quality results in better cognitive performance and less absenteeism due to illness. Air quality matters, during the COVID-19 pandemic, and will continue to matter long after the pandemic ends.
At Markiewicz Dental, we have always focused on providing a safe environment. Utilizing fresh air from our HVAC system, exhaust, and HEPA air filtration, we have established a minimum air exchange rate of 12+ per hour, similar to the level found in most hospitals.
In our treatment rooms, we have established an air exchange rate of 35. Ninety percent of the air in each treatment room is continuously refreshed in just under 2 minutes, protecting everyone in our office. Aerosols generated during a dental procedure are quickly filtered or exhausted and are never recirculated. We also added additional levels of protection which we activate based on the dental procedure being performed.
Masks Exhaust Fresh Air HEPA Filters=Clean and Safe Air
Just as we test our sterilization and our water quality, we also test our air. Here are some sample readings from 11/21/2020.
The cleanest air you will breathe all day is in our office and these readings prove it!
This meter measures large (PM10), small (PM2.5) and total particles as well as CO2 and Formaldehyde. The lower the numbers, the better.
Here is the reading outdoors, behind the office.
Here are the readings from the reception/front desk area. Notice how much cleaner the air is than outdoors. Thanks HEPA!!
Now notice how clean the air is in the treatment rooms:
While these types of devices don’t specifically measure airborne viral particles, they do measure the types of particles onto which viruses attach. The comparison of the indoor air to the outdoor air shows the effectiveness of our filtration systems.
Based on our monitoring, we noted we needed to increase humidity. 40%-60% is ideal, so we added humidifiers.
You can count on us to continually improve and innovate. While it may seem our only focus is COVID, we are still addressing all the other areas of our practice. Our practice and our team continue to innovate and improve:
- Our hygienists have implemented a new system which allows us to monitor your periodontal(gum) health more accurately
- Dr. David and I continue to expand our use of digital technologies which allow us to deliver care more comfortably and accurately.
- Our Business Team is implementing new technologies and protocols to improve our level of service and communication.
- We recently completed a team training day
- We continually upgrade our infrastructure. We have upgraded the systems that provide all the power needed to do the dentistry. We cannot work without the high-tech vacuum and compressor systems we recently upgraded.
- We completed our transition to all electric handpiece systems
Our team members are well trained and dedicated to making a difference. We are privileged to serve your needs. No question is too small or insignificant for us to answer. Call our office anytime at 847-566-2811.
Please browse through our website for more detailed information on the many dental services that we offer. Whether you need a Crown or Bridge, Cosmetic Dentistry, Implants, Root Canals, Dentures, or a dental cleaning.
Anthony Markiewicz, DDS, FAGD