Epidemiologist and renowned professor of Baylor College of Dentistry, now the Texas A&M College of Dentistry, Dr. Raghunath Puttaiah, is the expert on infection control. Back in college, he was my own infection control professor, and now retired, he is here to tell us what precautions we should be taking during the  COVID-19 crisis.

Dr. Puttaiah encourages dentists to begin by following simple control measures. Have open communication with staff, screening questions for all patients, public messages on your front door and website addressing key issues and guidelines, and what he refers to as a “skeletal crew.” 

My own skeletal crew that has continued to take emergency cases is composed only of those that feel safe to come to work. Dr. Puttaiah advises us to ensure that this smaller group of staff is ready and willing to take on cases and that we as leaders take on various precautions to protect their health. 

Along with implementing the standard safety guidelines we are all familiar with, Dr. Puttaiah advises dentists to do three more things: employ careful case selection, have all patients pre-rinse, and limit aerosols. 

You can carefully select the patients you see by having your team call them prior to their appointment with screening questions to determine if they’ve been exposed to the virus. All cases with those whose health may have been compromised should be postponed. 

Secondly, if you’ve strayed away from having all your patients pre-rinse before treatment, now is a great time to bring it back. Pre-rinsing can eliminate the vast majority of potentially dangerous microbes that could become airborne during treatment. 

During our talk, Dr. Puttaiah reminded us that there are two types of viruses: enveloped and non-enveloped. Fortunately, COVID-19  is a non-enveloped virus and is, therefore, easier to kill with Peridex of at least 0.12% concentration or an alcohol-based mouth rinse like Listerine. 

If possible, eliminate or reduce all operations that involve splash or spatter, such as polishing. Dr. Puttaiah vouches for four-handed dentistry so that your assistant can manage an HVE. He also encourages the use of handheld instruments and rubber dams instead of isolates to reduce these aerosols. 

Many of us have been discussing air purifiers, and when I brought it up to  Dr. Puttaiah, he agreed on the benefits of using them in our practices. Using an air purifier like Surgically Clean Air or Austin Air’s unique dental system can yield up to 95% aerosol removal. 

Another way to prevent harmful aerosols from reaching you is, of course, masks. While Dr. Puttaiah believes that only a respirator can fully protect you from droplets and the smallest microbes, he recommends finding a snug mask that has a changeable filter to deter any droplets that may travel from coughing or sneezing patients. According to Dr. Puttaiah, the droplet is the greater threat in the case of COVID-19, so a snug mask is an effective protection.

Along with his infection control tips, Dr. Puttaiah wanted to remind us that life goes on. As a species, we’ve been through many plagues and challenges, and despite them all, life always goes on. As dentists, we are licensed leaders that already have training in infection control. Now is the time to retrain our team and implement our expertise as healthcare providers. 

Learn more about:

• Which control measures are most important during COVID-19
• Mask or respirator, which should you use?
• How to reduce potentially harmful aerosols