COVID19 Update

To our Patients and Friends of Smile & Shine Dental Clinic.

Smile & Shine Dental Clinic Re-Opening Policy updated 29th May 2020
This policy has been created based on multiple updated sources from within the dental and medical professions and the government. It outlines modifications to our normal procedures that we intend to employ once the practice can be reopened after the COVID-19 pandemic peak has subsided.

It is not known at this time whether these procedures are temporary or whether they will become a permanent feature of the way dental practices must be run to ensure patient and staff safety in the future. The worldwide COVID-19 pandemic is still being evaluated and studied and policies and recommendations are likely to change in line with new scientific evidence over time.
We would like to thank all of our patients for their patience during the period of temporary practice closure and for their understanding and cooperation whilst we implement new measures at the practice. We will of course be providing dental care to all of our patients in the safest possible environment. We greatly appreciate your assistance with any new or modified procedures at the practice.
Provisional timetable
It is our intention for the practice to re-open for emergency patients on Monday 29th of June 2020 unless an extension to the current lockdown is mandated by the government or professional bodies. The Smile & Shine team will prepare the practice for reopening and practising our updated procedures before patients return to the practice.
From 9th of June we will be prioritising:
• Patients with treatment that was incomplete before the practice was temporarily closed
• Patients with emergency problems or other dental problems that require urgent assessment and treatment
From 1st August we will be prioritising:
• Patients wanting preventative care: dental examinations and manual hygiene care
• Routine non emergency treatments not requiring aerosol generation
Patient communication before an appointment
We will be contacting patients to confirm appointments, along with updating each patient’s medical history records, and completing a risk assessment for coronavirus infection before attending the surgery.
Details of new measures at Smile & Shine to reduce risk of COVID-19 transmission
Our normal cross-infection control protocols against all previously known pathogens are already woven into all clinical activity carried out at Smile & Shine. It should be remembered that a dental practice is already a very clean environment compared to public areas and there is no evidence of COVID-19 transmission occurring in increased rates in dentists or their staff.
We have collectively evaluated all of the updated guidance and observed what measures have been put in place in other countries. We feel that the following measures will reduce risk to the minimum level at the practice. Please be assured that all of our clinical staff will also be complying with these procedures to reduce the risk of cross infection in both directions.
Before attending the practice
• Via telephone, we will carry out a pre-attendance medical history and risk assessment the day before your appointment. If we feel that you are at risk of having possibly been infected, even if you are asymptomatic, we will respectfully request for you to delay booking any appointments with us for at least one month.
• We would recommend that patients in the high-risk groups for developing complications from coronavirus delay non-essential dental treatment for as long as possible until the trend of the pandemic becomes clear. To find out whether you are in a high or very high-risk group please see the link below:
https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk- from-coronavirus/
• If you are in a high-risk group and do require treatment, we will schedule your appointment at the beginning of the day to limit your potential exposure to other patients and aerosols.
• We request that payment is made with contactless card for your appointment, this reduces the requirement for unnecessary contact or use of pin entries on card terminals at reception.
• When travelling to the practice, we would recommend that you limit close contact with other members of the public as far as possible.
• One adult is able to attend with a child; please do not bring additional family members with you unless they are happy to wait in the car or outside the building.

Arriving at the practice
• We intend to eliminate waiting inside the practice and at reception. Accordingly, appointments will be staggered so that patients do not arrive or leave at the same time as other patients as far as we are able to manage.
• When you attend the practice, the front door will remain locked and we will welcome you into the practice
• If you are well, we would direct you straight to the surgery and request that you do the following before or during your appointment:
o Use the hand sanitiser in the reception area or
o Thoroughly wash your hands for 30 seconds with the hand wash provided in the surgery
o Rubber dam or other barrier mechanisms will be used for more procedures than previously.
• Use of the restroom will be limited and it is advised that you use your restroom before travelling to attend your appointment.
• In the event that you use our restrooms, please do your best to ensure that you leave the facilities as you would expect to find them and wash your hand thoroughly. The restrooms will be regularly disinfected between each patient.
Practice procedures
• The Smile & Shine team have spent time critically looking at every aspect of the practice with a view to removing all non-essential items that can potentially be the cause of infection. You will find that the practice may appear to be quite bare when you attend.
• All clinical and common areas including door handles and surfaces will be regularly disinfected in addition to our normal surface cleaning protocols between patients.
• We will be providing a buffer period between patients to allow additional time for additional decontamination procedures, allow for any treatment overruns and allow preparation time for the next patient so that they do not need to wait in the reception area.
• All future appointments will be made and confirmed by email or telephone to limit your time spent at reception.
Dental procedures
• All dental staff will be using personal protective equipment in line with current recommendations and evidence. We apologise in advance for the necessary reduction in social interaction that this will necessitate. Whilst our masks may make us appear impersonal and distant, please be assured we are still the same friendly team underneath it all!
• We are especially mindful that many dental treatments are aerosol-generating procedures (AGP’s). It is difficult for us to carry out some dental procedures without generation of some level of aerosol. Aerosol suspended in the air is a theoretical source of infection which we obviously wish to keep to a minimum. Currently the dental literature suggests:
o Our use of our normal high-volume suction reduces aerosol production by over 90%.
o The use of dental rubber dam where possible reduces bio aerosols by a further 30 to 90%
o Our regular facemasks filter approximately 60% of remaining airborne particles.
o FFP2 and FFP3 masks filter 94% and 99% respectively of airborne particles in both directions (patient to clinician and clinician to patient).
• We therefore feel that our normal dental procedures can be carried out with minimal risk by the use of high-volume suction, rubber dam and FFP2 masks and, in high aerosol generating procedures FFP3 masks as appropriate.
Summary
The vast majority of our patients are otherwise healthy without coronavirus infection and we are confident that we are able to provide normal dental care for these patients in as normal an environment as possible while bearing in mind our responsibilities to mitigate risks of infection spread as far as is practically possible.
This policy will be constantly reviewed and updated as necessitated by circumstances over time.
If you have any questions regarding this policy or about your dental care at Smile &Shine please do not hesitate to contact us on 02088005080

Thank you
The Smile & Shine Team

SMILE & SHINE DENTAL PRACTICE

288 SEVEN SISTERS ROAD
FINSBURY PARK
LONDON N4 2AA

TEL:02088005080
EMAIL:Danesi.Sadoh@nhs.net
June 17th 2020

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