DHCPs must always use appropriate PPE, particularly during a global pandemic such as COVID-19. If an AGP procedure is being performed, then a fit-tested N95 respirator or the equivalent (as approved by Health Canada), or a surgical mask and face shield must be worn, as well as a surgical gown/lab coat and gloves.

If a dental office is identified by Public Health as a source of original exposure for a COVID-19 case, or a source of exposure of others by a COVID-19 case, the dental office will be contacted by Public Health.

If you have been contacted by Public Health, in addition to co-operating with them you should ensure that you and your staff continue to monitor for symptoms through diligent daily screening.

All DHCPs and office staff must screen themselves daily for symptoms and risk factors. DHCPs who develop any new or worsening symptoms of COVID -19 must exclude themselves from the workplace and call 811.

If a dental office is identified by Public Health as a source of original exposure for a COVID-19 case, or a source of exposure of others by a COVID-19 case, the dental office will be contacted by Public Health.

If you have been contacted by Public Health, in addition to co-operating with them, you should ensure that you and your staff continue to monitor for symptoms through diligent daily screening.

All DHCPs and office staff must screen themselves daily for symptoms and risk factors. DHCPs who develop any new or worsening symptoms of COVID-19 must exclude themselves from the workplace and call 811.

Nova Scotia Public Health states, “You should wear a non-medical mask if you have respiratory symptoms (like coughing or sneezing) and you’ll be in close contact with other people, or if you’re going out to access medical care or other essential health services.” https://novascotia.ca/coronavirus/staying-healthy/#masks
In addition, patients are encouraged to use hand sanitizer or wash their hands when entering and exiting a dental office. Further, patients are encouraged to wait outside the dental office or practice social distancing in the waiting room while waiting their turn for dental treatment.

Patients wearing a non-medical mask will obviously need to take it off prior to starting their treatment. In this case patients, should wash their hands or use hand sanitizer immediately prior to taking their mask off.

Lab coats are long-sleeved garments that are intended to be patient-specific items of protective clothing and must be removed prior to seeing the subsequent patient. Lab coats are to be worn over regular clinic clothing, such as uniforms or scrubs, during AGPs or during procedures likely to generate splatter or droplets. Lab coats should be closed to the neck if possible, with buttons, zippers or other fasteners. The length of the lab coat can vary, but the length of the lab coat sleeves should be full arm length, not short sleeves. It is preferred if the lab coat sleeves could be tucked inside the treatment gloves, but if this is not possible, then proper hand hygiene must include the wrists and any exposed skin on the forearms.

Commercial and surgical grade N95 respirators are of similar structure and design. The main difference between the two grades is that commercial N95 respirators are not tested for fluid resistance of any type. Therefore, surgical grade respirators are preferred for patient care. If surgical N95 respirators are not available and there is a risk that the worker may be exposed to high velocity droplets or splatters of blood or body fluids, a face shield or surgical mask must be worn over the commercial N95 respirator to provide the fluid resistance necessary. Always check to ensure that your respirator is fluid resistant, and, if it is not, create fluid resistance by adding a surgical mask or full-face shield as mentioned above. This will also facilitate the possibility of re-using the N95 respirator, as it will protect it from becoming moist or visibly soiled requiring its disposal. DHCPs are to use their own judgement regarding when to replace their mask.

If you practice in an open concept office with no physical barriers between chairs and you are performing an AGP, you must only have the patient being treated in the space and no others. This does not apply if providing a non-AGP and social distancing measures can be met.
An office may consider installing barriers such as a plexiglass barrier between chairs in order to treat more than one patient at a time when performing an AGP.

The importance of screening cannot be over-emphasized. Screening helps to identify patients who are possibly infected with COVID-19 before they enter a clinic, receive care and possibly transmit the virus in the process. Pre-screening (telephone screening) should be done prior to the office visit, as well as in-office screening during the appointment and must include COVID-19 symptoms and COVID-19 risk factors.

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