What type of UV light used inside Dynamic extra oral suction? Why UV-C light Cannot Produce Ozone?
What type of UV light used inside Dynamic extra oral suction? Dynamic DS1000 adopts UV-C light, mainly used to eliminate bacteria adsorbed on the HEPA filter, and also has a certain sterilization effect to the fast flowed air. 9W, wavelength 253.7nm It cannot produce ozone. UV lamp classification: UVA: wave length 320~400nm UVB: 275~320nm UVC: 200~275nm , widely used in hospitals, air-conditioning systems, disinfection cabinets, etc. UVD: 100~200nm (Produce Ozone) Why the UV-C light Cannot Produce Ozone? The Ultraviolet Germicidal Irradiation (UV-C) wavelength is an invaluable tool for an HVACR system. By leveraging germicidal energy to keep refrigeration coils free of microbial growth, facility managers also enjoy the benefit of reducing the spread of airborne infectious agents. However, some facility managers may hesitate to leverage these benefits for their application due to a concern about ozone. While the Ultraviolet spectrum contains four separate wavelengths—UV-A, B, C and Vacuum UV—each operates at different energy levels and only one is capable of producing ozone (Vacuum UV). As you’ll note in the graphic below, Vacuum UV operates in the 100-200nm range, where it is capable of producing ozone. UV-C, conversely, reaches its optimal germicidal strength near 253.7nm. Because ozone may only be produced below 200nm, at 253.7nm (rounded to 254nm), the germicidal wavelength does not generate ozone. In addition to the stronger 254nm wavelength that does not produce ozone, UV-C lamps offer another layer of ozone protection. Most germicidal lamps, including those from UV Resources, are produced with doped quartz glass, which blocks the transmission of the 185nm ozone-producing wavelength. The doped quartz glass allows the 253.7nm radiation to pass through, but it blocks the 185nm wavelength from escaping. Therefore, germicidal lamps with doped glass CANNOT produce ozone. WHAT IS OZONE? Ozone is present in low concentrations throughout the earth's atmosphere. Some researchers say that this chemical is “good up high, but bad down low.” Without the ozone layer protecting our Earth’s stratosphere, for example, the Sun's ultraviolet radiation would make life on Earth uninhabitable. At street level, however, a high concentration of ozone is toxic to plants and animals. In humans, ozone can irritate nasal passages, cause nausea and extended exposure can lead to lung inflammation. Ozone, also called Vacuum Ultraviolet (UV-V), is a gas molecule that contains three (3) oxygen atoms – and as such, it has a destabilizing effect on oxygen in the air (leading to its irritation and danger to humans). A UV lamp “tuned” to 185nm can create ozone from oxygen (O2) by disrupting the O2 molecule and splitting it into two oxygen atoms. These two oxygen atoms attempt to attach to other oxygen molecule (O2). It is the attachment of this third oxygen atom that creates ozone (O3). Ironically, UV light in the 240-315nm wavelength will break this third oxygen atom attachment above and convert it back to oxygen. The peak ozone destruction occurs at the 254nm wavelength. So, a UV-C lamp at the 253.7nm wavelength will actually destroy ozone! ASHRAE has said that certain air cleaners produce ozone and thus, its position is to recommend discontinuing utilizing "devices that use the reactivity of ozone for the purpose of cleaning the air." KEEPING PERFORMANCE SUSTAINABLE Keeping buildings operating at their most efficient level and sustaining that performance over the life of a building is one of today's key challenges for specifying engineers, HVACR contractors and facility managers. Today, with germicidal technology, virtually all HVACR systems are potential candidates because of the many proven operational benefits it offers, including: (a) destruction of surface and airborne microorganisms; (b) the restoration and preservation of heat transfer and airflow capacities to "as-built" conditions; (c) greatly improved indoor air quality; and (d) reduced maintenance. Again, while UV-C technology has been proven to restore HVACR performance to its original capacity, specifying engineers, HVACR contractors and facility managers can rest assured that the germicidal wavelength is incapable of producing ozone. Moreover, the 253.7nm germicidal wavelength will destroy ozone. So stay ozone free in the 254nm zone.
Understand when and why to choose HEPA or ULPA. HEPA filters (High-Efficiency Particulate Air) are not all manufactured to the same high standard. The filter systems we offer, remove 99.99% of particles down to 0.3 micrometers in diameter from the air that passes through the filter. This exceeds ASME and DOE standards, which require 99.97%. You may be aware that there's a filter that removes even smaller particles, called the ULPA (Ultra-Low Particulate Air) filter. The ULPA standard requires removal of 99.9995% of particles down to 1.2 micrometers. That sounds much more effective than HEPA.
Boosting your hygiene care one of the key steps as dental practices begin re-opening across the country. I imagine your dental practice is experiencing a severe challenge after the recent pandemic. Good news is that as of today, most dental practices are in phase I: a soft opening. Do you feel like you are still in a crisis mode? Like many of our dental colleagues you may have a pit in your stomach and it seems like we have a daily reminder that we are living in extremely uncertain times. When we experience stress, challenges and uncertainty, our minds and body go into “fight or flight mode.” This is not a good place to be and the question is, how do we recover quickly when life seems so uncertain? Today, I list 5 things to consider as you walk through this first phase of reopening your dental practice. 1. Take a Look. Your first step is to look at where you are today. First of all, try to look at where we were in our world prior to the COVID-19 pandemic. As of January 2020, our economic climate in the U.S. was very good. Our S & P 500 was at an all-time high. Unemployment was at an all-time low. Life “seemed” so good. Let’s take a look at the freedom we felt prior to the pandemic. Let’s remember the great profession we have and know that dentistry can still be a great career path. Our thoughts must remain positive, however, our new norm is going to look and feel different. Next, take a close look at your dental practice. Let’s look at the numbers. Look at your number of active patients, the number of patients who need an appointment (Restorative and hygiene patients) since the COVID-19 shutdown and a total of how many patients need to return pre-COVID-19. Know what numbers to look at. For example: production, collection, insurance fees for your area, your case acceptance rate, hygiene patient recare, etc. Once you know your numbers you can understand your untapped potential for 2020. Remember your goals for 2020. Focus on the goals you can achieve when you reverse engineer these numbers once you take a look at them. “Measure Only What Matters.” If you want to lose weight, getting on the scale to see how much weight you gained over the holidays is no fun. Neither is looking at your numbers and the lost revenue during the COVID-19 pandemic. Yes, however painful you think this feels; you must look. Not sure you know what numbers to look at? Maybe creating your success plan seems like a daunting task. It’s important that you have the best support and a trusted advisor, an expert, who can help you through this challenging time. 2. Communication Many dental practices chose not to stay in communication with their team members and their patients during the pandemic. If you took a break from your “normal life” in your dental office without team or patient communication then today is the day to begin communication with your team and patients. Today the team and your patients need you more than ever. It’s also important to understand what type of communication you should have with your patients. Brainstorm as a team about who to contact and how each of these (hundreds) of patients must be contacted. Many people in today’s world will respond best to a text message so find out how each patient prefers to be contacted and use their preferred method to get them back on your schedule. If doctor and even the team can create a welcome back video (approximately 60 seconds), many patients will respond to schedule their appointment when you text this video message. Make sure to automate your appointment scheduling with a link people can click to schedule. Now is the time to update and share your “Change of Appointment Procedure” because patients will schedule a dental appointment but when they are offered a hair or massage appointment at the same time as their dental appointment, unfortunately, most patients will choose to “change” their dental appointment over to the hair or massage appointment. I always say: “Teach patients how you want to be treated.” As you move through the soft opening of your dental office, schedule time with your team to discuss your new and updated processes. How are these new processes working for your team and the patients? The key now and always is communicate, communicate, communicate! I always say, “Communication can never be too much.” 3. Evaluate your patient hand-off process. How the end of each patient appointment will occur is different once we return post- pandemic. Do you have one person who can assist with the room turn-around? Who is there as a back-up to support your clinical team? Plan for one team member to greet patients, check them in using the pulse oximeter and temperature check. 1 Chose one or two different team members who can meet patients outside the office. These are the team members that complete your assessments and re-check their pre-assessment questionnaire. Patients will enter at the time their provider is ready to seat them. No more waiting in the reception area. Once the patient services have been completed you must have a plan in place for scheduling future patient appointments. Patients can easily pay for their services if you have a link that is automated and texted to their mobile device. Plan out what works best for the check-in and hand-off. Reassess your various new processes and systems after each week. Reorganize your processes and systems as necessary to meet your dental practice philosophy of patient care. Always assess the climate of the current pandemic (check your state BOD and the for updates) and any necessary changes to your processes. 4. Empower your team. Part of communication with your team is empowering them. Give your team members hope for success and a positive outlook for your new norm. Let the team know that you are open to communication and allow your team time to communicate and understand all the dynamic changes post-pandemic. Discover how each team member can be a leader in helping to recover and grow your dental practice. There is a lot happening in our world today and it is important to have systems with implementation. Delegate specific tasks and performance indicators to achieve your goals for 2020. Encourage and share appreciation for everyone (including the doctor) on your team. Make sure that there is not only implementation, but accountability for everyone and every process necessary for your success. 5. Optimize and sustain a successful dental hygiene department. Your hygiene department at this point in time, should produce no less than 30% of your dental practice production. This is not about working faster, harder or seeing more patients. This is about proper diagnosis of periodontitis and gingivitis. We must STOP “cleaning teeth.”We must show our patients what oral inflammation looks like and talk about the systemic risk factors associated with inflammation in their mouth. Our message is about the “mouth-body connection”. We want to get our patients to understand that “people with a healthy body are more likely to live a longer and healthier live.” We want our patients to know that prevention costs a little money and treating disease costs a lot of money. Understand how much production comes from your hygiene department. How many patients in your hygiene department receive a “cleaning” and how many of these patients have completed a CDT code in the 4000 codes? How many patients leave their hygiene appointment and schedule necessary treatment needs? Think about making sure 80% of the doctor’s schedule comes from hygiene appointments. With a COVID-19 success strategy you will implement a schedule-to-goal formula using a blocked schedule. Once you have this formula implemented you can stage the hygiene schedule after determining how many additional hygiene days you need to open over the next 90 days. I call this “Super Hygiene Days.” This is not to be confused with accelerated hygiene appointments. “Super Hygiene Days” refers to super-charging your hygiene schedule with more hours and days to tap into lost revenue during the COVID-19 pandemic. On the days (or evening hours) you are normally closed, you need to add hygiene only days where doctor(s) is present, and he/she is only there to do “hygiene exams.” Use a temp service, new hygienist grads or colleagues of your current hygienists to fill these Super Hygiene Days. During “Super Hygiene Days” the doctor can utilize the dental assistant(s) to treat child prophies (under 13 years of age). You can also schedule teledentistry visits on these special days. Conclusion Every successful and sustainable dental practice is willing to “step outside the box.” They will look at their numbers routinely. The leaders and owners of every successful business are willing to ask for expert advice and they are open to receive support as they walk the path towards their goal. The business owner and the entire team must have open communication. They will understand various methods of communication with their patients outside of the dental office. Think of this global pandemic as a time to reset your business towards great success. Know that now is a time to create your best success plan. As you take your first step forward you should recognize that along your way to success you need to make time to review these 5 tips. Enjoy the ride and celebrate as you take each step along your path to success in 2020. Resources 1. Pulse Oximeter Information for COVID-19. Accessed: June 2, 2020. 2. Centers for Disease Control & Prevention. During the pandemic this is frequently updated: 3. American Dental Association. Updated with COVID-19 Info and webinars. 4. United States Environmental Protection Agency. Great resource for COVID-19 disinfection.
Guidance for Acute, Long Term, Community and Dentistry Care
Guidance for Acute, Long Term, Community and Dentistry Care Acute Care Routine practices and additional precautions for preventing the transmission of infection in healthcare settings (Government of Canada) Infection prevention and control for novel coronavirus (COVID-19): Interim guidance for acute healthcare settings (Government of Canada) Infection prevention and control for COVID-19: Interim guidance for outpatient and ambulatory care settings (Government of Canada) COVID-19 FAQs for AHS Staff (Alberta Health Services) Hospital and critical care (BCCDC) Dialysis patients (BCCDC) Cancer care (BCCDC) Guidance for Acute Care (Ontario Health) Guidance for Labour, Delivery and Newborn Care (Ontario Health) Updated IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19 (PHO) COVID-19: Aerosol Generation from Coughs and Sneezes (PHO) PIDAC Best Practices for Prevention, Surveillance and Infection Control Management of Novel Respiratory Infections in All Health Care Settings (PHO) Recommandations intérimaires sur les mesures de prévention et contrôle des infections pour les milieux de soins aigus (Gouvernement du Québec) Algorithme décisionnel clinique pour coronavirus COVID-19 (Gouvernement du Québec COVID-19 : Avis du CINQ : gestion du risque pour la protection respiratoire en milieux de soins aigus (Gouvernement du Québec Long term, Home and Hospice Care Routine practices and additional precautions for preventing the transmission of infection in healthcare settings (Government of Canada) Infection Prevention and Control for COVID-19: Interim Guidance for Home Care Settings (Government of Canada) Infection Prevention and Control for COVID-19: Interim Guidance for Long Term Care Homes (Government of Canada) Long-term care and assisted living (BCCDC) Guidance for Long-Term Care (Ontario Health) Screening Tool for Long-Term Care Homes and Retirement Homes (Ontario Health) Guidance for Hospice Care (Ontario Health) Guidance for Independent Health Facilities (Ontario Health) Prehospital Care First responders (BCCDC) Guidance for Paramedic Services (Ontario Health) Community Care Guidance for providers of services for people experiencing homelessness in the context of COVID-19 (Government of Canada) Public health management of cases and contacts associated with coronavirus disease -COVID-19 (Government of Canada) Interim guidance on continuity of immunization programs during the COVID-19 pandemic Lifting of restrictive public health measures - Recommendations from the F/P/T Special Advisory Committee on COVID-19 (Government of Canada) Public Health Guidance for Schools (K-12) and Childcare Programs (COVID-19) Community-based measures to mitigate the spread of coronavirus disease (COVID-19) in Canada (Government of Canada) COVID-19 and people with disabilities in Canada (Government of Canada) Guidance for a strategic approach to lifting restrictive public health measures (Government of Canada) Risk mitigation tool for outdoor recreation spaces and activities operating during the COVID-19 pandemic (Government of Canada) Community-based measures to mitigate the spread of coronavirus disease (COVID-19) in Canada (Government of Canada) A framework for risk assessment and mitigation in community settings during the COVID-19 pandemic (Government of Canada) Risk mitigation tool for child and youth settings operating during the COVID-19 pandemic (Government of Canada) Risk-informed decision-making for mass gatherings during COVID-19 global outbreak (Government of Canada) Caring for vulnerable populations (BCCDC) Caring for people who use substances (BCCDC) Providing immunization services (BCCDC) Guidance for Home and Community Care Providers (Ontario Health) Guidance for Community-Based Mental Health and Addiction Service Providers in Residential Settings (Ontario Health) Guidance for Mental Health and Addictions Service Providers in Community Settings (Ontario Heath) Guidance for Community-Based Mental Health and Addiction Service Providers in Residential Settings (Ontario Health) Guidance for Mental Health and Addictions Service Providers in Community Settings (Ontario Health) Guidance for Primary Care Providers in a Community Setting (Ontario Health) Guidance for Essential Workplaces (Ontario Health) Guidance for Pharmacies (Ontario Health) Guidance for Occupational Health and Safety (Ontario Health) Guidance for Food Premises (Ontario Health) Guidance for Consumption and Treatment Services (Ontario Health) Guidance for Industry Operators (Ontario Health) Guidance for Emergency Childcare Centres (Ontario Health) Guidance for Homeless Shelters (Ontario Health) Guidance for Group Homes and Co-Living Settings (Ontario Health) Dentistry COVID-19 (Canadian Dental Association) COVID-19 (Canadian Dental Hygienists Association) COVID-19: Guidance for the Use of Teledentistry (Royal College of Dental Surgeons of Ontario) COVID-19: Guidance on Returning to Dental Hygiene Practice (College of Dental Hygenists of Ontario) COVID-19 Recommendations (Canadian Dental Assistants Association) Recommendations for Dental Hygienists and Canadian Dental Assistants During COVID-19 Outbreak (Canadian Dental Assistants Association) Transitioning Oral Healthcare to Phase 2 of the COVID-19 Response Plan (BC College of Dental Surgeons/College of Dental Hygienists of BC) Expectations and Pathway for Patient Care during the COVID-19 Pandemic (Alberta Dental Association & College) Interim IPC Guidelines Related to COVID-19 Management (Manitoba Dental Association COVID-19 Operational Plan for the Practice of Dentistry in the Province of New Brunswick (New Brunswick Dental Association Pandemic Plan COVID-19 For Emergency and Urgent Care (Newfoundland and Labrador Dental Association) COVID-19: Managing Infection Risks During In-Person Dental Care (Royal College of Dental Surgeons of Ontario) COVID-19 Pandemic: Level 2 IPC Interim Protocol Update (Saskatchewan College of Dental Surgeons)
Reopen Dental Office Post COVID-19 The guidelines listed below are general recommendations for dental offices to consider as they design and implement their own protocols. Every practice is unique and their solution will be as well. We offer these guidelines for the initial phase of each practice’s “soft launch”. As we learn how to treat patients within our new circumstances, offices should expect to return to a full schedule. Looking to the Future in Dentistry The COVID virus has been extremely difficult for all of us. Beyond the devastation to people’s health and well being, dental offices are experiencing complete shutdowns in some places. This will lead to poorer health over time since good oral hygiene is directly linked to better overall health. As dentists, we need to prepare for a new “future” in dentistry for the time being. The proper time to reopen involves many factors. State regulations, practice location Outbreak significance in your area Emergency dentistry provided Dental team health Employee availability All these factors need to be considered before the decision to reopen or “soft” reopen is made. In the meantime, dental practices and dentists need to prepare for the new polices they will need to put into place to begin seeing patient’s again. Here are 10 points to consider and implement to protect yourself, your team and your patients. Please share your thoughts and ideas to help others in the dental profession work toward a safe reopen process.
10 Points to Consider when Reopening Dental Office Patient Communication: Most Important Step. Explain how the use of Personal Protective Equipment (PPE) Works to every patient. Stagger Patients: Do not stack dental appointments – Ramp-up slowly. Only use chairs 1-3-5. Change Appointment Confirmation Style: Explain new safety policies over phone appointment confirmation calls. Ask if patient has any symptoms of fever. Modified Patient Check-In: Reception room is closed. Check-in is done over the phone. Patients wait to be called-in for an appointment once the previous patient is gone and sanitation is complete. Office Entry Restricted: Only patients may enter office for appointment. Spouses, friends caregivers and parents need to wait outside. They can assist patients to the front door and hand-off to Sanitization / Disinfection Technician. Remove Non-essential Items: Any non-clinical items should be stored. Dental display models, flyers, brochures, nightguard samples, implant displays, etc. Dental Supply Deliveries: All supply deliveries from package carriers or dental suppliers must be accepted outside and sanitized once in practice. Contain all Aerosol Spray, Extraoral Suction: Use rubber dam to contain spray. Dental Hygienists should have an dental assistant help them and use a high volume ejector (HVE) for hygiene procedures. The modified (Extra-Oral Vacuum Aspirator) EOVA machine is highly effective in preventing air contamination by dental procedures. Its main advantages are that it can easily be modified for use with any dental unit and it is relatively inexpensive. Sanitization Technician / Environmental Dental Assistant: A new dental position. A roaming dental assistant is most qualified for this new job. They are responsible for sanitizing all areas of concern. Take Patient Temperatures: Most difficult for dentists. You are not diagnosing or recommending medical steps to the patient based on temperature. You are simply protecting yourself, your team and your patients.