Summary breakdown of new guidance from FGDP -1st June 2020

The guidance from the FGDP is for the preparation of returning back to work for dental practices in the UK on the 8th of June 2020 with the decision of treating patients by key points:

Key points:

• Correct PPE & Risk mitigation
  
• Social distancing
• Cross infection control
• Patient low/high risk assessment
• Procedure low/high risk assessment for AGP/AGE

Pre-appointment (remote communication if possible via phone or digital):

• Up to date information
• Patient form / questionnaire
• COVID19 – screening pre-assessment
• Updated medical / health assessment before appointments
• Information on payment
  
  

Pre-treatment (Patient attendance to the practice):

• High level of cross infection control – social distancing and PPE for staff, barrier screens, anti-septic hand gel on entry and exit
• Patients to attend alone, arrive promptly, pre-appointment paperwork to be completed before arrival
  
• Minimize waiting time – New appointment times tailored to the new ways of working
  
• Temporal and zoning for vulnerable patients via a individual risk assessment
  
  

During treatment:

• Standard IPC protocols apply
• AGP/AGE need to be considered as low/high risk
• Low/high risk determined by patient assessment and procedure
• Low risk: Standard PPE for low risk procedures considered as basic
• High risk: FFP2, visor and gown for high risk procedures considered as basic
• High risk: AGP/AGE procedures require 60 mins fallow period
• Rubber dam and high volume suction important for mitigating measures
  
  

Procedure assessment of high / low risk in relation to laboratory work:

PPE:

• Determined by low / high risk patient assessment and procedure
• Risk assessment for individual staff
• Face masks FFP2/FFP3 must be fit tested
• If unable to wear a face mask: Air purifying respirator hood to be used
• Rubber dam and high volume suction important for mitigating measures
• Eye protection: Full face visor recommended
• Appropriate head wear/shoe covers to be worn when a risk assessment indicates
  

Procedural risk mitigation to be used:
High volume aspiration:

• Significantly reduces bio-aerosols
• Reduces risk of aerosol spread

Rubber dam:

• Used in all AGP/AGE
• Where not possible, high volume aspiration is used with an orifice diameter of 8mm
• Reports show this reduces quantity of bio-aerosol by 90-98%

After treatment:

• Patient to leave immediately and hand sanitize outside surgery room
• Standard decontamination procedures
• Low risk: Routine cleaning
• High risk: Downing of gowns with mask retained and removed outside surgery
• High risk: 60 minute recommend fallow time
• High risk: Floor cleaning at the end of each high risk AGP/AGE
• High risk: No paperwork present in surgery during or after in the fallow period

Management tasks:

• Regular reviews on level of risk
• Prepared facilities to support social distancing, cross infection control and signage
• Risk assessment of staff prior to recommencement of work
• Access and occupational health support available for staff
• Appropriate training in place, including medical emergencies
• Stock control – PPE, cross infection control, materials, sundries.
  
  

Full version available from link below (Accessed 1st June 2020):
https://www.fgdp.org.uk/implications-covid-19-safe-management-general-dental-practice-practical-guide