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COVID-19 Frequently Asked Questions

Our Practice Advisory Service receives many emails and phone calls daily from dentists and the public about COVID-19. Below is a list of FAQs compiled by the Practice Advisory team to assist you in getting up-to-date information in a timely manner.

A list of FAQs for dentists who are considering performing Antigen POCT in their practice is available here

A list of FAQs on vaccination status for COVID-19 and how dental offices should handle this topic is available here


Updated November 9, 2021

Where can I access information about vaccination for myself and my dental office employees? 

The Ministry has provided an updated document on Guidance for Prioritizing Health Care Workers for COVID-19 Vaccination.

This document assigns priority for vaccination of health care workers (HCWs), from highest priority to very high priority, high priority, and moderate priority. Dentistry has been placed in the very high priority level.

Vaccination will be coordinated by local Public Health Units (LPHUs). For more information on vaccination in your area, please contact your LPHU directly. 

A list of LPHUs and their contact information is available here (http://www.health.gov.on.ca/en/common/system/services/phu/locations.aspx). 

To determine the LPHU region for your dental office, you may refer to this tool (https://www.phdapps.health.gov.on.ca/PHULocator/Default.aspx). 

Are dentists allowed to provide non-essential care through teledentistry during this pandemic?

Yes, teledentistry enables the remote provision of “non-essential” care to patients while ensuring ongoing physical distancing. Dentists must exercise professional judgment to determine whether teledentistry is appropriate to manage the case or whether they should be seen in-person.

Please refer to the COVID-19: Guidance for the Use of Teledentistry for information.

Does the teledentistry platform I’m using (e.g. Zoom, FaceTime, Go-to-Meeting, Skype for Business, Microsoft Teams, etc.) comply with privacy requirements?

The College does not review, endorse nor approve of any specific technical platforms for teledentistry. To ensure that the platform you use complies with current privacy legislation, please contact the Information Privacy Commissioner: https://www.ipc.on.ca/about-us/contact-us/

You should protect the privacy and confidentiality of the patient’s personal health information, specifically by: 

  • using technology that has privacy and security settings in accordance with the Personal Health Information Protection Act, 2004. At minimum, technology must have controls to ensure only the intended patient has access to the appointment and where personal health information is stored and/or transmitted, strong encryption must be used. If unsure, dentists can confirm with the service provider that the technology meets Ontario privacy requirements.
  • conducting the teledentistry appointment in a private environment that will ensure patient information is not overheard or seen by other individuals; and
  • confirming with the patient that they are in a private setting and that the technology they are using is secure.

During this pandemic can we prescribe outside of the College’s recommendations for the management of dental pain for our patients? 

Dentists must continue to practice within the College's Guidelines with respect to prescribing narcotics and opioids.

The Guidelines provide guidance regarding the suggested maximum number of tablets for a single opioid prescription. However, it also states that in some situations, practitioners may consider exceeding the suggested maximum number of tablets. Practitioners are expected to exercise reasonable professional judgment in determining when this is justified, which should be documented.

Refer to COVID-19: Managing Infection Risks During In-Person Dental Care.

Please ensure that you keep a record of any patients that you speak with over the phone, so that you can provide documentation in the patient record once you return to the office.

Can I remotely provide a prescription to new patients (i.e. who are not existing patients of the practice) on an emergency basis over the phone or by video?

In order to prescribe medication for a new patient, technology with both audio-video capacity will be required to allow for an adequate assessment prior to prescribing medication. This means that you cannot provide a prescription to a new patient who does not have video conferencing capability.  

Please review the College Guidance on COVID-19 - Guidance for the Use of Teledentistry

Are we allowed to use sedation?

First confirm sedation is required and that the treatment cannot be provided without it.

Technique

Oral sedation used alone can be a sedative technique that minimizes aerosols vs. other sedative techniques. However, patient acceptance and an effective dose is key to prevent coughing, crying etc. that could also create more aerosols with any conscious sedation technique. You must stay within your level of authorization for the sedation dose provided.

Nitrous Oxide Oxygen

If oral sedation alone is not sufficient and nitrous oxide oxygen is used, a viral filter may be placed between the tubing and the machine. However, all delivery systems are different and one technique does not fit or apply to all systems. Check with the manufacturer on what is necessary to guard against viral transmission. You are responsible for ensuring the system is sterilized for viruses in between patient use as suggested by the manufacturer of the delivery system that you have.

Monitoring and Emergency Equipment

Use disposable emergency equipment where possible. All equipment for patient monitoring must be cleaned and disinfected according to manufacturer’s instructions for use. In the unlikely event of cardiopulmonary resuscitation, a viral filter should be placed on the bag-valve-mask to protect the equipment from contamination if used. If oxygen delivery is required, it is advisable to use disposable nasal cannula/nasal hood or other oxygen delivery device. All tubing should be properly cleaned and disinfected as per the manufacturer’s instructions for use. Try to limit gas flows to the minimum required to prevent surplus gas from the patient contaminating the air. Similarly ensure the nasal hood fits snugly, to minimize gas leaks.

Where can I get more information about the fees and procedure codes used for teledentistry?

Please contact the Ontario Dental Association (ODA) by phone at 416-922-3900 or by email at info@oda.ca.

What are the COVID-19 screening questions we should ask our patients?

See the Ministry’s Patient Screening Guidance Document

At what temperature do we consider that a patient has a fever?

A fever is a temperature of 37.8°C or greater.

The College does not require dentists to take a patient’s temperature upon their arrival to the office. However, at the discretion of the dentist, temperature taking may be included in the office’s patient arrival protocol.

Click here for more information.

What is fallow time?

During an aerosol-generating procedure (AGP), high concentrations of droplets are created, which may contain infectious viral particles. Fallow time is the amount of time, measured in minutes, needed for these droplets to settle or be cleared from the operatory.

Fallow time begins when the patient and all clinical staff have exited the operatory and close the door. The operatory MUST remain vacant during the fallow period necessary to achieve 99% removal of airborne contaminants based on air changes per hour (ACH). At the end of the fallow period, the operatory is cleaned and disinfected, prior to treating the next patient.  

For aerosol generating procedures, all patients (regardless of whether they have screened negative or positive for COVID-19) MUST be treated in an operatory that is capable of containing aerosol. This requires floor-to-ceiling walls and a door (or other barrier) that must remain closed during and after such procedures. For such patients, the fallow period is 138 minutes (i.e., 2 hours and 18 minutes), unless the HVAC system has been assessed by a qualified HVAC professional and the number of air changes per hour (ACH) for the specific operatory is known to be greater than 2 ACH. If the number of ACH for a specific operatory is known, then the fallow time may be reduced using Table 2 of the guidance document

How should the operatory be managed after performing an AGP for a patient who screens COVID-19 negative?

The operatory must be managed with the same protocol used for patients that screen positive for COVID-19. 

At the end of the procedure, the patient and all clinical staff exit the operatory, which must remain vacant during the fallow period. The dentist must not remain in the operatory to write up the patient’s chart.

PPE are doffed outside the operatory. 

At the end of the fallow period, the operatory may be cleaned and disinfected, in preparation for the next patient. Unless otherwise calculated by a qualified HVAC professional, the fallow time is 138 minutes (i.e., 2 hours and 18 minutes), beginning from the time that the patient and all clinical staff have exited the operatory, which must remain vacant during the fallow period.

The fallow time may be reduced if an HVAC assessment has been conducted by a qualified HVAC professional and additional mitigating measures have been implemented. Refer to our guidance document for further details

How should the operatory be managed after performing an AGP for a patient who screens COVID-19 positive?

At the end of the procedure, the patient and all clinical staff exit the operatory, which must remain vacant during the fallow period. The dentist must not remain in the operatory to write up the patient’s chart.
PPE are doffed outside the operatory.

At the end of the fallow period, the operatory may be cleaned and disinfected, in preparation for the next patient. Unless otherwise calculated by a qualified HVAC professional, the fallow time is 138 minutes (i.e., 2 hours and 18 minutes), beginning from the time that the patient and all clinical staff have exited the operatory, which must remain vacant during the fallow period.

The fallow time may be reduced if an HVAC assessment has been conducted by a qualified HVAC professional and additional mitigating measures have been implemented. Refer to our guidance document for further details

What should I do if a patient that I recently treated tests positive for COVID-19?

You should contact your local public health unit for advice.

Staff members that treated the patient should self-isolate and seek guidance from their primary care provider or TeleHealth Ontario.

Who can perform an HVAC assessment?

An HVAC professional, such as a licensed professional engineer or licensed HVAC technician who is experienced in HVAC design and operation in a health care facility,  can provide valid documentation to support their findings and recommendations. Dentists should exercise due diligence to ensure they are working with an appropriate company/individuals.

Is a fallow period required for non-aerosol generating procedures (NAGP)?

No, a fallow period is not required for non-aerosol generating procedures (NAGP). Following an NAGP, the operatory may be cleaned and disinfected immediately, as per standard procedures, in preparation for the next patient.

What do we tell a patient if they screen positive for COVID-19? 

A patient who screens positive for COVID-19 infection should self-isolate and contact their primary care provider or Telehealth Ontario at 1-866-797-0000 to determine next steps, or visit an assessment center to get tested.

Do I need to notify Public Health about patients who screen positive?

Although COVID-19 is a designated disease of public health significance and reportable under the Health Protection and Promotion Act, dentists are not required to report patients who screen positive to the local public health unit. Only probable and confirmed cases of COVID-19 must be reported. Please refer to this document for the definition of a probable case

How do I deal with a patient who is a health care worker and has had close contact with a confirmed case of COVID-19?

The Ministry’s Patient Screening Guidance Document addresses health care workers (HCWs). Please ensure that you are using Version 5.0 – August 26, 2021 of the screening tool.

For HCWs who are fully immunized, have no symptoms, have not tested positive for COVID-19 in the past 10 days and have not been told to self-isolate, they will screen negative and can be seen for routine care, in addition to emergency and urgent care.

For HCWs who are not fully immunized, additional screening questions are required.

For example, question 6 now reads: “Has the person had close contact with a confirmed case of COVID-19 without wearing appropriate PPE?” and should be asked if the person is not fully immunized (i.e. they answered ‘No’ to question 1).

HCWs who are not fully immunized, but were wearing appropriate PPE when dealing with a confirmed case of COVID-19, may answer “NO” to this question.

HCWs who are not fully immunized and were not wearing appropriate PPE when dealing with a confirmed case of COVID-19 will answer “YES” to this question and screen positive.

For any patient who screens positive, elective or non-essential dental care should be deferred. Consideration should also be given to having the patient visit an assessment center to get tested. The dentist, in consultation with their local Public Health Unit, should also complete a risk assessment on a case by case basis.

When emergency or urgent dental care is provided to a patient who screens positive, HCWs must use enhanced PPE precautions for all procedures. For more details, dentists should refer to the College’s guidance document.

How do I deal with an employee who has had close contact with a confirmed case of COVID-19?

The Ministry has updated the Screening Tool for Workers. Please ensure that you are using Version 10 – October 25, 2021 of the screening tool.

Question 4 now reads: ‘In the last 10 days, have you been identified as a “close contact” of someone who currently has COVID-19? If public health has advised you that you do not need to self-isolate (e.g., you are fully immunized* or have tested positive for COVID-19 in the last 90 days and since been cleared), select “No.”

(*Fully vaccinated is defined as an individual ≥14 days after receiving their second dose of a two-dose COVID-19 vaccine series or their first dose of a one-dose COVID-19 vaccine series.)

If the employee is not fully vaccinated, but was wearing appropriate PPE at the time of the close contact, they should advise public health to take this into consideration. If a Local Public Health Unit (LPHU) advises them that they do not need to self-isolate, they may answer “No” to this question.

How do I treat other essential workers, such as pilots and international truck drivers, who have travelled outside of Canada in the past 14 days?

Some patients, because of their occupations, will travel outside of Canada on a regular basis.

The Ministry’s Patient Screening Guidance Document addresses essential workers who travel for work. Please ensure that you are using Version 5.0 – August 26, 2021 of the screening tool.

For essential workers who are fully immunized, have no symptoms, have not tested positive for COVID-19 in the past 10 days and have not been told to self-isolate, they will screen negative and can be seen for routine care, in addition to emergency and urgent care.

For essential workers who are not fully immunized, additional screening questions are required.

For example, question 5 now reads: “Did the person travel outside of Canada in the past 14 days?” and should be asked if the person is not fully immunized (i.e. they answered ‘No’ to question 1).

Essential workers who are not fully immunized and have not travelled outside of Canada in the past 14 days may answer “NO” to this question.

Essential workers who are not fully immunized and have travelled outside of Canada in the past 14-days will answer “YES” to this question and screen positive.

For any patient who screens positive, elective or non-essential dental care should be deferred. Consideration should also be given to having the patient visit an assessment center to get tested. The dentist, in consultation with their local Public Health Unit, should also complete a risk assessment on a case by case basis.

When emergency or urgent dental care is provided to a patient who screens positive, HCWs must use enhanced PPE precautions for all procedures. For more details, dentists should refer to the College’s guidance document.

How should I manage patients who have returned from international travel and have been exempted from quarantine?

The Federal and Ontario governments have both issued advisories for who may be exempt from quarantine upon return from international travel, provided they meet certain requirements.

COVID-19 vaccinated travellers entering Canada - Travel restrictions in Canada – Travel.gc.ca

Travelling during COVID-19 | Ontario.ca

COVID-19 and travel: Exemptions from testing and quarantine - Travel restrictions in Canada – Travel.gc.ca

When returning travellers who are fully immunized enter Canada, officials at the point of entry will determine if they are exempt from quarantine.

Screening must still be performed for all patients prior to dental appointments, regardless of immunization status. The Ministry has updated the Patient Screening Guidance Document. Please ensure that you are using Version 5.0 – August 26, 2021 of the screening tool.

For patients who are fully immunized, have no symptoms, have not tested positive for COVID-19 in the past 10 days and have not been told to self-isolate, they will screen negative and can be seen for routine care, in addition to emergency and urgent care, upon their return from travel outside of Canada.

For patients who are fully immunized, but screen positive (i.e., answer ‘YES’ to questions 3 or 4), elective or non-essential dental care should be deferred.

For patients who are not fully immunized, additional screening questions are required. For example, question 5 now reads: “Did the person travel outside of Canada in the past 14 days?” and should be asked if the person is not fully immunized (i.e. they answered ‘No’ to question 1). If the patient screens positive (i.e., answers ‘YES’ to question 5), elective or non-essential dental care should be deferred. Consideration should also be given to having the patient visit an assessment center to get tested. The dentist, in consultation with their local Public Health Unit, should also complete a risk assessment on a case by case basis.

When emergency or urgent dental care is provided to a patient who screens positive, HCWs must use enhanced PPE precautions for all procedures. For more details, dentists should refer to the College’s guidance document.

How should I manage staff who have returned from international travel and have been exempted from quarantine?

The Federal and Ontario governments have both issued advisories for who may be exempt from quarantine upon return from international travel, provided they meet certain requirements.

COVID-19 vaccinated travellers entering Canada - Travel restrictions in Canada – Travel.gc.ca

Travelling during COVID-19 | Ontario.ca

COVID-19 and travel: Exemptions from testing and quarantine - Travel restrictions in Canada – Travel.gc.ca

When returning travellers who are fully immunized enter Canada, officials at the point of entry will determine if they are exempt from quarantine.

Screening must still be performed, regardless of immunization status. The Ministry has updated the Screening Tool for Workers. Please ensure that you are using Version 10 – October 25, 2021 of the screening tool.

If a fully vaccinated dentist or staff person is returning from travel outside of Canada and is exempted from quarantine (i.e., not told to self-isolate), they may return to work if they screen negative (i.e., answer ‘NO’ to questions 1-7). The College’s COVID-19 guidance still applies, and the worker must continue to screen negative prior to the beginning of each shift.

Workers who screen positive must not enter the workplace. They should inform their employer of this result and go or stay home to self-isolate immediately and contact their health care provider or Telehealth Ontario (1-866-797-0000) to get advice or an assessment, including if they need a COVID-19 test. Additional details are available in the worker screening tool linked above.

What should we do if I or my staff screen positive for COVID?

Dentists and staff must self-monitor daily for any symptoms of COVID-19 and use the COVID-19 screening questions developed by the Ontario Ministry of Health or the online self-assessment

You and/or your staff should self-isolate and contact your primary care provider or Telehealth Ontario at 1-866-797-0000 to determine next steps, or visit an assessment center to get tested. You should also contact your local public health unit to self-report.

If I or my staff member have tested positive for COVID, when can we return to work?

If you or your staff have tested positive for COVID-19, self-isolate immediately. The self-isolation period will be determined by the seriousness of the case, based on guidance from the Ontario Ministry of Health.

For mild to moderate cases where a health care worker self-isolates at home, the waiting period is 10 days from symptom onset (or 10 days from positive test collection date if asymptomatic).

For serious cases where the health care worker has been hospitalized, the waiting period is 20 days from symptom onset (or 20 days from positive test collection date if asymptomatic and severe immune compromise).

For more information: COVID-19 Quick Reference Public Health Guidance on Testing and Clearance

For case specific guidance on safe return to work, contact your local public health unit directly.

What PPE is required when treating patients who screen negative for COVID-19?

The types of PPE required will depend on whether patients have screened positive or negative for COVID-19, as well as the procedure being performed Please refer to Table 1 of the College’s guidance.

When performing non-aerosol generating procedures (NAGPs) on patients that have screened negative for COVID-19:

  • ASTM level 2 or 3 procedure/surgical mask
  • gloves
  • eye protection: goggles or face shield
  • isolation gown (optional)

When performing aerosol-generating procedures  (AGPs) on patients that have screened negative for COVID-19, dentists must ensure that care is provided using the enhanced PPE precautions set out in Table 1 of the College’s guidance for all patients, including:

  • fit-tested and seal-checked N95 respirators (or the equivalent, as approved by Health Canada)
  • gloves
  • eye protection: goggles or face shield
  • isolation gown

Dentists must ensure that clinical staff are trained in and use proper donning and doffing procedures for PPE (dentist are advised to review Public Health Ontario’s Recommended Steps for Putting on and Taking Off Personal Protective Equipment).  

What PPE is required when treating patients who screen or test positive for COVID-19?

The type of PPE required will depend on whether patients have screened positive or negative for Covid-19, as well as the procedure being performed.  Please refer to Table 1 of the College’s guidance.

When performing non-aerosol generating procedures (NAGPs) on patients that have screened or tested positive for COVID-19:

  • ASTM level 2 or 3 procedure/surgical mask
  • gloves
  • eye protection: goggles or face shield
  • isolation gown

When performing aerosol-generating procedures (AGPs) on patients that have screened or tested positive for COVID-19, dentists must ensure that care is provided using the enhanced PPE precautions set out in Table 1 of the College’s guidance for all patients, including:

  • fit-tested and seal-checked N95 respirators (or the equivalent, as approved by Health Canada)
  • gloves
  • eye protection: goggles or face shield
  • isolation gown

Dentists must ensure that clinical staff are trained in and use proper donning and doffing procedures for PPE (dentist are advised to review Public Health Ontario’s Recommended Steps for Putting on and Taking Off Personal Protective Equipment).  

What should I do if a patient requests an exemption from wearing a mask?

The College has created specific guidance on this issue: Mask-wearing exemptions (rcdso.org). The pandemic has created a new legal landscape that has not yet fully formed, and this information represents the College’s best efforts to help dentists understand their obligations at this time. Dentists should consult with a lawyer for more information on this evolving area of the law.

What is an accommodation under the Ontario Human Rights Code?

Under the Ontario Human Rights Code dentists have a duty to provide health care services free from discrimination and a duty to accommodate. Dentists can obtain more information about these duties from the Human Rights Commission, who have a range of resources

There is not a defined list of what constitutes ‘reasonable accommodations’.  Determining what is a reasonable accommodation requires a careful case-by-case analysis.  Dentists will need to speak with patients about their needs, and work with the patient to determine what alternatives exist that can address those needs.

Some examples of potential reasonable accommodations related to masks could include the following:

  • having the patient wear a different type of face covering such as a face shield or other covering/barrier
  • having the patient wear a mask for portions of the visit (e.g., as they move through the waiting areas) and/or
  • scheduling the patient at the end of the day to limit exposure to other patients
  • waiving the requirement for the patient to wear a mask

If dentists have questions about how to comply with their legal obligations under the Human Rights Code, they should seek advice from legal counsel. 

Should I include anything in the patient’s medical record about this?

Yes. The College recommends that dentists document relevant information in the patient’s medical record.  If the patient has indicated that they have a medical reason for not wearing a mask, this information should be recorded.  Additionally, the dentist should record what accommodation they reached with the patient. 

Dentists must note that they cannot require patients to provide proof that they are exempt from the requirement to wear masks.    

Are N95 respirators required for all treatment?

Refer to our latest guidance: COVID-19: Managing Infection Risks during In-Person Dental Care.

Fit-tested N95 masks are required for aerosol-generating procedures (AGPs) on all patients. 

For ALL AGPs, care MUST be provided using enhanced precautions; namely fit-tested N95 mask (or the equivalent, as approved by Health Canada), gloves, eye protection (goggles or face shield) and isolation gown.

In addition, when performing AGPs on patients who have screened or tested positive for COVID-19, dentists should use a rubber dam with high-volume suction, when possible, to minimize aerosols and possible exposure to infectious agents.

Do N95 respirators require fit testing?

N95 respirators require a tight fit for protection against aerosols. Fit testing is required for each clinical staff member and for each brand or model of N95 respirator. In other words, the fit test is only applicable to the specific respirator model, unless the manufacturer indicates otherwise.

Can N95 respirators be used past their expiry date?

Health Canada has issued a document on “Optimizing the use of masks and respirators during the COVID-19 outbreak”.

According to this document, there is no specific timeframe beyond the expiry dates for N95 respirators at which they would no longer be considered suitable for use. In times of increased demand and decreased supply, consideration can be made to use these expired N95 respirators. An expired mask can still be effective at protecting a health care provider if:

  • the straps are intact
  • there are no visible signs of damage
  • they can be fit-tested

Health care providers should inspect the mask and perform an appropriate seal check.

The Ministry has issued a Guidance document on “Information on the Use of N95 Filtering Facepiece respirators beyond the manufacturer-designated shelf life”.

Can I reuse or extend the use of N95 respirators?

Extended use refers to the practice of wearing the same N95 respirator for more than one patient, without removing/touching the respirator between patient encounters. Extended use of N95 respirators has previously been permitted during times of widespread PPE shortage.

Currently, there is no widespread shortage of N95 respirators.  

N95 respirators are single use items and must be disposed of after each patient use. Manufacturer’s instructions for use must be followed.

If you are having difficulty procuring N95 respirators, please contact the ODA at info@oda.ca.

The Government of Ontario, through a partnership with the Ontario Dental Association, is providing 3M Aura Health Care Particulate Respirator and Surgical Masks, 1870+, N95 to dental professionals free of charge.

Click here for more information

Can we use respirators with exhalation valves?

Some commercially available respirators have exhaust valves, which are intended to make the respirator more comfortable for the person wearing it, but also allow infectious respiratory droplets to be released outside the respirator. Respirators with exhaust valves will not protect others from COVID-19. Health Canada and Public Health Ontario do not recommend the use of respirators with exhalation valves. If no other options are available and such respirators must be used, cover them with a facemask that does not interfere with the respirator fit.

Reference:

Optimizing PPE During COVID-19 Pandemic (Ontario Health)

COVID-19 medical masks and respirators for health professionals

Guidance for Dental Settings (CDC)

Can we use KN95, P95, P100 or other “equivalent” masks instead?

Health Canada accepts the NIOSH certification as an appropriate quality standard for N95 respirators. Equivalent alternate standards are also acceptable.

These include respirators that are approved or certified under standards used in other countries that are similar to NIOSH-approved N95 respirators.

Find out if the brand, model number/product line of your P95 or P100 respirators is listed under the Centers for Disease Control and Prevention (CDC) listing of NIOSH-approved P95 or P100 respirators.

NIOSH-Approved P100 Particulate Filtering Facepiece Respirators

NIOSH-Approved P95 Particulate Filtering Facepiece Respirators

NIOSH-Approved Particulate Filtering Facepiece Respirators

Some concerns have been recently identified with some KN95 respirators (specifically those with ear loop design) that pose a difficulty in achieving a proper fit, which is essential for use.

Health Canada has asked manufacturers and importers to stop the sale of any products that do not meet the filtration criteria of 95% and re-label them as face masks.  KN95s that meet the filtration criteria and that can be fit tested may continue to be sold and used as respirators.

Health Canada maintains a list of NIOSH N95 alternatives.

Prior to selecting a respirator, dentists should review Health Canada’s respiratory guidance or check Public Health Ontario for selection guidance.

How do I know if the N95 respirator is a counterfeit?

  • Confirm that your product has been certified by NIOSH by entering the approval number, which can be found on the respirator, in the NIOSH database.
  • Review the product package and respirator to ensure it has the appropriate markings and details, as required by NIOSH. This includes the TC (Testing and Certification) approval number (a number set by NIOSH), the name of the manufacturer, the NIOSH name or logo, the model number, and filter efficiency (N95).
  • Look at product markings, such as the name of the manufacturer, to determine whether there are any obvious signs that the product is counterfeit (e.g., incorrect spelling).
  • Check for the presence of this symbol on the mask:

  • If your mask is fraudulent or unauthorized, stop using it as it may not protect you against COVID-19.
  • Report information on the potential false or misleading advertising or sale of unauthorized products to Health Canada.

For more information: Fraudulent and unauthorized N95 respirators may not protect consumers against COVID-19

What type of dental procedures require dentists to wear gowns?

Isolation gowns are required for ALL aerosol-generating procedures performed on ALL patients, regardless of whether they have screened positive or negative for COVID-19.

Isolation gowns are also required for non-aerosol generating procedures performed on patients who have screened or tested positive for COVID-19.

Isolation gowns are optional for non-aerosol generating procedures performed on patients who have screened or tested negative for COVID-19.

Gowns must be changed after each patient use. For more information on gowns:

Health Canada Personal protective equipment against COVID-19: Medical gowns

Medical Isolation Gowns for COVID-19 in Health Care Settings

What type of clothes and PPE are non-clinical/front desk/administrative staff required to wear?

Like clinical staff, staff who do not have clinical responsibilities must change their clothes and shoes upon reporting to work and when leaving to return home. Non-clinical staff may wear casual shoes and clothes for work or scrubs, as per the office policy. Clothing worn in the office must not be worn outside of the office and should be laundered after each shift.

Staff in the reception area must wear an ASTM level 1 procedure mask (minimum) and maintain physical distancing. A physical barrier is also recommended.

Can dentists and their staff use washable/reusable gowns instead of disposable gowns?

Yes, both disposable and reusable/washable gowns are acceptable. As with any personal protective equipment (PPE), attention must be paid to the donning and doffing procedure in order to avoid contaminating the user.

For more information on donning and doffing of PPE, click here

Reusable/washable gowns must be changed and laundered after each patient use. 

Please note: reusable/washable gowns must be laundered either on-site or at a commercial laundry facility. Home laundering is not permitted.

Public Health Ontario (Best Practices for Environmental Cleaning for Prevention and Control of Infections in All Health Care Settings) and the Canadian Standards Association have listed the following requirements for the on-site laundering of reusable/washable gowns in dental offices:

  • There must be a dedicated space, physically separate from other areas of the laundering facility.
  • The space must contain a sorting area for soiled items that is kept under negative pressure.
  • If the dental office is unable to comply with these requirements, another option is to use a commercial laundry service.
  • Household laundering and laundromats do not meet these requirements.
  • While awaiting on-site laundering or pickup for transportation to a commercial laundry facility, reusable/washable gowns should be stored in laundry bins/containers lined with a barrier (such as a garbage bag) to avoid contamination.
  • For on-site laundering, use hot water and an appropriate detergent. If the items are heavily soiled, a disinfectant (e.g. chlorine bleach) may be added.

Scrubs worn as clinic attire may be laundered at home.

Can I use a fabric lab coat instead of a gown?

The use of lab coats instead of gowns is discouraged and should only be used as a last resort because they do not provide the same degree of protection. Most lab coats have V-necks and/or do not have elastic bands at the wrists. Because of their design, they can expose the healthcare worker’s skin/clothing at the neck and wrist area.

The front buttons of lab coats can also pose risks of contamination during the donning and doffing procedures.

In the event of a disposable gowns shortage, reusable gowns would be the preferred alternatives.

References:

US Centers for Disease Control and Prevention – Strategies for Optimizing the Supply of Isolation Gowns

Public Health Ontario -  Recommended Steps for Putting On and Taking Off Personal Protective Equipment

Must I have floor-to-ceiling walls and a door that can be closed in all my operatories?

All AGPs must be performed in an operatory that is capable of containing the aerosol, which means floor-to-ceiling walls and a door or other barrier that can be closed. This requirement for AGPs applies to ALL patients (whether they have screened positive or negative for COVID-19).

Temporary walls and doors are permitted, provided they create an area to contain aerosols and are constructed of materials that can withstand repeated cleaning and disinfection.