CHARLESTON — A shortage of masks, surgical gowns and other personal protective equipment (PPE) may force some West Virginia dentists to postpone reopening their offices Monday, the return-to-work date recommended by the West Virginia Board of Dentistry’s COVID-19 Dental Task Force.
“The closer we get to that date, it becomes increasingly clear that we will probably have some offices not able to open then because of PPE availability issues,” Dr. Vince Veltri, president of the West Virginia Board of Dentistry, said last week.
“Some offices may have to delay opening a week or more. Suppliers are saying things may open up a bit by the middle or the end of the month, but meanwhile, the Level 3 masks and visors that are now required are very difficult to come by and the shortage of gowns is amazing.”
Gov. Jim Justice had included dental offices on his list of medical businesses and services deemed ready to resume operations April 30, the first day of Week 1 of his phased reopening plan, but the West Virginia Board of Dentistry urged state dental practitioners to delay reopening until May 11.
The later reopening date was designed to give dentists the time needed to acquaint staff and patients with new COVID-19 safety protocols and to procure the additional PPE needed to safely provide patient care during the coronavirus pandemic.
Veltri said his Clarksburg dental office will be able to open Monday, but how long it will be able to continue to operate without interruption depends on how soon additional stores of PPE items will be available to purchase.
The shortage of PPE supplies is believed to be due in part to dentists in neighboring Kentucky, who reopened their offices April 28, and Ohio and Virginia, who reopened by May 1, getting the draw on their counterparts in West Virginia in placing orders with suppliers.
“We have a backorder with a supplier for N95 masks that we don’t expect to get until June 15,” said Barbara Lambert, office manager for and wife of South Charleston dentist Mark Lambert.
“Every supply chain we have contacted is backordered on masks and protective gowns, which are necessary to protect both the worker and the patient,” she said. “Dentists across the area are scrambling to obtain the PPE needed to reopen their offices, getting no help from the state. I assume the majority of the PPE bought up by the state is for hospitals, EMTs and other first responders. But dentists work closer to the aerosol from people’s mouths than anyone.”
Luckily, the Lamberts’ storage area contained several unopened boxes of N95 masks bought during a previous epidemic scare that failed to materialize here, and they bought a quantity of single-use face shields at $6 a pop, giving them enough facial PPE to be able to reopen Monday.
A less-than-bountiful supply of PPE has forced the practice to postpone the reopening of its dental hygiene operation. “We plan to start that back up on June 1, if we get more PPE,” Lambert said.
Another Kanawha Valley dentist the Lamberts encountered while shopping for supplies said he planned to cut his normal operating hours in half, due mainly to the scarcity of PPE items.
Meanwhile, on Thursday, “We were lined up at Sam’s Club at 7 a.m. trying to build up our supply of sanitizer,” Barbara Lambert said. “Since you could only buy one bottle at a time, we went through the line three times. You can still hardly find disinfectant wipes.”
“We managed to get some N95s that used to cost 50 cents to a dollar each shipped in for $5.25 apiece, and found a guy who 3D printed shields,” said Cross Lanes dentist Stan Kaczkowski as he and his staff prepared his practice’s reception area for reopening Monday.
Patients visiting their dentists in coming weeks can expect to experience major changes in procedures from the days before the arrival of the coronavirus pandemic.
Patients must sign an informed consent waiver prior to treatment, in which they acknowledge that social distancing standards cannot be kept while dental work is being done, and that inherent risks of exposure to COVID-19 are possible, despite enhanced sterilization and safety procedures.
After scheduling appointments, patients arriving at their dentist’s office will wait in their vehicles until the appointment time arrives and entry to the office is approved, generally by a telephone call. Friends or relatives are not allowed to wait in the office unless they are parents accompanying children who are patients. Once inside, the patients’ temperatures are taken and they are questioned about whether they are experiencing any symptoms commonly associated with COVID-19.
Waiting areas will have fewer chairs, and they will be placed at least 6 feet apart. Magazines, toys and operable water fountains won’t be available. Plexiglass screens are likely to be found atop reception desks. All dental office employees will be wearing protective masks.
“Every two hours, the chairs, countertops, door handles and bathrooms will be cleaned,” said Dr. John Moore, of Moore and Moore Dental Associates in Charleston. “Our employees also take their temperatures at the check-in area when they arrive for work.”
They will change into their scrubs at the dental office and leave them there before going home for the day, he said.
Moore’s practice took the extra precaution of having an attorney make sure it was in compliance with all reopening requirements.
“It’s an unprecedented situation,” said Kaczkowski. “We’re trying our best to move ahead and keep everyone safe.”