Dental Treatment at ECHS Polyclinics: Advisory of preventing measures to be adopted against Covid-19
Central Organisation ECHS
Integrated HQ of MoD (Army)
Adjutant General’s Branch
Near Gopinath Circle
27 May 2021
All Regional Centres (ECHS)
ADVISORY OF PREVENTIVE MEASURES TO BE ADOPTED AGAINST COVID-19 FOR DENTAL TREATMENT AT ECHS POLYCLINICS
1. ‘Further to fwgs :-
(a) COECHS letter No B/49773/AG/ECHS/Treatment Policy dt 18 Mar 2020.
(b) COECHS letter No B/49773/AG/ECHS/Dental/Policy dt 20 Mar 2020.
2. This advisory is a reiteration of advisories issued earlier on the subject. There has been an unprecedented rise in number of COVID-19 cases in the country. It is important to take measures to prevent its spread and also to protect our staff from any cross infection.
3. Concern about Coronavirus transmission during dental practice is widely recognized the world over. Due to the nature of dental procedures and the proximity of the dental team with the patients the disease can spread rapidly from infected patients to the dental team and vice-versa, if strict infection control measures are not instituted.
4. Due-to-airborne transmission of COVID-19 virus, adhering to the Universal Infection Prevention and Control guidelines in all the Dental Care PCs of the ECHS is of paramount importance to control cross-infection.
5. Every patient should be considered as potentially infectious at all times while in the dental office. Non-emergency patients being taken up for any dental procedure should preferably be taken up subsequent to conduct of RT-PCR test. Rapid antigen test should be sought for emergency cases.
6. Measures to prevent cross-infection in dental care settings in PCs ECHS :-
(a) Manpower. Segregation of manpower should be done whenever possible to avoid mass exposure.
(b) Vaccination. All OIC PC’s to ensure that all health care works of their respective PCs are vaccinated.
(c) Teledentistry. Army/Mobile number of the DO’s PC’s and Duty Offr should be circulated to the AOR for teleconsultation.
(d) Demand for additional funds. Demand for addl funds will be met by Dte Gen of Dental Services for COVID related procurement.
(e) Personal Protective Eqpt. Use of appropriate PPE is compulsory for the DOs’ and paradental staff employed in active treatment and any personnel coming in close contact with the patient. All the necessary precautions while donning and doffing PPE must be ensured. Before donning the PPE, the incl should ensure that they have removed all jewelry, consider the need to drink water to prevent dehydration and check the equipment required. During treatment, the user should not make any adjustments to the protective equipment.
(f) Aerosol and High Speed Evacuation. Aerosol generating dental procedure if undertaken should be done under high-speed evacuation suction. Aerosol generating procedures which includes ultrasonic scaling/restoration requiring use of airrotor handpiece/piezo surgical procedures are to be generally avoided but can be performed in highly essential/emergency situations with recommended disinfectants eg. lodine/Chlorhexidine based disinfectanis.
(g) HEPA Filters and lonisers. Dental surgeries should be equipped with HEPA filters & ionisers where feasible.
(h) Training. Regular trg of COVID appropriate tasks to prevent cross-infection should be done for DO and paradental staff actively involved in patient care.
(i) Supplies. Availability of adequate quantities of disinfectants, consumables and personal protective equipment must be ensured by OC/CO/Comat of the unit.
7. Steps taken to mitigated corss infection of SARS-CoV-2 in the dental centres will improve the safety and restore the confidence required to provide dental care to the veterans and families during the COVID-19 pandemic. Dental Officers should regularly keep themselves abreast with the contemporary developments regarding COVID-19 and evaluate the rationale for the indicated recommendations, including the cost-to-benefit ratio, without ever placing any of the involved individuals or the public at risk: These recommendations are not meant to supersede but, rather complement the information a issued by national and international health authorities.
8. The Advisory has also been uploaded on echs.gov.in.
9. This letter may be circulated to all PCs under your AOR treating dental patients.
Jt Dir (Dental)
for Dir (Med)