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ADA responds to change from CDC on waiting period length

Centers remove recommendation that originally appeared in May guidance

June 19, 2020

By David Burger

The ADA advises that it is still important to wait before disinfecting patient treatment rooms after aerosol-generating procedures, even though the U.S. Centers for Disease Control and Prevention recently removed a recommendation calling for a 15-minute waiting period in its Guidance for Dental Settings.

“The safety of patients, dentists and dental team members has been and always will be ADA’s utmost concern,” said ADA President Chad P. Gehani.

Dr. Kirk Norbo, co-chair of the ADA’s Task Force on Dental Practice Recovery agreed, stating, “While there is no strong evidence that supports a one-size-fits-all 15-minute waiting period recommendation, it’s still very important to allow some time for aerosol droplets to settle prior to disinfection of the room to reduce the potential for virus transmission. How much wait time is needed before disinfecting patient treatment rooms is dependent on a number of variables based on the individual practice setting.”

For example, Dr. Norbo noted that “if an exam had been done in an operatory then the wait time would be much less than if a quadrant of restorative procedures had been performed.”

Dr. Norbo added that it is also important for dental team members to be wearing the appropriate level of personal protective equipment when performing disinfection and other infection control procedures.

Dr. Norbo advised dentists to complete the ADA COVID-19 Hazard Assessment so they can use the results coupled with their professional judgment to make informed decisions about the waiting period for disinfection in their individual practices.

Some variables to consider include:
•    Room air flow rate. Higher air flow generally shortens the wait period.
•    Length of aerosol-generating procedures.
•    Volume of patients.
•    Use of HEPA air filtration devices.
•    Use of rubber dams and high speed evacuation.

The ADA’s Return to Work Interim Guidance includes ways dentists and hygienists can reduce aerosols such as:
•    Hand scaling when cleaning teeth rather than using ultrasonic scaling.
•    Use of high-velocity suction whenever possible.
•    Use of rubber dental dams whenever possible.

Dr. Norbo concluded, “The ADA’s Return to Work Interim Guidance is based on currently available evidence. As more data is published, we will continue to build upon and refine the recommendations within the guidance. I have greatly relied on the guidance when reopening my own practice, and I believe we have a safe environment for our patients and the dental team.”