The chief dental officer for Wales has updated the profession on changes to the settle time in dental practices.
In a letter to all primary care dental teams, CDO Colette Bridgman has reviewed the standard operating procedures (SOP).
The key change is amendments to the fallow time requirements:
- For AGPs in a room with the recommended number of air changes (10) as outlined in HTM-03-01, a minimum of 16 minutes fallow time is considered appropriate for short treatments (less than 10 minutes) where high volume suction is used
- This extends to 18 minutes fallow time for AGP treatments of 40 minutes
- Where other mitigating factors are also used, fallow times cannot be under 10 minutes. For example, the use of rubber dam
- A minimum of 10 minutes must be in place for larger droplets to settle. This should happen before decontamination and before the next patient enters the room. This is irrespective of any calculated fallow time and mitigation.
It reemphasises that no fallow time is required for most non-AGP treatments.
Universal precautions
‘Until such time as a vaccine and/or point of care testing is widely available, it is necessary that dental practices and services continue to adhere to infection control and health protection measures advised in the SOP,’ said Colette Bridgman.
‘We cannot write specific rules for every treatment scenario. The SOP uses available and emerging evidence to outline the safest possible regime practices should use. It now includes more flexibility for clinical judgement, which we know will be welcome. For example, mitigating factors that allow a reduction in fallow time following an AGP from 60 minutes.
‘These include, a surgery having optimal ventilation (10 air changes per hour), the length and complexity of treatment provided, the use of rubber dam, the use of high-powered suction, pre-rinse etc. Although community transmission is Wales is now low, we know COVID-19 infected people can be asymptomatic.
‘This will therefore mean that universal precautions will be necessary for some time to come.’
Author’s analysis
Wales is the first UK country to amend its fallow time requirements for dental practices.
It follows several calls from the profession nationwide for a reduction as the government continues to ease lockdown.
Many groups and associations also point to the dental regulations of other countries, many of which have no fallow time requirements at all.
The question now is who will be next to follow in Wales’ footsteps.
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