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COVID-19 Update

Sunday, November, 1, 2020

Dentistry has always been on the forefront of infection control and safety measures for our patients. As a community, a nation, and a world we have collectively been weathering the COVID-19 Pandemic together.  Because each community and even each person has been affected differently by COVID-19, we wanted to do our best to keep you updated about what we are doing here at Sophisticated Smiles.

Our approach has been three fold:  Safety, Safety, and Safety.

As part of our ongoing process to always go ABOVE and BEYOND…

In preparation to re-open our office to non-emergency dental procedures, our team completed very intensive training sessions prior to re-opening.  The training mainly focused on integration and proper use of new COVID-19 safety protocols.  We are committed to being PROACTIVE when it comes to our patients’ PROTECTION.

We completed practice runs of all new protocols prior to re-opening in order to insure everything would work smoothly and safely for all of our wonderful patients.  In our opinion, this is a very important step when integrating new procedures in order to make certain what works on paper will work smoothly in a clinical setting.

Below you will find a detailed list of the new SOP (Standard Operating Procedures) and COVID-19 Safety Protocols.  We look forward to seeing you soon!


  1. All team members will check and record temperatures upon arrival to the office each day.
  2. All team members will screen themselves for COVID-19 symptoms each day.
  3. No team member shall report to work if signs of illness are present.
  4. All team members shall report to Dr. Cameron via phone or head set if they have been directly exposed to a diagnosed COVID-19 patient, have symptoms, or a fever.
  5. If a team member tests positive for COVID-19, then our office will need to inform any patients that have recently (within the past 14 days) undergone treatment in our office, notify Dr. Cameron so that the TN Dept. of Health can be notified and give us guidelines.


  1. Patients should be screened over the phone before scheduling/confirming to avoid allowing sick patients in office. Any patients with symptoms of COVID-19 should be booked out 14+ days.
  2. Scheduling should allow smooth, limited patient flow through office.
  3. Patients informed that no one should accompany them inside the office. The only exception is a minor child, who may have 1 parent/guardian remain with them during the visit.
  4. No books, magazines, or drinks will be kept in the waiting room.
  5. The waiting room will not be used, unless a patient is waiting for a ride or accompanying a minor. If a patient must wait in this case, they must maintain social distancing.
  6. Patients should be instructed to check in at front desk (see below). Once check in process if completed, they will be asked to wait in their car until we are ready to take them back.  Please get cell phone number to call them.


  1. Upon arrival, the patient will check in at the front desk. A team member wearing a mask, and eye protection (face shield or goggles) will ask patients to sanitize their hands, put on a face masks (if not already wearing one), take their temperature, and re-screen them with the COVID-19 questionnaire.  Anyone exhibiting 100.0 degrees or higher will be referred to their physician or instructed to call their local hospital emergency room to be tested for COVID-19.  If there is no temperature, but they have other risk factors, they will be re-appointed for another day, 14 + days or longer.  
  2. Once the screening process is completed the patient will be asked to sign the COVID-19 Consent to Dental Treatment form, and their treatment consent form (for restorative procedures). Please ask the patient to use the pen that they brought with them OR provide an office pen which will need to be wiped off after it is handed back OR simply let the patient keep the pen.
  3. If patients are deemed okay to be treated, they will be escorted directly to the operatory and instructed to rinse for 60 seconds with a hydrogen peroxide-based pre-procedural rinse.


  1. Clinical team members will wear clean scrubs, clinic coats, or disposable/reusable gowns when working.  All team members will wear Level 3 or higher masks in the presence of patients, and face shields when appropriate. Clinical and admin team members will keep proper social distancing when interacting with patients, and use hand sanitizer after handling patient’s personal items such as credit cards or insurance cards.  Administrative team members are required to wear a mask while interacting with patients at the front desk.
  2. For non-aerosol procedures, clinical staff will wear a level 3 surgical mask or higher + goggles/loupes and a face shield. For aerosol procedures, clinical staff either will wear an N95 or KN95 mask protected by a new surgical mask for each patient (during supply limitations) + goggles/loupes or a Level 3 surgical mask in combination with a face shield. All masks MUST be in place prior to entering the treatment room.  Hand washing and putting on gloves will be done after entering treatment room.
  3. Operative: Use of Optragate or rubber dam with HVE (High Volume Evacuation) under ALL aerosol creating situations is recommended. Careful use of HVE will be used to minimize aerosols. NO USE OF HIGH-SPEED DRILL, WITH OR WITHOUT WATER, WITHOUT Optragate OR HVE USE.
  4. Hygiene: UNTIL FURTHER NOTICE, HYGIENISTS ARE TO HAND-SCALE ONLY. Use of prophy cups/paste is allowed.  HVE as well as slow suction to be used during all cleaning procedures.  Please the slow suction in patient’s mouth and have patient help hold HVE near mouth.  If patient unable to help hold HVE near mouth, then position it beside patient in holder and leave it turned on.
  5. HVE & Aerosols: The goals for actions 4, 5 & 6 are to limit the amount of aerosols that we allow to escape the oral cavity. Techniques for assistants holding the suction, the angle and positioning the suction are all meant to capture the spray or aerosol and vacuum it away before it has a chance to escape the oral cavity.
  6. Operatory Pre-Prep: Procedure set up in the operatory needs to be timely and complete, prior to patient’s visit obviously, but not left out for hours to allow room aerosols to settle on the exposed instruments and cassettes. Therefore, room set up should be completed as close to the patient’s visit time as possible, or draped/covered if there’s a waiting time between setup and the actual appointment time.  In addition, all counters shall remain clean of any items or those items need to be covered with disposable plastic wrap to prevent any potential contamination from aerosols if those items cannot be decontaminated with Lysol.   Items on counter tops should be moved to cabinet storage areas or covered with plastic barriers.
  7. Face shields and Safety glasses:  Face shields are available for each team member. They are either multi-use and recommend for high splatter situations. Safety glasses are also available for non-splatter situations.  Both face shields and safety glasses should be cleaned between patients.
  8. Clean Air Systems: We will have medical-grade HEPA air purifying units spread throughout the office to help cleanse the air and diminish aerosols. Please turn on “Auto” setting at the beginning of each day and turn off at end of day. If you will be doing a procedure that generates aerosols, then please turn to a higher setting.  Do not leave on higher setting all day because this could cause machine to stop working from being over heated.
  9. Isolation gowns: Disposable isolation gowns or washable cloth jackets will be available for use under high aerosol situations. After an aerosol procedure, a disposable gown must be thrown in the trash and a cloth gown thrown in the washing machine after the patient is dismissed.  In non-splatter situations, gowns may be worn more than once.  Change gowns/jackets after patient if soiled.
  10. Surgical Caps: Caps are optional, and will be provided upon request. Should a staff member choose not to wear a surgical cap, it is advised to wash hair at the end of the day upon returning home.  *All team members with long hair must wear their hair up and back away from their face while with patients.
  11. Paper charts and forms should be kept stored away and not sitting out on counter tops.
  12. COVID-19 Testing: We are hopeful that testing will be available to rapidly screen patients. Antibody testing will be provided to test our team members once available to see if they’ve been exposed to the virus already and have built up immunity.
  13. Treatment Planning & Financial Disclosure Forms: Our rule of informing prior to performing will continue to be followed and all treatment plans will be presented by the team. For same-day procedures, this discussion will happen in the treatment room, in which the team member will wear a mask and disposable gloves. This will prevent potential cross contamination to other areas of the office. If a patient has to sign a document, the pen that is used will be provided by the patient OR if the patient does not have a pen, then the office will provide a pen and the patient can keep the pen or the pen can be sanitized once it has been used.
  14. Patient Dismissal & Scheduling Next Appointment: ONLY 1 PATIENT AT A TIME AT EACH OF OUR FRONT DESK AREAS (CHECK IN and CHECK OUT). Once treatment is completed, please complete the check out process chair side. All receipts and post op paperwork will be taken care of in treatment room. The next appointment scheduling should also be completed in the treatment rooms. When team members are at the front desk they are to wear a mask and maintain proper social distancing with patients.  Hand sanitizer should be used after handling cards or personal items of patients.  Pens and credit card machines should be disinfected after each use. Once everything is completed, please radio to make certain that the front office area is clear and then escort your patient out.
  15. Bathrooms should be disinfected after each use. The team member with the patient at the time will be responsible for attending to the bathroom.


  1. Patients should not be allowed to linger in front desk area or waiting room after checking out, but should return to their car so that the next scheduled patients can enter.
  2. Check out areas should be sanitized with disinfecting wipes prior to seeing the next patient.
  3. All front admin computer workstations should be wiped off with disinfecting wipes at the beginning and end of each day, and at any time where you feel necessary.
  4. All treatment room workstations should be wiped off at the end of each appointment and prior to seeing the next patient.
  5. Treatment room disinfection and instrument sterilization protocols will remain as they always have, except treatment room air will be sprayed with Lysol or Clorox spray, or Thieves disinfectant after each patient. The air purifiers also help clean the air.
  6. Patients are to be scheduled in such a way to stagger the treatment room occupancy so that each room will be vacant for approximately one hour after each procedure.
  7. In the front office all hard surfaces will be wiped off and disinfected at least once per hour.


  1. All team members are to bring a change of clothes and shoes to work each day. Please change clothing and shoes prior to leaving office.  Once home, wash work clothing immediately.  Work shoes should be wiped off at home prior to wearing again.
  2. Clinical jackets are to be washed at the end of each day.
  3. Each team member is responsible for keeping PPE clean and disinfected between patients.


  1. Lunches will be rotated to keep phones on during lunch.
  • 11:30 am to 12:30 pm 1st Front office Team member
  • 12:00 pm to 1 pm clinical Team Members (2) plus Dr. Cameron
  • 12:30 pm to 1:30 pm 2nd Front office Team Member
  1. Phones will be assigned, so that one person is using their own phone, with one group phone.
  2. Please consider bringing your lunch to minimize being in public settings and potentially bringing Virus into the office.
  3. The snack area and coffee machines will be temporarily closed. However, if a patient requests a snack or drink due to low blood sugar or needing to be placed on nitrous oxide, then find out what they want and bring it to them. 
  4. Shared community food items, such as ice, and ketchup will no longer be allowed in break room. Please bring individual items or packs from home.
  5. This is a detailed, but not an all inclusive list. Additional items can be verbally added at any time in order to comply with new updates.

The above guidelines are in compliance with the latest updates and recommendations from the ADA, TN Board of Dentistry, TN Department of Health, and CDC.

Sophisticated Smiles