Interview with Dr. Iñaki Cercadillo: “Above all, we want to protect ourselves and the patient”.

What security measures has AHOA taken to protect itself from COVID-19?

First of all, we have reviewed a lot of contrasted scientific information, as well as the prevention manuals of our professional association. From here, we have adapted the asepsis and disinfection protocols we already had to the prevention of the new disease, in a coherent and critical way. Among others, the distancing and individual protection measures that we all know. On the other hand, we will incorporate the disinfection of the air in the work boxes with UltraViolet radiation (UVC). We have also thoroughly reviewed the cleaning and disinfection protocols, times and products, as well as disposable materials to be applied as protective barriers. Above all, we want to protect ourselves and the patient, while at the same time trying to create a certain atmosphere of normality and, above all, of safety and professionalism in this new situation. In fact, what we have been doing up to now is already sufficient; we only need to improve some aspects and make them sustainable over time, so that in six months’ time we will be able to continue applying them.

How will my visit to the dentist change from now on?

In reality, for the patient there should not be a big difference. It is obvious that he/she will have to collaborate in following the recommendations from the entrance to the exit: hand disinfection, putting on the mask, etc. This is something you will already be used to, because it will be the norm in any facility. What you will see is more protected personnel. Although, for example, the face shields we see now, we used to use them years ago for some procedures, such as mouth cleanings, because they generated a lot of splashes and aerosols. Perhaps the waiting room will be a bit duller and colder, as there will be no magazines and not much company, but overall you will not feel much change. In fact, we want to work to keep the experience as pleasant as possible.

How do I know that AHOA personnel are not infected?

This is not easy to know at all times and in real time. Let us be aware that, if we have not created antibodies, i.e. we have not been immunized, we should be tested for the virus by PCR every 14 days. This is unfeasible. As healthcare professionals, what we want to know when we start our activity is whether we are immunized or not. This is something that the whole team will have checked. Obviously, if there is any symptom, it will be mandatory to do the PCR test to know if it is COVID-19. We also want to know if the incidence of infection has really been high or not. In spite of this, health safety measures will always be universal and maximum with all patients and with all healthcare personnel, because as we already know, de-escalation is a delicate moment and there is a greater risk of contagion. This implies that we may be more at risk outside the clinic than inside, when we increase the number of social contacts.

Will AHOA make the treatments more expensive due to the purchase of protective equipment and the security measures you have had to adopt?

The decision of the Clinic’s management has been not to increase the cost of treatments or to apply a charge for protective material used, as recommended by some consultants of dental clinic franchises. This is not the time, there will be an important economic damage for the majority of the population, and we have to facilitate access to our services, not hinder it. Another issue is that we will have to be more efficient in our management to allow the viability of our clinics in the medium term, but this is our job.

Due to the security measures to be taken when AHOA reopens, will visits last longer than usual?

Perhaps at the beginning the patient may perceive that everything goes a little slower, in reception or waiting room, but in itself the treatment time will be the same. What will force us to invest more time will be in the cleaning of the spaces after the treatments, something that the patient should not notice if we do a good job of programming.

Why were dental clinics closed when the quarantine was established?

There is some confusion in this regard. As health centers were not officially closed, their activity was restricted exclusively to emergency visits. This made it possible to provide care to patients with specific needs and to avoid saturating hospital emergency services.

Are there any oral health measures we can take at home to prevent the virus?

In addition to all the measures we have discussed, such as aeration with outside air and cleaning and disinfection of hands, there is a step in our clinic protocol that we do prior to treatment that can be of help. This is mouthwash with hydrogen peroxide (hydrogen peroxide) at a concentration of 1%. The commercial form is sold at 3%, so it should be diluted, 2 units of water for one unit of peroxide. This is a common disinfectant, and has been studied to reduce the viral load in the oral cavity by 90%. In addition, if gargled, we can even disinfect the nasopharyngeal area. This measure is not really indicated by any clinical study to prevent the disease, but it is indicated to reduce the viral load in saliva and reduce infectivity. This is important, as it has recently been identified in viral count studies that the presence of SARS-CoV-2 virus is higher in saliva than in the oropharyngeal mucosal area. This finding has made it possible to create a rapid test with a simple saliva analysis.