H1N1 (Swine Flu) Information for Dental Offices and Dental Patients

The 2009 H1N1 flu continues to cause havoc across the country. The Centers for Disease Control and Prevention (CDC) reports laboratory-confirmed flu rates are climbing, and are higher than expected for this time of year. More notably, hospitalization rates continue to be the highest among our younger populations, with the highest rate of hospitalization reported in children 0-4 years old. Sadly, 129 laboratory-confirmed pediatric 2009 H1N1 deaths have been reported since April 2009.
If you are concerned about your upcoming dental appointment, and are wondering what your dentist is doing to prevent the spread of H1N1 in the dental office, here are some of the guidelines the CDC prepared for dental offices to consider adapting into their practice during this obviously stressful time:

Patients with an acute respiratory illness should be identified at check-in and placed in a single-patient room with the door kept closed.
• Staff should offer a disposable surgical mask to persons who are coughing, or provide tissues and no-touch receptacles for used tissue disposal. The ill person should wear a surgical mask when outside the patient room.
• Dental healthcare personnel assessing a patient with influenza-like illness should wear disposable surgical facemask, non-sterile gloves, gown, and eye protection (e.g., goggles) to prevent direct skin and conjunctival exposure.
• Patient and dental healthcare workers should perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand rub, or antiseptic handwash) after having contact with respiratory secretions and contaminated objects/materials.

Routine cleaning and disinfection strategies used during influenza seasons can be applied to the environmental management of swine influenza.
• Staff experiencing influenza-like-illness (ILI) (fever with either cough or sore throat, muscle aches) should not report to work.

• Staff who experience ILI and wish to seek medical care should contact their health care providers to report illness (by telephone or other remote means) before seeking care at a clinic, physician's office, or hospital.

• Staff who were not using appropriate personal protective equipment during close contact with a confirmed, probable, or suspect case of swine influenza A (H1N1) virus infection during the case's infectious period should receive chemoprophylaxis according to CDC guidance (http://www.cdc.gov/swineflu/recommendations.htm).

• Staff who have difficulty breathing or shortness of breath, or are believed to be severely ill, should seek immediate medical attention.

We are all advised to stay home if the signs of influenza-like-illness are present. If you have an appointment, contact your office for instruction. Chances are, the dentist will recommend the appointment is rescheduled until the ILI symptoms are gone. If you require emergency dental treatment, the following guidelines have been established:

"If urgent dental care is required and swine influenza A (H1N1) has either been confirmed or is suspected, the care should be provided in a facility (e.g., hospital with dental care capabilities) that provides airborne infection isolation (i.e., airborne infection isolation room with negative pressure air handling with 6 to 12 air changes per hour).

For aerosol-generating procedures, use a procedure room with negative pressure air handling. Personnel providing direct patient care for suspected or confirmed swine influenza A (H1N1) cases should wear a fit-tested disposable N95 respirator when entering the patient room and when performing dental procedures. Respirator use should be in the context of a complete respiratory protection program in accordance with Occupational Safety and Health Administration (OSHA) regulations.

Talk to your dentist if you have any concerns or questions about visiting the dental office during flu season.
_{Source:
Centers for Disease Control and Prevention.}