A number of dental hygienists in Florida say the state should not be resuming regular operations this week because conditions in many dental offices remain unsafe for them and their patients.
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Those hygienists are speaking out following Governor Ron DeSantis executive order that said that Florida dentists can resume providing preventive and routine care services this week. That’s despite the Centers for Diseases and Control's most recent directive that dental offices still “postpone elective procedures, surgeries and non-urgent dental visits.”
“We miss our patients. We love them…but we cannot risk their safety – our safety – and that of our families,” says Pinellas County based dental hygienist Kayte Bush.
Spectrum Bay News 9 received nearly a dozen emails from dental hygienists following our interview last week with Dr. Rudy Liddell, the president of the Florida Dental Association. Liddell said that procedures were being put in place to make it a safe environment for patients to come back to get the dental care they’ve been putting off since elective surgeries were canceled by Governor DeSantis last month.
But Bush is the only hygienist who is speaking out publicly, even though it could result in losing her job when she’s ordered to resume work this coming Friday.
She and many of her colleagues have two specific concerns at the moment: that the spread of aerosols in dental offices make patients and hygienists extremely vulnerable for COVID-19. And they worry that not enough dentist offices are fully up to date with Personal Protection Equipment (PPE).
“There is no way to eliminate these aerosols from any procedure we do, therefore endangering ourselves and the entire community,” she says.
Liddell acknowledges that the hygienists have a legitimate concern when they use what is called an ultra-cavitron scaler with patients, “which produces a lot of aerosols.”
Safer alternatives for hygienists, he says, would be for them to use a high velocity/volume suction or to “hand-scale” their patients teeth.
Liddell says that he’s asked his own hygienists in his Brandon office to tell him what their comfort level is.
“If you’re scared of aerosols, then do hand scaling for now. And go back to the cavitron when the conditions you deem that to be safe,” Liddell says. “There’s a little bit of give and take there.”
Kayte Bush responds: “To address Dr. Liddell and be clear: It is not just one dental hygiene instrument that creates aerosols, even just the tool (an air/water syringe) that we use to rinse your mouth out or the 'slow-speed' polishing hand piece we use for every, single cleaning creates massive splatter AND aerosols and we simply can not do our jobs without these tools. There is nothing to give or take, our job consists of far more than just 'hand-scaling'. Treating patients only by hand scaling is not ethical and does not adhere to dental hygiene standards of care.”
The other major concern is that some dentists may not yet have the PPE required for their hygienists to work safely.
“Many hygienists have been advised that, due to lack of inventory and the need for frontline workers to have that PPE, that we will not be provided with it, but we still must report to work,” says Bush.
Dr. Liddell says if an individual dentist doesn’t have sufficient personal protection equipment, “he shouldn’t be opening his office this week.”
In the emails sent anonymously to Spectrum Bay News 9, several hygienists expressed similar worries.
“It’s not safe to get your hair done, but it’s OK to get your teeth cleaned??” one hygienist wrote.
“We can sit about 12 inches from our patient’s open mouth and we can go back to work but yet salons can not open even if both parties wear masks? It makes no sense,” another wrote.
“I am concerned with anyone’s health who enters a dental office during this time,” a third hygienist wrote.
Alluding to how citizens are being advised to wear face masks when they go out in public, she laments, “In a dental office, there is no way to wear a mask.”
The Florida Dental Association has a page on their website indicating how things will be different in the coronavirus age when they make their next dentist visit. That may include being screened for recent travel history before making an appearance, and waiting in your car before the dentist is waiting for you to observe social distancing.
Unlike nurses who are very much on the frontlines in battling COVID-19, dental hygienists don’t have a union. But Bush says the novel coronavirus has been a real “wake-up call” in terms of safety and expectations of the workplace.
She recently created a Facebook page to start up a movement to unionize dental hygienists across the nation, and says it’s grown in the past few days from 5,000 publicly to thousands more privately.
“We shouldn’t have to make this decision,” she says about having to decide to go back to work this week.
As for as creating a union? “It’s going to be a long and arduous process, one of which I’ll be proud to part of for the future of all hygienists.”