Safety in the dental office is a common concern, especially following recent events highlighting airborne transmission risks. Dentistry is an essential healthcare service that has operated under strict infection control standards for decades. Modern dental practices are highly regulated environments that adapt to new scientific knowledge and public health needs. These facilities employ multiple layers of protection to ensure the safety of both patients and the dental team.
Foundational Infection Control
Dental practices adhere to rigorous infection control protocols established by organizations like the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA). These foundational measures prevent the spread of pathogens through direct contact, contaminated instruments, and environmental surfaces. Disposable patient-care items, such as suction tips and prophy angles, ensure many tools are never reused, eliminating cross-contamination risk.
Reusable instruments undergo a multi-step decontamination process culminating in heat sterilization, typically using an autoclave. Instruments are categorized by risk: critical items that penetrate tissue, like surgical instruments, always require heat sterilization. Semicritical items, such as mouth mirrors, are also heat-sterilized whenever possible.
Between every patient, all clinical contact surfaces—including the dental chair, countertops, and X-ray equipment—are thoroughly cleaned and disinfected. This process uses EPA-registered, hospital-grade disinfectants designed to kill a broad spectrum of microbes. Standard personal protective equipment (PPE), including gloves, surgical masks, and protective eyewear, is worn by the dental team during procedures and is changed between every patient.
Mitigating Airborne and Aerosol Risks
Dental procedures, such as cleanings and drilling, generate fine mists known as aerosols. To manage this risk, dental offices employ advanced strategies beyond traditional surface disinfection. The most effective method for controlling these mists is high-volume evacuation (HVE) suction, which captures 90% to 98% of aerosols at the source.
Many practices utilize specialized air filtration systems containing High-Efficiency Particulate Air (HEPA) filters. These units remove at least 99.97% of airborne particles as small as 0.3 micrometers, cleaning the air within the operatory. The combination of HVE and a HEPA filter unit can reduce aerosol concentrations by over 99% during a procedure.
The rubber dental dam is a physical barrier used during certain treatments to isolate the tooth, reducing the amount of saliva and contaminants escaping into the air. For aerosol-generating procedures, the dental team upgrades PPE, using N95 respirators or higher-filtration masks and full-face shields. Some offices implement a “fallow time,” where the room remains vacant to allow the air filtration system to clear remaining aerosols before the next patient.
Patient Screening and Scheduling Protocols
Administrative controls manage risk before a patient enters the treatment room. Offices conduct pre-appointment health questionnaires, often via phone or text, to screen for symptoms of illness or recent exposure. Patients reporting symptoms like fever, cough, or recent exposure are instructed to reschedule their appointment.
Upon arrival, measures continue with temperature checks and a final review of the health questionnaire. To minimize the number of people in the office, waiting room seating is spaced out for social distancing. Patients may be asked to wait in their vehicle, and policies limit accompanying guests to only those necessary.
Patients are required to wear a face covering upon entering and leaving the facility, and hand sanitizer is readily available. Some practices also ask patients to use an antiseptic pre-procedural mouth rinse before treatment begins. These steps identify and isolate potential sources of infection, protecting staff and other patients.
The Greater Risk of Delaying Needed Care
While safety concerns are understandable, delaying necessary dental care introduces significant health risks. A small cavity, treatable with a simple filling, can quickly progress if left untreated. Decay can penetrate deeper into the tooth, potentially infecting the nerve and requiring a complex procedure like a root canal or extraction.
Mild gum inflammation (gingivitis) is reversible with professional cleaning and improved hygiene. Skipping regular cleanings allows this to worsen into periodontitis, involving irreversible destruction of supporting bone and tissues. Untreated infections, such as an abscess, can spread beyond the mouth, leading to systemic inflammation. Regular appointments are preventative measures that catch minor issues before they become complex health problems.