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No touch dental screening

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No touch dental screening

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No touch dental screening

  1. 1. Dental Screening Using a “No Touch” Technique Melissa Lesk, RDH & Heather Murray, RDH, BA, BEd. (Adult) 1
  2. 2. 2 Dental Screening 1 § A short assessment by a regulated dental professional that can indicate the need for dental care. § Not a replacement for a complete dental examination. Source: Oral Health Protocol, 2018 (MOHLTC)
  3. 3. School-based dental screening programs Legislated by the MOHLTC § Part of the Ontario Public Health Standards and the Health Protection and Promotion Act (HPPA). § Health Unit’s shall conduct programs in accordance with the Oral Health Protocol, 2018 and the Population Health Assessment and Surveillance Protocol, 2018. Source: Ministry of Health and Long –Term Care, 2018 http://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/docs/protocols_guidelines/Oral_Health_Protocol_2018_en.pdf 3
  4. 4. 30-60 second assessment 4 § Assessment of a child’s oral cavity. § Only informed consent is required as no treatment is provided.
  5. 5. Informed Consent §Poses little or no risk of harm to students. Thus, it is excluded from the meaning of “treatment” under the Health Care Consent Act (HCCA). §A notification letter is provided to parents/guardians at least 10 business days before oral screening is scheduled to take place (Oral Health Protocol, 2018, MOHLTC). 5 School-based dental screening
  6. 6. Grades targeted for screening Health Units are mandated to provide dental screenings in all publicly-funded elementary schools. High Screening Intensity Schools JK, SK, Grade 2, 4 & 7 Medium Screening Intensity Schools JK, SK, Grade 2 & 7 Low Screening Intensity Schools JK, SK & Grade 2 6
  7. 7. School-Based Dental Screening Programs § Identify children at high risk for dental disease. § Ensure children with urgent dental concerns receive the necessary interventions. § Offer free dental treatment to families who are eligible for Healthy Smiles Ontario Program. § Allow Health Unit’s to conduct oral health surveillance and oral health promotion. 7 Ontario Newsroom, 2016, Ministry of Health and Long-Term Care https://news.ontario.ca/mohltc/en/2016/04/ontario-expands-free- dental-care-for-eligible-children-and-youth.html
  8. 8. School-Based Dental Screening §Health Unit staff visit schools within their catchment area. §Dental staff request that the school provides: §A private room. §Two tables and three classroom chairs. 8 *Please note: A portable dental chair is not required for screening.
  9. 9. Health Unit Supplies: 9 § 70%-90% alcohol-based hand sanitizer. § Labelled containers with locking mechanism. § IPAC cleaning schedule. § Locking briefcase. § Laptop computer. § Extension cord along with cable protectors. § Portable dental light § Sterile mouth mirrors. (Front surface #4) § Sterile dental explorers. § Environmental surface cleaner/disinfectant wipes. § Personal Protective Equipment (PPE) readily available if required.
  10. 10. (RDH) Roles & Responsibilities §Dental screenings. §Equipment and supplies. §Cleaning and disinfection of screening area. 10 *Please note that all staff are trained in the MOHLTC’s protocol requirements, IPAC routine practices and no touch dental screening techniques.
  11. 11. (CDA) Roles & Responsibilities §Data entry into Ontario Oral Health Information System (OHISS) and completing ministry forms and oral health report cards. §Completing IPAC cleaning schedule and the cleaning/disinfection of clerical area. *Please note that all staff are trained in the MOHLTC’s protocol requirements, IPAC routine practices and no touch dental screening techniques. 11
  12. 12. DENTAL SCREENING SETUP 12 Cleaning & Disinfection of Room
  13. 13. DENTAL SCREENING SETUP 13 RDH Screening Area
  14. 14. 14 Dental Screening Setup CDA Administrative Area
  15. 15. Dental Screening Setup Optimal Room Design 15
  16. 16. “No touch” Dental screening Picture 16 § A quick visual assessment. § Screener has no direct contact with child. § Sterile mouth mirror used has minimal contact. § Is a low risk activity; thus, no PPE is required unless determined post risk assessment.
  17. 17. Screening Vs Examination Screening: § School/community-based setting. § Quick visual inspection (30-60 seconds). § No medical/dental history is required. § Completed without or minimal contact. § Minimal tools required (mirror and light). 17 Examination: § Clinical-based setting. § Comprehensive examination (30-60 min). § Medical/dental history is taken. § Contact is necessary. § Diagnostic tools are utilized such as radiographs, intra-oral cameras etc.
  18. 18. Hand Hygiene §70 to 90 % alcohol-based hand rub (PIDAC, RCDSO) §Applied routinely before and after screening a class of students. §Utilized when there has been contact with dirty surfaces. §Applied before and after PPE is put on and taken off. 18
  19. 19. Personal Protective Equipment When should it be considered? Dental Mask: indicated when potentially exposed to contaminated droplet material Gloves: indicated when contact with mucous membranes or a tooth is required *Please note that protective eyewear and clothing are not required as there is no production of aerosol, spatter or debris during a dental screening. Source: Infection Control & Prevention in the Dental Office, 2010, Royal College of Dental Surgeons of Ontario, 19
  20. 20. THE NUMBERS § Each RDH screens up to 175 students daily. § Approx. 26,000 students are screened annually. § 2,176 students identified as having urgent dental conditions last year. 20
  21. 21. “NO TOUCH” TECHNIQUE 21
  22. 22. Disposal & Transportation of Used Instruments 22 § Labelled Containers that are designated “Dirty” § Instruments disposed into a puncture-resistant holding container with a locking mechanism and transported to the HU’s instrument reprocessing area. § The container is decontaminated after each use.
  23. 23. REPROCESSING OF DENTAL SCREENING INSTRUMENTS 23 § Instruments are cleaned in an automated washer with an enzymatic cleaner. § Automated washers do not require pre-soaking or scrubbing of most instruments (RCDSO). § Instruments are sterilized according to PHO IPAC guidelines.
  24. 24. Final highlights “No touch” Dental Screenings Performed in a non-clinical school-based setting by a trained public health Registered Dental Hygienist. Is a Low risk activity; thus, PPE is not routinely required. Is not an exam nor an intervention (no clinical services are provided). Is an environmentally responsible approach to screening. Improves student acceptance. Reduces parental concerns. 24
  25. 25. Questions?
  26. 26. References Best Practices for Infection Prevention and Control Programs in Ontario In All Health Care Settings, 2012 Provincial Infectious Diseases Advisory Committee (PIDAC). http://www.publichealthontario.ca/en/eRepository/BP_IPAC_Ontario_HCSettings_2012.pdf. Dental topics, Simcoe Muskoka District Health Unit, 2017, http://www.simcoemuskokahealth.org/Topics/Dental Health Care Consent Act, 1996, S.O. 1996, c. 2, Sched. A, Government of Ontario https://www.ontario.ca/laws/statute/96h02#BK13 Infection Control and Prevention in the Dental Office, Draft Copy, 2018, Royal College of Dental Surgeons of Ontario IPAC Core Elements in Dental Practice Settings, 2015, Public Health Ontario, https://www.publichealthontario.ca/en/eRepository/IPAC_Checklist_DENTAL_Core_Elements.pdf Oral Health Protocol, 2018, Ministry of Health and Long-Term Care http://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/docs/protocols_guidelines/Oral_Health_Protocol_2018_en.pdf

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