Swine Flu Highlights Infection Control

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When the CDC declared a health emergency in the US because of H1N1 influenza, we asked dentists if they were making any changes as a result of the threat. Most are not, but 12% have, and another 29% are considering it.

These are some of the changes dentists have made:

More frequent hand washing and use of hand sanitizer
Not treating patients who feel ill
Encouraging sick employees to stay home
Using R-95 face masks to block virus particles
Use of eye shields

Making specific changes

"No pigs allowed in the waiting room." (West Virginia dentist)
"Yes, we'll use R95 masks." (dentist) [Note: R-95 masks block viruses more effectively than less expensive surgical masks.]
"At the extreme we close the office to avoid unnecessary contact with the general public. At level 5 we will be masked, gloved and eye shields at all times. Level 4 means that anyone with the hint of an illness will not be seen for routine appointments. A pandemic is nothing to sneeze at."
"Maybe ask patients if they don't feel well to wait to come in for appt. Hand out masks in the waiting room???Otherwise, will follow our normal universal precautions." (California dentist)
"We will be reviewing our policy manual to see if it should be modified for the potential for staff taking more sick time off. We will also be looking at supply levels and adjusting accordingly." (Maryland dentist)

No worries

"Not worried. I only treat humans."
"I think it is a bogus threat, in line with SARS and any number of so-called possible pandemics." (Kansas dentist)
"Certainly you have something better to do than this! Get a life!" (dentist)

Hand washing and hand sanitizer

"More diligent about hand washing and infection control." (New Jersey dentist)
"No changes, but I am encouraging my staff to double their hand washing/sanitizing routines." (Washington dentist)
"Have hand sanitizer available in the reception room and all ops."
"Re emphasize the importance of hand washing." (California dentist)

We already practice infection control

"Basic cleanliness already practiced is all that is necessary." (Utah dentist)
"Just our normal daily precautions, which should protect us from this or any other infectious difficulty." (Michigan dentist)
"Not worried. We wash our hands and scrub down everything." (Georgia dentist)
"We already have excellent infection control, including wiping doorknobs." (California dentist)
"All offices should have been prepared for this and any type of flu outbreak. What else can you do but follow all proper precautions and protective barriers as recommended by the CDC -- in other words all that must be done on a daily basis to always protect our patients, staff, and ourselves!" (Ohio prosthodontist)

A little extra caution

"I am keeping an eye on the situation. I am following CDC, CDC e-health, FEMA and NIOSH on Twitter, and have received some useful updates (better than what I get from the news media). Some preparations I took care of years ago." (California dentist)
"I believe that we are all worried. We treat all our patients with the same quality and strictest sterilization procedures." (Florida dentist)
"Not worried, but we'll take extra precautions with patients with flu-like symptoms." (Illinois dentist)
"When confirming patients review the symptoms of swine flu. Making sure that all providers in our practice are healthy," (Wisconsin dentist)

Universal Precautions

"Universal Precaution standards apply to this threat as well as any other." (Alabama dentist)
"We continue to practice universal precautions to prevent transmission of disease." (dentist)
"We continue to use universal precautions." (Illinois dentist)
"Universal Precautions are not changed" (California Orthodontist)
"We already practice dentistry under strict Universal Precautions and we don't treat anyone with a fever or not feeling well. Wash hands frequently." (California orthodontist)
"We will reinforce universal precautions and inform our patients of our concern and protocol." (Louisiana dentist)
"There should be no concern if proper infection control protocols are in place." (Wisconsin dentist)

Media hype

"Pandemic??? Give me a break! 325 million US residents, and what, 50 cases with no fatalities. Even Mexico, only 150 deaths. More people died last weekend on the golf course from lightning!" (Washington dentist)
"No special changes. 20-30,000 people die every year in this country from influenza and related complications. Now 20 people have been hospitalized and we have a pandemic? Give me a break. With 30,000 people a year dead the media can't get Americans to get flu shots, but they can whip up a frenzy with a new strain of swine flu. Classic case of media and politics driving public health policy." (Rhode Island dentist)
"We are not worried about the swine flu. media hype is no reason to panic. Mortality vs morbidity rates are nothing to worry about, at this point, and I really don't think, at least in the US, they will ever reach rates which will require any more behavior modification than we already do for the flu." (Colorado dentist)
"Not worried. People catch the flu, and guess what? They can pass it on to someone else--it's contagious. Occasionally people are hospitalized due to a virus, and even less often, sadly, the immune system of some individuals can become overloaded by a virus and they pass away. I'm not convinced that the effects of this flu strain are much different than those of any other flu virus, but I am convinced that all the media attention is creating a lot of fear. I choose to be as aware as I always am of the well-being of myself and others around me, and will continue to practice universal precautions and common sense." (California dentist)

Note: Survey sample included 136 respondents.