Gar N. Chan, DDS, INC


Are Salivary Diagnostics for COVID-19 as Reliable as Nasopharyngeal Swabs?

Excerpts and edited notes for this blog were referenced from a post by Perio Implant Advisory written by Dr. Scott Froum, DDS on August 26th, 2020. The following blog is presented for viewers to validate, accept and/or decline its content and findings on their own.

A new noninvasive COVID-19 test utilizing salivary diagnostics has recently been released for public and point-of-care use. But are salivary diagnostics as reliable as the gold standard nasopharyngeal swabs? Dr. Scott Froum examines the research.

Nasopharyngeal swabs administered by health-care workers have become the gold standard in testing for COVID-19. Nasopharyngeal swabs demonstrate a high sensitivity and specificity. False negatives and positives can occur, however, and these tests are open to operator error, lab contamination, and handling errors that can compromise accuracy. The swab has to be placed deep into the nasopharyngeal region of the patient, often eliciting an unpleasant sensation. Due to high demand, the process may take up to three weeks to receive laboratory results after administering the test.

Recently a new noninvasive COVID-19 test utilizing salivary diagnostics has been released for public and point-of-care use. Sample collection is easy, and the test is less prone to operator error. The question is, are salivary diagnostics as reliable as the gold standard nasopharyngeal swabs? A new prospective study in the Journal of Clinical Microbiology looked to answer that question.

The study was performed at the University of Utah and analyzed more than 1,100 samples from 386 patients, comparing traditional deep nasopharyngeal swabs collected by health-care workers to self-collected samples (by patients) using anterior nasal swabs and saliva collection. This study found that patient-collected saliva tests for SARS-CoV-2 was just as accurate as traditional nasopharyngeal swab collection by health-care workers.

Saliva tests have definite benefits over traditional nasopharyngeal swabs:
1. Health-care workers do not need to be exposed to patients upon collection.
2. These tests are noninvasive and simple to use.
3. The patient does not have to go to a clinic with sick patients to be tested.
4. Lab results can take 48–72 hours depending on demand.

The salivary diagnostics testing procedure:
A. The patient expectorates (spits) into a collection tube up to a required volume.
B. The patient screws on a buffer solution and mixes the saliva and buffer.
C. The patient places the sample in an envelope and mails it overnight to the lab.

Mass implementation of a COVID-19 test that is accurate, easy to use, and efficient with test results can assist both health care and public health officials in ending the COVID-19 pandemic in an expedited manner.


Decontaminating N95 Respirator Masks after SARS-CoV-2 Exposure

Excerpts and edited notes for this blog were referenced from a post by Perio Implant Advisory written by Dr. Scott Froum, DDS on September 1st, 2020, who examined the results from a new study that looked at four decontamination methods on N95 respiratory mask filter fabric that had been exposed to SARS-CoV. The following blog is presented for viewers to validate, accept and/or decline its content and findings on their own.

The COVID-19 pandemic has created a shortage of N95 respirators worldwide in both the medical and dental fields. Because N95 respirator masks are designed for one use only prior to disposal, concern has arisen over the forced need for health-care workers to use these masks for multiple patients and extended periods of time (hours, days, and sometimes weeks).

N95 decontamination methods have been described in the literature for bacterial spores, bacteria, and influenza A with regard to filtration efficiency and seal, but not the virus that causes COVID-19, SARS-CoV-2.1 Studies on various decontamination methods have shown adverse effects on both filtration and seal of N95 respirator masks, causing them to become ineffective after decontamination.2

A new study in the Journal of Emerging Infectious Diseases looked at four decontamination methods on N95 filter fabric that had been exposed to SARS-CoV-2.3 The decontamination methods included vaporized hydrogen peroxide, dry heat at 70 degrees Celsius (158 degrees Fahrenheit), ultraviolet light (UV-C), and 70% ethanol spray. Although all four methods eliminated detectable viruses from the N95 fabric, they altered the filtration and seal in different ways.

Researchers found that vaporized hydrogen peroxide was the most effective decontamination method and killed all detectable viruses after 10 minutes, without affecting integrity of the mask fabric for use up to three times. UV-C light needed 60 minutes of exposure to the mask to kill all detectable viruses, with similar effects on mask integrity (use up to two or three times). Dry heat needed 60 minutes of exposure to mask fabric to kill all viruses, with effects on mask integrity after two uses. Lastly, 70% ethanol could kill all detectable viruses but affected the integrity of the mask after one use.

In conclusion, vaporized hydrogen peroxide and UV-C light allowed N95 respirator masks to function for three uses, while dry heat allowed two uses. 70% ethanol was not recommended. The authors finished by stating that anyone decontaminating an N95 respirator mask should carefully check the fit and seal over the face before each reuse.


Dr. Gar Chan & South-Bay-Backpackers Rescued From Raging Creek Fire

Dr. Gar Chan and his two hiking friends had to make alternate plans on their backpacking trip this past week due to the raging fires. For all of our family, friends and patients who have been calling about him, Dr. Chan arrived home safely and today he is back at the office doing what he does best – Dentistry.

The following are excerpts and edited notes referenced from www.nbcbayarea.com/news/California.

“After all we have seen through the past weeks the fire near Yosemite is an unprecedented disaster. That is according to Cal Fire. This is at the Sierra National Forest, northeast of Fresno, more than one hundred and forty people trapped by the Creek Fire were rescued by helicopter early Tuesday morning on September 9th, 2020. Over the holiday Labor Day weekend the National Guard helicopters rescued two hundred other campers out of this area. People are being evacuated from several place, Hidden Lake, China Peak, Lake Edison, Shaver Lake. These are all popular spots. Among the people rescued were three backpackers from the South Bay.

NBC’s Marianne Farvo reports fast moving flames engulfing miles of trees in the Sierra National Forest. This is what three friends from South Bay escaped as the Creek Fire edged towards them. San Jose Geology Professor Robert Miller, Gilroy Dentist Dr. Gar N. Chan , and Program Manager Ken Oliver left the South Bay for a Labor Day trip to deliver new supplies to a friend hiking the John Muir Trail. But when ash started to rain, they raced twelve miles back to their car at Hidden Valley Resort near Lake Edison.

It was another day of dramatic rescues at the fast moving Creek Fire outside Yosemite as the fire continued to trap hundreds of people camping in the area. A total of 148 people have been airlifted to safety Tuesday, including three South Bay backpackers. Marianne Favro reports.”

Link to NBC’s news video clip:
https://www.gilroysmiles.com/wp-admin/post.php?post=9540&action=edit


Ask An Expert: HOW TO CHECK IF YOU’RE VENTILATING INDOOR SPACES PROPERLY

Hepa filter with functional description

Excerpts and edited notes for this blog were referenced from an “Ask An Expert” KCBS radio station 740 FM segment on September 3rd, 2020 at 9:20 AM sponsored by Stanford Health Care, hosted by Stan Bunger. The following blog is presented for viewers to validate, accept and/or decline its content and findings on their own.

As we continue to navigate these unprecedented times, KCBS Radio spoke with Carolne Savello, chief commercial officer for Color, a Bay Area health company running many of the region’s COVID- 19 testing sites.

Ask An Expert

There has been much discussion about how to properly ventilate and dilute air in indoor spaces in order to reduce transmission of the novel coronavirus through aerosols.

But how do you check if your set-up is actually working?

“A simple way we’ve been sharing with the public is to buy a carbon dioxide detector,” said Dr. Shelly Miller, professor in the College of Engineering and Applied Science at the University of Colorado in Boulder on KCBS Radio’s “Ask An Expert” segment Thursday.

Dr. Miller said carbon dioxide detectors are readily available online and cost about $100 each.

While some people may be concerned if they see condensation building up on windows, for example on public transit or in a shared car, Dr. Miller explained moisture operates somewhat differently and is not necessarily a good indicator of aerosol flow.

A carbon dioxide detector, on the other hand, can give people a good idea of whether or not exhalation is building up in a shared indoor space.

“If you monitor the carbon dioxide in a space and you keep it below – I’m saying 600, 800 parts per million, outside is 400 – if you keep it below that, you can use it as a proxy for how much exhaled CO2 is being released into your classroom by the people who are in the room,” Dr. Miller explained. “And if that is building up, that means you’re not getting enough outside air to dilute that carbon dioxide.”

Carbon dioxide levels should indicate whether or not air is being properly diluted, whether through filtration or ventilation. They do not, of course, detect for the presence of the virus itself.

In normal situations, 1,000 ppm is a recommended level for carbon dioxide, “but I’m being cautious and saying let’s aim for 600-800 if we could,” she said.

Most spaces are generally well mixed so readings should be fairly consistent throughout a space, unless you are close to a concentration of people or breathing on the detector.

This interview has been edited for clarity and conciseness.

TAGS: Ask An Expert Indoor Air aerosols Coronavirus health all news all local


Ask An Expert: COVID TESTING

Excerpts and edited notes for this blog were referenced from an “Ask An Expert” KCBS radio station 740 FM segment on July 29th, 2020 at 9:20 AM sponsored by Stanford Health Care, hosted by Stan Bunger. The following blog is presented for viewers to validate, accept and/or decline its content and findings on their own.

As we continue to navigate these unprecedented times, KCBS Radio spoke with Carolne Savello, chief commercial officer for Color, a Bay Area health company running many of the region’s COVID- 19 testing sites.

Ask An Expert

1. Stan: This area obviously has been an area of great concern to people; we all know now that it’s an important part of the nation’s response. I wonder if you’d walk us through Color’s transition, in many ways, from a slightly different business that you were set up to be in, into suddenly being in the middle of COVID-19 testing.

Caroline:  Back in March everyone was thinking, how can we help? Our roots were in providing very large scale, technology-driven testing access to large populations.  Although it was not COVID testing,  it was still testing.  We saw what was happening and over the course of a weekend, we decided to mobilize the company to try to support the effort.  We built and constructed a high automated COVID-19 testing lab  in Burlingame,  next to our existing headquarters, and we repurposed a lot of the company’s infrastructure and our software to be able to offer this to large populations in order to have an impact.

2. Stan: Those of us who go get tested understand: there’s a swab in the nose and then there’s some results. There must be a lot that goes on in between. What is the part in between?

Caroline:  Our thinking process was, how do you setup a system for individual patients to be able to sign up for a test, register for a test, collect a sample, process the test, and provide results, as quickly as possible.  We tried to set up our entire system and process to be super simple for anybody to be able to register for a test without having to wait for an appointment or wait for a doctor’s appointment.  Our sample collected is simply just a nostril swab, which is at this point performed in all of our work in San Francisco and in the Bay Area.  We have those samples delivered directly to our lab in Burlingame and loaded into our machines.  Our machines extract the viral RNA, if it’s present, from the sample. We run the testing, which takes a number of hours, and then that data actually feeds into a report that then is texted or emailed to every individual with their results.

So what happens in the middle? There are a lot of steps in that process that happen in our lab.  Effectively, it takes about 6-8 hours for a sample in total to go from getting loaded on our machines to a sample readout.

3. Stan: And obviously this is something that happens in the physical world. The sample has to go from the collection location to Burlingame, in your case, to be run. So there are issues around that. I think we all saw the Major League Baseball mess a few weeks back where they tried to get everything to Salt Lake City on the Fourth of July weekend.

Caroline:  Since the beginning we believed that quick results would have an impact. So the entire team process and the logistics has to be really tight and integrated. We have to know where samples are at all points in the process. Everything we do is bar coded. We know exactly where things are from the point that somebody’s signing up for an appointment to the point that their data is getting back to them, and when their results get back to them.

Our focus has always been on turnaround time. With all of our public health efforts in the Bay Area,  we have been trying to make sure that tests are resulted within two days, so that there can actually be an impact on public health.  People know if they have it and can isolate quarantine appropriately.

4. Stan: Fair enough. Let’s get to questions, and we’ve got a bunch of them here. People are obviously very curious about everything around testing these days. These have been sent in to [email protected]

First one: I’m an essential worker and have done three tests at the Embarcadero testing site in San Francisco, all negative. Tests one and three involved the test takers sticking the swab up my nose and twirling it around for 10-15 seconds, leaving my eyes watering and nose feeling funny. Second test: just swabbed lightly inside my nose, no aftereffects. Why the difference? I have another test coming up. Can I ask it to be done like the second one?

Caroline: It’s a good question.  Since we started, there have been changes in how we collect samples due to developments in science,  automation and technology.   So very early on when we started our efforts back in March and April, all of the samples being collected were nasopharyngeal swabs, the ones with the very thin swab that go all the way back up the nostril, the nasal cavity, into what people have referred to as the back of the brain.  Those are likely the ones that left the eyes watery and the nose feeling funny.

We have since been able to move to a much less invasive sample collection type based on data that we’ve gotten over time. That is just a simple swab in both nostrils twirled around in the near upper part of the nose. It is a lot more comfortable for people.  We have shifted all of our work to that, as have many testing companies and clinicians. It is really important that people are not worried about getting a test so that we can actually get this pandemic under control. That has been  part of how we have tried to design our process as well.

5. Stan: The next questioner wants to know in general what to expect after you’ve signed up online, because that’s how the process works. This person is going to the 7th and Brannan site next week.

Caroline: Great. So you’ve signed up and you have an appointment confirmation. We try to make it super efficient and simple from there. So you drive to the site or walk to the site. There are basically two stations:  You check-in at the first station and hold your ID up to the window or up to an individual with all of the proper social distancing and infection control protocols in place.  They are running  Color software on an iPad, and they are checking you in.  The data is preloaded.  They are checking you in as somebody who has registered.  Then you drive or walk to the next swabbing station.  At that point a clinician will administer the non-invasive nostril swab, put it in a tube,  and then they will hand you a card with a barcode on it. That barcode is how you will be able to access your results within 24-48 hours, sometimes up to three days.  You will get a text message or an email from Color saying your COVID results are ready, and with your barcode and clicking on that link, you will be able to go and view your results, which will say very clearly what the test result was.

6. Stan: Next question, and this is not specific to Color but obviously everybody wants to know the answer to this: why are some test results taking so much longer than others?

Caroline: That is a really good question and something that has really affected the pandemic response in a lot of regions. Every lab will take a different philosophy as to how they want to manage the volume and the testing.  As much as possible, we have been  trying to make sure that our test results come back in a time period that makes them useful.

Other labs, have two things happening to them:

1. They cannot control the amount of testing.  They are basically over-committing in terms of the volume that they can process. They are getting samples that are coming in from everywhere.  There is too much coming in and they cannot handle the volume;

2. More importantly, is a lot of other labs do not have a fully integrated, automated process.  When we get a sample coming in, it is fully digitally barcoded. We know where everything is and we have built all of the automation to be able to process these simply. Our lab is paperless; whereas, many other labs are laden with the administrative overhead and with the task of having humans process a lot of different types of both samples and order forms.  That causes time processing bottlenecks to return a results.

7. Stan: And this next question maybe you’ve already answered a good part: what are the biggest hurdles in testing? Personnel? Materials? Lab throughput?

Caroline:  One of the biggest hurdles is that a lot of our efforts in testing in this country have not been thought of very systematically. The lack of integration causes a lot of bottlenecks. For instance, I have just received a new FDA authorization to allow unmonitored testing. This  helps with another one of the bottlenecks, which is clinical monitoring and the clinical administration of samples of having to have a health care professional actually be at the point of administering a sample collection. Those are the types of things where we have been trying to be very systematic about breaking down all of those bottlenecks.

8. Stan: Is it safer to conduct testing outdoors versus indoors?

Caroline:  Outdoors is, given the airflow, obviously better just in general. But there is  a lot of efforts going into the retrofitting of indoor spaces to ensure that there’s appropriate airflow as well. I am not an expert on whether infection control put in place in indoor areas really can help and make it just as safe as outdoors.

9. Stan: How often should essential workers get tested if they don’t show symptoms and the first test was negative? I did my first test over a month ago.

Caroline: Unfortunately, the reality of this virus is you can contract it at any time. You can become infected by any kind of exposure event. Over the course of a month, especially as an essential worker, you may have a lot of interactions with individuals where you may have had possible exposure. A test result from a month ago is unfortunately no sign that today you haven’t been infected.

We have done a lot of modeling of this kind of work and basically very routine surveillance. The ability to be able to test very frequently,  really helps with controlling the pandemic. There are a lot of things that feed into that: how easy is it to access, how quickly can you get the test results? I don’t know what the Department of Health’s recommendation is on this, and I would defer to them in the context of San Francisco. But a monthly test does not unfortunately guarantee that there’s no infection present today.

10. Stan: What is the time frame between being infected and testing positive? In other words, if I were infected with COVID-19 on the same day I was tested, how soon would it take for my test results to come back positive?

Caroline: The World Health Organization has said that there’s a couple of key points in time. You will never get a positive test result on the day that you were exposed. There is always a lag. About three days after symptoms start, almost all of the time,  if you have been infected, you would get a positive result.  The middle period of time is still relatively unknown. It can be a week or it could be a few days. It really depends on how the virus is manifesting.

11. Stan: Can your expert offer advice on where timely testing and results are available for me if I’m willing to pay out of pocket? I’ve heard that many insured services can take over a week for results, making them pretty useless.

Caroline: The out-of-pocket payments right now are not significantly different. A lot of the underlying lab infrastructure is the same for many of those services that are offering what I would call “patient initiated testing.” The ones that you can  request online and get delivered to your house have a lot of the same lab infrastructure and similar turnaround time.  Where people should be looking is at a lot of the public health infrastructure in the Bay Area.  We are  working in San Francisco, in Alameda County and  in Marin County.  Those services  are really trying to make sure, whether it’s with Color or with other labs, that those results come back very quickly.

12. Stan: I have a whole bunch of questions here around accuracy so let me just lump them together. What is the current standard? How confident should people be in either a positive or a negative result?

Caroline: This does range a bit by different types of labs and different types of tests, so I will speak to at least our testing. The accuracy is very high, but the accuracy also depends over time, over that period of infection, based on how the virus is presenting in your body. Over time as the virus spreads, it becomes easier and more accurate to determine if you actually are infected. That said, the accuracy of our testing is basically the gold standard. It  depends on sample collection and it depends on the virus within you. It is as accurate as it can be when you’re running this kind of technology that’s been authorized by the FDA.

There is  other testing, such as the antibody testing and some of the newer testing technologies. One of the ones that’s been talked about a lot recently is antigen testing and the sensitivity of those. The accuracy of those is lower. Information is as good as it is at any given point in time and that’s why we always reiterate CDC guidelines. If you have symptoms or you are feeling unwell, you should continue to isolate yourself, even in the case of a negative test results just out of an abundance of caution.

13. Stan: I’m a nurse, I’d like to get tested, do I need a referral for my doctor? Can I go somewhere on my own? How much does it cost? I have Kaiser coverage, how do I find out where to go in Marin County?

Caroline:  There are a number of options and one is Kaiser. I know that Kaiser has been offering testing for its members. The second is, a lot of the Bay Area counties that we’re working with, including Marin, have set up public testing health infrastructure sites. We opened one in Marin County last week. The Marin County Public Health website will direct you to the Color Marin County site that is operating at Marin Center, and that has testing availability for essential workers and any individuals who are symptomatic. You can sign up very easily online, come to the site and have a sample collected. The test is run at Color and its results sent back to you. Those are two options for you.

14. Stan:I can get nose bleeds and worry about driving in for a test and having to drive home with a nosebleed. Is there an alternative to this?

Caroline: A lot of the testing in the Bay Area has been a sample collected from the nose. There are some tests out there – ours is not one of them – where you can submit a saliva sample. I don’t actually know across the Bay Area specifically, where that is accessible. There are some options online where you as an individual can go online and order one of those, but I don’t know offhand any publicly accessible saliva testing in the area.

15. Stan: The next question touches on that too and wants to know whether your technology at Color could be adapted to point-of-care testing at a doctor’s office and/or an at home test like a pregnancy test? And could saliva be used as an alternative to the nasal swamp?

Caroline: With our recent FDA authorization, we are able to provide testing at home, unmonitored. That will be starting downstream. We are trying to provide that as a public health tool as well. The point-of-care tests are quite different, but our technology, what we’ve been trying to do is make it as accessible as possible to large populations, even while we still are running everything in our facility, in our lab in Burlingame.

16. Stan: My sons and I had pneumonia in late February, too early to have taken a COVID test. I took the antibody test two weeks ago; it came up negative. Will there be a test any time soon for T-cells or other long term immunities?

Caroline: The way that testing technology is evolving, I think there is going to be a lot of new introductions of that type of technology over time. I do not know specifically about whether or not long term immunity is one that will actually be very testable in any relatively short period of time. I think that a lot of the focus right now is on, how do we identify as quickly as possible as many infectious cases as possible so that we can isolate and actually manage the public health outbreak that’s occurring?

17. Stan: Everybody is curious about the swab Caroline, I have to tell you. You’re probably well aware of that. If I ever feel the need to get a test, what’s the most accurate test I can get? I’d like to avoid the unpleasantness of the deep nasopharyngeal swab, especially if I can get accuracy. Is there any difference in accuracy between the different ways of gathering the sample that anybody’s noted?

Caroline: We get that question a lot. Effectively, the FDA and the CDC have said that a nasopharyngeal swab or a nostril swab or what’s called a mid-turbinate swab, which goes partially up the nose, that all of these are perfectly acceptable sample collection types. And I think that’s really important, because I think that should give people a lot of confidence that a less invasive nasal swab still will help perform a very high quality, high accuracy test and be less invasive.

There are always trade-offs in these decisions. We have not seen any meaningful impact on accuracy from using a less invasive swabbing type. It really does help change how people view testing. We actually want people who are feeling symptomatic, who may have had an exposure event, to understand if they have the virus. If concerns or fear of sample collection will prohibit them from doing that, that’s not good for anybody and that’s not good for public health.

18. Stan: I live in the Las Vegas area where there’s a backlog of 16,000 tests awaiting lab processing. I had my second test on July 20; received results today, so that’s nine days. Why is it that athletes get tested and get results quickly while the rest of us have to wait for results? Am I any less important or valued than a baseball, basketball or hockey player?

Caroline: This is a really tough topic. That is why we’ve been dedicating so much of our efforts to public health in the Bay Area specifically, and making sure that we are providing really fast results for everybody, regardless of who they are or where they come from. I think that this is where the state governments, county governments should really be trying to work with labs for public health purposes that are committed to a really fast turnaround time. This will help not only individuals feel safe and secure, but also help public health, schools.

19. Stan: How replicable is this recipe that you’ve cooked up at Color? The whole process you talked about: the paperless part, the lab back-end, all of it. Is this something that others could be doing or is this stuff that you folks have figured out on your own?

Caroline: Others could be doing it. We work nationally and we have put this in place across the country. It is really a philosophical thing of how different companies and different labs approach the process, and being focused on efficiency and integration. I think others could be doing this and we would be happy to help. There is a real opportunity to add this kind of infrastructure to, for instance, state level efforts in the state of California or Bay Area-wide efforts.

This interview has been edited for clarity and conciseness.

TAGS: Ask An Expert Coronavirus coronavirus Bay Area Coronavirus Special Features coronavirus testing Covid-19 all news all local


Ask An Expert: FLU SEASON APPROACHES WITH CORONAVIRUS STILL SPREADING

Excerpts and edited notes for this blog were referenced from an “Ask An Expert” KCBS radio station 740 FM segment on Friday, August 21, 2020 at 9:20 AM sponsored by Stanford Health Care, hosted by Stan Bunger, who spoke with Professor Brad Pollock, Chair of the UC Davis Department of Public Health. This segment was published by Jim Taylor, Friday, August 21, 2020 2:16 PM. The following blog is presented for viewers to validate, accept and/or decline its content and findings on their own.

Ask An Expert

Flu season is approaching and the coronavirus pandemic shows no signs of dissipating.

Two Epidemics?

“This is a hugely important point: we do not want to have two epidemics going at the same time. That is not good, that will overwhelm the system,” said Professor Brad Pollock, chair of the UC Davis Department of Public Health on KCBS Radio’s “Ask An Expert.”

“Every year you’ll have on average 30-40,000 influenza related deaths, so we don’t want to have that matrixed on top of a COVID epidemic,” he said.

Should I Get The Flu Shot This Year?

Professor Pollock, like many public health officials, are saying that everyone who can should get the flu shot this year.

In fact, at the UC system where he works, it is required.

“We mandate this at all of our UC medical centers, you can’t be an employee there without having your flu vaccination every year,” he explained. “This is now being broadened out to all the UC campuses, influenza vaccinations will be required.”

Concerns About Getting Two Vaccines?

He says while people may have concerns about getting the flu shot and a COVID-19 vaccine at the same time, the coronavirus vaccine mostly likely will not be ready until next year, and the country has to make it through flu season between now and then.

“It is absolutely important to have people vaccinated for influenza, particularly this season,” Pollack said.

Upside To Pandemic

There is one small upside; the habits people have adopted to reduce coronavirus transmission should make the flu less likely to spread as well.

TAGS: Ask An Expert, Coronavirus, Flu, Influenza, Vaccines, health, all news, all local


Ask An Expert: IS IT SAFE TO GO TO THE DENTIST?

Excerpts and edited notes for this blog were referenced from an “Ask An Expert” KCBS radio station 740 FM segment on Monday, August 10, 2020 at 9:20 AM, hosted by Stan Bunger, who spoke with Dr. Alan Gluskin D.D.S., President of the American Association of Endodontists This segment was published by Mallory Somera, Monday, August 10, 2020 3:12 PM. The following blog is presented for viewers to validate, accept and/or decline its content and findings on their own.

Stan: Today we’re taking a deep dive into the dentists office.

  • Is it safe to go in for that annual cleaning?
  • What factors should you weigh in decided to go in for an appointment?
  • What safety procedures are already in place?

Ask An Expert

As the coronavirus pandemic continues to take its toll on reopening and a return to “normal,” individuals are worried about visiting seemingly high-contagion spaces like the dentist’s office.
Dr. Alan Gluskin D.D.S., President of the American Association of Endodontists, wants to ensure those antsy to get back into their dentist’s office for their routine cleaning or emergency procedures that there’s not much to worry about, as dentists are using high-standard Personal Protective Equipment and have been taking every precaution to keep their patients and staff safe.
He told KCBS Radio on Monday’s “Ask An Expert” that even when the pandemic first hit, 90% of endodontists were open to treat emergencies and a vast majority are up and running now, but there are some things to look out for when you get there.

Take notice of how the staff follow safety protocols

“You should notice when you visit your dentist, that they’re wearing gloves, that when the gloves are off they are washing their hands, they’re wiping down surfaces in the office continually, that there are very few magazines, if any, out now,” he said. “And when you’re in the chair, you should feel comfortable, that everybody is protecting themselves in meaningful ways for you, the patient.”
With the specialized procedures endodontists perform, they have the advantage of using equipment that allows for physical distance between them and the patient.
“100% my specialty uses microscopes, which distances you from the patient by about one or two feet as they look through a microscope and magnify 10 or 20 times the kind of complex tooth they might be looking inside,” Dr. Gluskin said.
His specialty also uses three-dimensional imagery that keeps the X-ray beam around the patient’s head, which helps endodontists avoid “invading” the mouth.
Dr. Gluskin added that patients concerned about scheduling their appointments so they’re the first visitors of the day could be potentially safer, but that it’s up to the dentist’s office to maintain good sanitation practices.
“When you are the only patient that’s been seen early in the morning, the office has been cleaned overnight and early morning,” he said. “So you are in an environment that essentially that’s as clean as it’s going to be, but it should be cleaned continually during the day.”

Extra safety precautions and screening

While some dentists do require that patients get tested for COVID-19 before going in for an appointment, the inefficiency and delaying of test results could make that measure redundant, so Dr. Gluskin said it’s crucial for staff to take a patient’s temperature before going forward with any procedures in addition to asking them questions about their health and travel schedule.
Like all spaces that are open again and required to comply with CDC requirements, dentist offices are sometimes charging patients anywhere between $10 to $50 extra for staff usage of PPE. Dr. Gluskin said that some insurance companies are reimbursing patients for these fees, and some are not.

Dental emergencies and your overall health

When it comes to pain and dental emergencies, he emphasized that it’s not the time to skip seeing the dentist if you want to “save your tooth.”
“There’s no such thing as a moderate toothache, that can’t turn into a major toothache,” Dr. Glaskin said.
Even with routine procedures, he added that there’s no need to delay a dental visit, as it’s important to both oral and general health.
“Postponing a month isn’t the end of the world, but waiting a year might not be a good idea,” he said.
The bottom line for dentists is ensuring that the following precautions are used: screen patients for history of travel; monitor for symptoms of infections; use COVID-19 screening questionnaires; utilize masks, goggles and rubber dams; frequently disinfect surfaces; let operatory space rest for 10 to 15 minutes (if possible); and request patients to sit in their cars when waiting for their appointment.


Tele-Dentistry: Virtual Consults Now

 

The Doctor is In – Virtual Consults Now Available!

Dr. Gar N. Chan is proud to offer Live Video Consultations to you, our valued dental patients.
In response to the evolving COVID-19 situation and our commitment to the health and safety of our patients, staff and the community, this expansion in our services is meant to offer critical access to dental care during these uncertain times.
Through virtual consultations (E-Consults), Dr. Chan is able to remotely provide his professional medical opinion, discuss symptoms and aspects of care management, and answer any questions or concerns that you might have, as well as prescribe medications and coordinate treatment plans without leaving your couch.
We understand that video consultations do not replace conventional doctor-patient interactions, but it is a crucial alternative to in-person doctor visits given the current crisis.
We will honor all insurance plans normally accepted at our office and as always, your privacy and safety are our number one concerns.
Please call our office at 408-847-1234 to set up your remote appointment today.
We look forward to speaking with you.

Best Regards,
The Gilroysmiles.com Team

Virtual Appointment Request

Our scheduling coordinator will contact you to confirm your appointment. If you are an existing patient, this contact form should not be utilized for communicating private health information.
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COVID-19: TESTING PRIORITY

Dear Patients, Family, Friends,

As the public health battle against COVID-19 continues, your help in slowing the spread is critical. COVID-19 affects us all — friends, family, neighbors, and co-workers. That’s why it is so important that we wear a mask, wash our hands, maintain physical distancing and don’t gather with people we don’t live with.

Most recently, the California Department of Public Health’s (CDPH) issued updated testing guidance. The guidance outlines different tiers to help determine who should be tested given the current context of the COVID-19 pandemic in California. We encourage you to review this guidance and assist in testing by ensuring your patients who need to be are tested.

You can access the new COVID-19 Industry Guidance for testing on CDPH’s website.

More information regarding COVID-19, Virtual Consultations available NS Safety & Wellness Screening Form download…