In this time of great uncertainty, many are feeling anxious and overwhelmed. Jobs have been lost, businesses are struggling to survive, and Hawaii’s tourism industry is at a standstill with no immediate end in sight. The trickle-down effect is already evident, as state revenues have drastically declined with an estimated shortfall of approximately $1 billion.

The good news is that Hawaii’s “stay at home” orders have helped the Department of Health identify positive COVID-19 cases, flattening the curve. Quarantine rules for visitors and interisland travelers and increased testing sites will help prevent the spread of more COVID-19 cases.

Hawaii dentists voluntarily limited their offices to emergency care, following the American Dental Association’s (ADA) and Hawaii Dental Association’s (HDA) recommendations to postpone elective procedures, to reduce the consumption of personal protective equipment, and to keep people at home to coincide with stay-at-home orders. Dentists provided this care, relying on existing infection control protocols to keep themselves, their staff and patients safe.

As with any industry, the dental associations are implementing procedures to help dentists adjust to the new normal. With the reduction in new COVID-19 cases, it is time for dentists to exercise their professional judgment in phasing in appropriate elective and preventive treatment.

While not all patients and staff will return during this period of time for various reasons, putting off preventive care would not be in the best interest of many patients. Prevention is the basis of good oral health and overall health. Dentists need to be able to diagnose potential problems before they become emergencies. When dentists work closely and in communication with their dental team members, there is no better way of serving patients than with preventive care. The benefits are worth the extra precautionary measures that are being implemented in this unprecedented time.

The ADA has developed a Return to Work Toolkit with clinical guidelines for dentists to safely serve their patients. These guidelines, which are being updated on a regular basis, include pre-screening questionnaires, temperature checks, supplying hand sanitizer, installing sneeze guards to protect front office staff, and frequently disinfecting high touch areas to greatly reduce cross contamination in the office waiting rooms.

Dental offices are expanding already stringent infection control procedures, to ensure safety during treatment. Antiseptic mouth rinses prior to treatment reduce bacteria and virus counts in patient mouths. High volume evacuation and oral isolation systems significantly control aerosols produced by dental handpieces, air/water syringes and ultrasonic scalers, keeping potentially infectious agents within the confines of the mouth. Routine disinfection of operatories between patients prevents cross contamination.

Enhanced personal protective equipment (PPE) will be used as indicated. Because of the pandemic, PPE has been extremely difficult to obtain. Through the continuous work of the ADA, dentistry is now No. 4 on the national priority list for PPE. This has allowed the HDA to obtain masks through the Hawaii office of FEMA (the Federal Emergency Management Agency) to be distributed to Hawaii dentists. Both the HDA and the ADA continue to work to ensure that PPE is available to ensure the safety of patients and staff.

Together all of these procedures and protocols ensure the safety of dental staff and patients. I am extremely proud of our dental community for being dedicated to their profession, patients and staff. We, as always, strive to give our patients the best care to which they are entitled.

We are all in this together. Please remember to be vigilant following social-distancing rules and wearing masks, and please support local businesses as much as possible to advance our economic recovery.