Ontario's strict rules for reopening dental clinics differ from other provinces

TORONTO -- Reopening Canada’s economy means many businesses will finally be able to bring in some much-needed cash flow. But for dentists in Ontario, reopening their clinics means fulfilling a long list of expensive safety requirements that could be challenging to meet.

Toronto-based dentist Dr. Robert Cappell has already spent tens of thousands of dollars retrofitting his office so he’s ready to restart cleanings and fillings. He’s added glass partitions to prevent the spread of droplets and added new medical filters to purify the air.

On top of that, he’s stockpiled personal protective equipment to protect everyone who steps into his clinic.

“I want to make my patients safe, I want to make my staff safe. And whatever it takes to make them feel comfortable is what we’re going to do,” Cappell told CTV News.

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The Royal College of Dental Surgeons of Ontario has issued a list of 48 recommendations for reopening. Among those recommendations: mandating that staff wear PPE on top of their scrubs; keeping rooms vacant for anywhere from eight minutes to nearly three-and-a-half hours between patients, depending on the procedure; and installing floor-to-ceiling walls and doors that effectively seal off treatment rooms.

The college says dental clinics are at “high risk” of spreading COVID-19 without careful planning and appropriate guidance.

“Dentists returning to any degree of in-person care must comply with the direction of government and the College to maintain the safety of patients and staff, and to not contribute to the transmission of COVID-19,” the college said.

For the moment, dentists in Ontario are only performing essential services.

But the expectations for dentists hoping to reopen their clinics vary from province to province. For instance, Ontario’s rules are considered more strict than those in British Columbia, Alberta and Manitoba, which are still quite thorough.

In B.C., dental clinics are expected to practise physical distancing, perform regular hand-washing and provide patients with PPE, among a long list of other guidelines.

In Alberta, patients who visit the dentist are not permitted to shake their dentist’s hand or have any physical contact with them. After the patient leaves the office, the clinic is required to disinfect every surface they touched, including clothes hangers, door knobs and pens.

In Manitoba’s phase two plan, which begins June 1, patients are being advised to wait in their cars if possible and be escorted directly into the operatory room upon arrival.

But none of those provinces go as far as Ontario when it comes to spelling out wait times between patients. In B.C., Alberta and Manitoba, dentists are advised to stagger appointments between patients. In Ontario, the guidelines break down just how long dentists should wait between aerosol-generating procedures based on airflow levels in their clinic.

Cappell said those longer wait times will be a big change for Ontario dentists.

“I think dentistry won’t be like it used to be, and the turnover and the time it took us was minutes before we moved on to another patient. And now, it’s 25 minutes to a half hour, depending,” he said.

Lisa Philp, chief visionary officer for dentistry company Transitions Group North America, said the various rules and recommendations across Canada is unclear. ​

“The confusing part nationally is that there are significant gaps from the west to the east on the rigidity of what dentistry has to do to return to work,” she said.

Most provinces require patients to undergo a pre-appointment screening to determine their risk of COVID-19. The pre-screening also provides dentists with a chance to explain the new rules.