Due to inclement weather, School of Dentistry clinics will be closed for patient care until Monday, January 3rd.
Per UW Policy and the State of Washington:
– Only the patient is allowed into the building and into the treatment area.*
– Once the patient has moved to the treatment area, anyone accompanying the patient must wait outside the building.
*One attendant may accompany certain patients if it is essential for the delivery of care.
We apologize for any inconvenience and thank everyone for doing their part to help reduce the risk during the pandemic.
To our valued School of Dentistry patients:
We continue to see encouraging signs of progress against the COVID-19 outbreak in Washington. While we had to restrict our services to urgent care during the outbreak, we are now in the process of welcoming you back to our clinics for regular care.
How quickly this proceeds depends on our state’s phased reintroduction of services and continued progress in containing the spread of the virus. However, we have now resumed full clinical services in our Oral Surgery, Oral Medicine, and Orthodontics clinics. We have also begun limited treatment in other graduate and resident specialty clinics such as Endodontics (root canals), Periodontics (gum treatment), Graduate Prosthodontics (dentures and bridges), and at The Center for Pediatric Dentistry on our Sand Point campus. Depending on the treatment that is needed, patients may have to be tested for COVID-19 no more than 72 hours before their appointment.
The Northwest Center for Oral and Facial Surgery, at our Sand Point campus, has resumed full patient services. We will continue the gradual resumption of all clinical services to full capacity on June 22. Our Dental Student Teaching Clinics are included in this plan, although their capacity may depend on staffing and other factors.
Patients who have been waiting for delivery of crowns, bridges, and partial or full dentures are being contacted regarding delivery. We will contact our other patients starting in mid-to late-June.
We regret that we cannot welcome new patients into our Dental Student Teaching Clinics yet, but all other clinics are accepting new patients. Please call 206-616-6996 for an appointment.
For our current patients waiting for treatment in one of our teaching clinics, this is especially important: Please wait for your provider to contact you about resuming your treatment. We will be operating with reduced staffing for a while as we prepare for your return, and we will not be able to respond to questions about scheduling. Also, our full clinical services in our teaching clinics cannot immediately operate at peak capacity starting on June 22. Instead, we will ramp up these services over time to make sure that we are delivering care in the safest way we can.
All of us at the School of Dentistry greatly regret that the pandemic forced us to postpone everything except urgent care, which we have continued to provide. We had to put off regular care for your safety, but we know that this has not just been inconvenient – it has been a hardship for many of you. Your oral health is our most important concern, and we are eager to have you back for your dental care so we can continue to protect your health.
We also know that for many of you – our DECOD clinic patients, our Medicaid patients, and others – your choices for care may be very limited. We play a major role in our state’s oral health safety net, and we take that role very seriously.
When we resume regular dental visits, you will see some differences, especially in our Dental Student Teaching Clinics. We are installing tall plexiglass dividers between each operatory – the cubicle where treatment takes place. One of our big concerns is the spread of aerosols – the tiny droplets that can be produced during treatment. These droplets can potentially spread viruses, and the new dividers will help control this. In addition, we are testing patients before performing any procedure that will produce aerosols, and we are installing new air purifiers that clean and filter the air with high efficiency.
We will also close off every other operatory in a checkerboard pattern so that no patient will be sitting next to or across from another one. Our clinical faculty, staff, and students will undergo daily COVID-19 screenings, and patients will be asked screening questions before and after their treatment.
We have a lot of catching up to do. To increase our efficiency and add another layer of protection, we have also created a new Virtual Clinic. This video platform lets one of our providers talk with you by computer, tablet, or smartphone for your initial consultation. We can usually determine a course of treatment with this “virtual visit,” and in some cases, you may not even need to make an in-person visit afterward. Your privacy and rights will be protected, and your video and voice will not be recorded or stored.
We have been using the Virtual Clinic to support our urgent care during the outbreak, and we already know that our colleagues at UW Medicine have been using this telehealth technology with great success for some time. And to further reduce wait times for treatment, we are also studying the possibility of offering extended clinic hours, including Saturdays.
This has been a difficult and frustrating time for all of us. Now we are anticipating the day when we can once again deliver the full range of dental care by our students, faculty, and graduate residents, and welcome you back to our clinics under the safest possible conditions.
In the meantime, please know that you can still rely on us if you need urgent care. You can call us at 206-543-5850 between 8:30 a.m. and 4:30 p.m. Monday through Friday. After hours, if you are an existing patient, please call 206-616-6996. If you have a serious problem with an injury, pain, or infection that demands immediate attention, you can call the University of Washington emergency department at 206-598-4000.
Thank you for your patience, and we look forward to seeing you!
A note about fees
As a result of the COVID-19 pandemic, the UW School of Dentistry, like all health care practices, has increased its infection control measures to continue protecting the health and safety of our patients, faculty, students, and staff. This has included increasing our use of personal protective equipment (PPE) such as gowns, gloves, higher-level protective face masks, and even face shields when aerosols (mist or vapor) are produced during patient treatment. New types of PPE are being used in some cases and they are often quite expensive.
As demand for these items has increased, so has their cost, which our standard rates do not cover. Consequently, this requires us to add a separate PPE charge of $20 for each patient visit. This fee is covered by some insurance plans, so please check with your insurance company about coverage of this fee.
Protecting the health and safety of our patients and the providers and assistants who participate in their care is the priority that guides all of our responses to the COVID-19 pandemic. We regret having to impose this additional cost, but we hope you will understand why we must do so.
Frequently asked questions for patients
If I have an appointment for urgent or emergency care at the School of Dentistry, who can come with me?
Only certified interpreters, parents, guardians, and other necessary adult support people are welcome to accompany our patients to appointments. They must remain in the waiting area unless their presence in the treatment room is required for treatment. Any other people, including children, may NOT accompany the patient to their appointment. You must honor social distancing recommendations and remain 6 feet from others in hallways and reception areas, and during social interactions. Depending on how many people are in the waiting area, you and your support person may be asked to wait in another area or outside. You both must pass the School of Dentistry COVID-19 screening procedure on arrival. Additional screening may continue later. Screening by UW Medical Center security staff is not sufficient for entry to any dental clinic.
Please note carefully: Patients may be accompanied into the actual treatment area by another person or service animal ONLY if they are essential for completion of the dental treatment. An accompanying person must first pass all our screening for COVID-19, including the absence of any fever over 100 degrees F. This screening must be done by School of Dentistry personnel. Screening by UW Medical Center security staff is not sufficient.
What are the symptoms of COVID-19?
Symptoms of COVID-19 are flu-like and include fever, cough, sore throat, shortness of breath, or a sudden loss of the sense of smell or taste. Most people develop only mild symptoms. But some people may develop more severe symptoms, including pneumonia.
People at higher risk of severe COVID-19 infection include:
- People who are age 65 or older
- People with chronic lung disease or moderate to severe asthma
- People who have serious heart conditions
- People who have weakened immune systems (This can be due to cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, or prolonged use of corticosteroids and other immune-weakening medications)
- People with severe obesity (body mass index [BMI] of 40 or higher)
- People with diabetes
- People with chronic kidney disease undergoing dialysis
- People with liver disease
- People who are pregnant
What do I do if I have COVID-19 symptoms?
If you have a cough, fever, or other respiratory problems, call and speak with your health care provider before going to a medical facility. Do not go to an emergency room. If you believe you are experiencing life-threatening symptoms, call 9-1-1.
If you do feel ill, don’t panic. Most people who get the novel coronavirus disease have only minor symptoms and do not need medical care. In fact, most people with symptoms who are tested for COVID-19 have a negative test. Their symptoms are most likely due to influenza or seasonal allergies. However, you should contact your doctor to inform them of your symptoms and get advice.
If you have a mild case, your doctor may advise you to treat your symptoms at home. Staying home also helps prevent you from exposing other people to the disease.
For those who have a more serious case, call before you head to the urgent care or emergency room. That will help the medical team to prepare for your arrival, so you can receive the fastest and best possible care. It will also help them to protect other people from your infection.
Should I be tested for COVID-19?
If you are in King County and believe you were exposed to COVID-19, contact the Public Health – Seattle and King County call center between 8 a.m. and 7 p.m. at 206-477-3977. Testing is generally conducted at a health care provider’s office, and Public Health – Seattle & King County recommends that anyone with COVID-19 symptoms be tested. UW Medical Center has expanded testing and is currently one of highest-volume testing sites in the nation. Limitations remain in laboratory capacity to obtain samples and process lab results promptly. Commercial testing is becoming more available. Health care providers may test any patient in whom they suspect COVID-19.
While there are no restrictions on who can get tested, not everybody who feels ill needs to be tested, particularly if you have mild illness. If you are sick with fever, cough, or shortness of breath, and are in a high-risk group, call your health care provider to discuss whether you should be tested for COVID-19.
What should I do to keep myself and those close to me safe?
The most important steps to take are the same as for every cold and flu season: Wash your hands frequently for at least 20 seconds with soap and hot water. If you cannot wash, use alcohol-based hand sanitizer. If it is ethanol-based, the ethanol content should be more than 60 percent. (If it is isopropyl alcohol-based, the content should be more than 70 percent.) Stay home if you are feeling ill. If you experience symptoms, call your doctor’s office. They will help you determine if you need to be seen and provide you with instructions for seeking medical care.
Public Health — Seattle & King County also recommends that EVERYONE in the Seattle area should stay home if possible and avoid groups of people, including public places and gatherings where there will be close contact with others. This is called “social distancing” and means that in any group, you would never be closer than 6 feet from any other person. This not only protects individuals from disease, it also slows the spread of disease in our community to make it less likely that our hospitals will become overwhelmed with large numbers of people with severe COVID-19 infection. Wearing a cloth mask in public, along with social distancing, also helps prevent the spread of the disease.
Where can I learn more about COVID-19?
UW School of Dentistry patient care is delayed on January 15th due to icy campus conditions and the University’s delayed start at 9:30am. Please view the Suspended and Limited Operations Policy for more information.
UW School of Dentistry patient care is delayed on January 13th due to inclement weather and the University’s delayed start at 9:30am. Please view the Suspended and Limited Operations Policy for more information.
Background: On July 16, 2019, clinical leadership at the University of Washington School of Dentistry received a report from a dental assistant that a dental student was not following standard sterilization procedures for dental burs. These are the small drill bits that are used to remove decay and prepare teeth for restoration such as fillings or crowns.
Instead of bringing used burs to Central Processing (the sterilization facility) immediately after patient treatment per the standard procedure, this student was reported to be placing the used burs in a storage locker that also contained the sterilized burs belonging to that student. If the student stored both sterilized and non-sterilized burs in the locker, we cannot be certain that the student used only sterilized burs. An immediate investigation was performed to confirm the report, and patient records for the student were reviewed to determine which patients could have been exposed to burs that were not sterilized. The investigation also looked into rubber dam clamps that could have been similarly unsterilized.
How many patients were potentially affected?
- The incident was limited to one student, and we have identified 18 patients who could have been affected.
How are patients being notified?
- We have sent certified letters to the identified patients letting them know of the incident and the extremely low risk, and our offer to test them for possible infection. We have also posted a notification on the homepage of our website. Patients who have questions not covered on this page should call 206-616-6153.
What will these patients be tested for?
- Testing will be offered for hepatitis B, hepatitis C, and HIV (human immunodeficiency virus). These infections are transmitted by exposure to blood, which would be uncommon during restorative dental procedures.
What is the risk of infection from this incident?
- The risk is extraordinarily low. A dental bur spins at high speed (about 300,000 RPM) while a spray of water under pressure continually washes across it. It is used to prepare teeth for restorations and, while it could be exposed to saliva, it is not normally exposed to blood. Vacuum suction is used to remove the water. The risk of transmitting an infection via a dental bur is extremely small.
What is the scientific basis for the risk assessment?
- There are no known studies of transmission of infectious diseases from unsterilized dental burs or dam clamps. The best scientific information about infection transmission risk comes from studies and data where there is a known risk. For example, we know the risks from accidental needle stick injuries. In these cases, the risk is normally one encountered by a health care professional who has an occupational accident with a contaminated instrument. The risk of transmitting HIV after an accidental needle stick where the needle contained HIV-positive blood is 0.2% to 0.5% (the average is 0.3%, or 3 out of every 1,000 cases). The risk for hepatitis C transmission with this type of accident is 0% to 10% (the average is 1.8%, or less than 2 out of every 100 cases). The risk for hepatitis B transmission is greater but has a large range that depends upon the type of hepatitis B virus that a patient might have. In addition, many people have been vaccinated for hepatitis B, and that normally eliminates the risk. The reason that there is a range for the risk is that some needles are used to draw blood and others are used to inject a medication. The ones that draw blood hold more blood inside and are riskier than an injection needle. Also, if a needle has been used with an HIV-positive, hepatitis-B-positive, or hepatitis-C-positive patient, some patients have higher levels of virus in their blood than do others.
- This information from the Centers for Disease Control and Prevention demonstrates the low risk of disease transmission after a relatively high-risk accident involving direct exposure to blood. Since a dental bur is far less invasive and does not carry blood, the risk after exposure to a non-sterile dental bur is nearly zero.
How are dental burs and other instruments sterilized?
- Dental instruments that have had any contact with a patient undergo a multi-step process for sterilization and safety. First, they are scrubbed to remove any visible debris. When the shape or design of an instrument does not allow debris to be removed by scrubbing alone, it is placed in a disinfecting solution in an ultrasonic bath to remove smaller particles that are not visible. After that, they are placed in bags or instrument boxes, sealed, and placed in an autoclave – a device that sterilizes them with high temperature, steam, and pressure. The sealed containers are then stored in an area reserved for sterilized instruments until they are retrieved for use.
What procedures are used to confirm that instruments are sterilized prior to use?
- Multiple controls are in place to ensure that all contaminated instruments are sterilized prior to being used. When dental students need instruments for a procedure, they must sign out a sterile sealed instrument cassette (metal box) containing the sterile instruments from Central Processing. When the student completes the procedure, the instruments are placed back in the cassette and returned to Central Processing. Central Processing closely monitors the inventory of the instruments and ensures they are properly sterilized as described above. If students require a special individual instrument that is not part of a standard instrument cassette, they must also sign this out from Central Processing. These types of instruments are sterilized and stored in individual autoclave bags to ensure that they stay sterile. All containers of instruments, whether in cassettes or bags, are inventoried. Boxed instruments are marked with a strip of autoclave tape that changes color after going through the autoclave cycle. Bagged instruments have an indicator dot on the outside of the bag that changes color when the items have been processed in the autoclave. The changed color of the tape or dot lets the user know that the contents of the box or bag have been through autoclave sterilization. In addition, autoclaves are tested every day to make sure they are functioning properly, using a biological indicator (a spore testing strip) that is run through an autoclave cycle and then tested to confirm appropriate sterilization function.
Has this happened before with this student or other students?
- We have investigated this event and are not aware of this occurring previously with this student or others since modern infection prevention measures were implemented decades ago.
How has this incident been addressed with students?
- The student involved in this incident was counseled immediately. In addition, all other students were notified about this incident and received refresher instruction regarding mandatory infection prevention procedures. Students treat patients only under the close supervision of faculty dentists.
It’s been more than a month since the incident took place. Why has it taken this long to issue a public response?
- We had to conduct a comprehensive review of all student records to determine whether sterilization protocols were followed. For the one student involved in the incident, we had to review all patient records going back to the beginning of the year (when this student started treating patients who required the use of burs) to determine where a bur or a rubber dam might have been used. This required a careful case-by-case search of patient records, which is time-consuming.
What are you doing to prevent a similar incident in the future?
- We continue to provide regular education regarding required infection prevention measures and require all students, faculty, and staff who provide patient care to receive annual training and updates on these protocols. We monitor all instruments that are checked out and returned to Central Processing. We continue to ensure that all our instruments and equipment used in patient care are sterilized according to Washington State law and/or Centers for Disease Control and Prevention policy.
- Staff and faculty are verifying, at chairside, that the sterilization indicator on the packaging has changed color (from pink to brown) prior to students opening packages for patient care.
- We are providing additional training specifically targeting this issue at our upcoming Blood Borne Pathogens Training and at future student orientations prior to their entering clinical service.
Are you considering any additional changes to prevent this type of incident?
- Students will be assigned a designated facility in the clinic area for the storage of their sterilized instruments that is closer and more convenient for them to access.
- We are now tracking individual burs issued by the school’s dispensary to ensure even tighter control over inventory.
For more information, please call us at 206-616-6153.
UW School of Dentistry patient care resumes after 9:30 a.m. on Wednesday, February 13th.