INTRODUCTION
Indonesia has had a Coronavirus
Disease (COVID-19) pandemic since February/March 2020. Dentists and dental and
oral therapists are not spared from the target of this virus because the
transmission can be through aerosol release. If you are doing aerosol release
treatment, it is obtained by using burs when burping the cavity, ultrasonic
tools such as scalers when cleaning tartar, water/water syringe when cleaning
and drying the cavity, and droplets of saliva or blood from the patient's oral
cavity. The virus that causes COVID-19 is also possible for transmission in
dental practices because of the possibility of inhalation of aerosols or
droplets containing the virus or direct contact with mucous membranes, oral
fluids, and instruments and surfaces contaminated with the virus (Chen et al., 2020). One infected patient can infect not only the dentist but also other
patients. In dental settings, this deadly virus can be transmitted through the
air, spread by contact, and contaminated surfaces (Muktawat, 2020).
In addition, the risk of
cross-infection can also occur in the dentist's office. The government also
appealed to dentists to temporarily not practice first. This was followed up by
the Indonesian Dental Association (PDGI), which issued guidelines for dental
services during the Pandemic. Dentists are asked to screen all patients and
postpone no-complaint and non-emergency, aesthetic, and aerosol-producing
measures, such as burbursing and tartar cleaning (Louisa et al., 2021). Dental and oral health providers should pay attention to infection
prevention practices to protect the health of patients and themselves (Aslam et al., 2020). Dentistry work procedures are classified as a high risk of
transmission and contamination of the SARS-Cov-2 virus. Therefore, work
procedures need proper infection prevention and control (Lubis et al., 2019).
This study aims to get an overview of the Layout and Design of Dental Clinics that are responsive to the spread of the virus during the Covid-19 Pandemic at Private Dental Clinics in Jakarta in 2022. �
The
method in this study is that this study is a descriptive study with a sample of
30 private dental clinics in the South Jakarta area with random sampling
techniques, an overview of the suitability of the layout of complementary
equipment in the dental clinic room in the South Jakarta area during the
Pandemic, an overview of the existence of complementary equipment in a private
dental clinic room in the South Jakarta area during the Pandemic,� description of airflow in dental clinic
practice rooms in the South Jakarta area during the Pandemic.
RESULTS AND DISCUSSION
Results
The COVID-19 outbreak severely impacted dentists & Dental
Therapists, so they had to limit procedures in their practice and reduce the
number of meetings with patients. During the COVID-19 Pandemic, several
protocols, such as physical distancing, limiting interpersonal contact and
reducing patient queues in waiting rooms, had to be applied to dental care.
Dentists should use level 3 personal protective equipment when performing
emergency treatment. (Hudyono, 2020). Clinic room layout & design plays an
essential role in infection prevention and cross-infection transmission (Fichman et
al., 2011). Cross-contamination has two approaches:
prevention from patient to doctor or vice versa and disinfection of surfaces
and objects (Palenik et
al., 2000). Various international dental health
guidelines published by the American Dental Association, Polish Dental
Association, the Societ� Italiana di Parodontologia e Implantologia,
dan the Swiss Association of Dentist Recommend avoiding non-emergency
care during a pandemic. Triage is vital to prevent nosocomial transmission and
transmission of infection (Gurzawska-comis
et al., n.d.).
The SARS-CoV-2 virus survives depending on materials. The virus remains
active on inanimate objects from 2 hours to 9 days (Ren et al., 2020). Aerosols/droplets
produced during dental procedures can remain in the air for 3 hours (Anfinrud et
al., 2020) (Isha et al.,
2020)
Sample This study uses samples with the following criteria: a).
Independent dental practice, joint doctor practice, and dental poly in private
hospitals in South Jakarta. The sample of this study is 30 private dental
clinics located in the South Jakarta area. The sampling method used is random
sampling by lottery. b). Observations by looking at the suitability of the
layout of complementary equipment in the dental clinic room in the South
Jakarta area during the Pandemic, the existence of complementary equipment in
the private dental clinic room in the South Jakarta area during the Pandemic
and the suitability of airflow in the dental clinic room in the South Jakarta
area during the Pandemic.
Discussion
Overview of Complementary Tool Layout Conformity
An overview of the suitability of the layout of complementary equipment
in private dental clinic rooms in the South Jakarta area during the COVID-19
Pandemic can be seen in Table 1 below:
Table 1 Suitability of PDGI Guide Supplementary Tools Layout
|
Compatibility of
Complementary Tools Layout |
Number of Respondents |
% |
|
Highly Incompatible (0 tools) |
6 |
20,0 |
|
Non-Compliant (1 tool) |
8 |
26,7 |
|
Compliant (2 tools) |
8 |
26,7 |
|
Highly Compliant (3 tools) |
8 |
26,7 |
|
Sum |
30 |
100 |
Based on table 1 above, it is known that the suitability of the layout
of the complementary equipment in the private dental clinic room in the South
Jakarta area, namely 6 clinics (20%) has a very inappropriate layout of the
complementary equipment, namely the location of the equipment is very
inconsistent with the PDGI guidelines, such as the location of the air
conditioner next to right or left of the operator, where the exhaust fan is on
the ceiling, and where the HVE aerosol is located other than to the left of the
dental unit, 8 clinics (26.7%) had an inappropriate accessory layout, namely
only having 1 out of 3 tools the location is suitable, 8 clinics (26.7%) have a
suitable layout of complementary equipment, namely only 2 out of 3 tools are
located according to the PDGI guidelines, and 8 clinics (26.7%) have a very
suitable layout of complementary equipment, namely water The conditioner is
located above the back of the head of the dental unit (behind the operator),
the exhaust fan is located under the patient's feet approximately 20cm from the
lower surface, and the HVE aerosol is located to the left of the dental unit
with the suction tip facing the patient's mouth.
Overview of Availability and Completeness of Complementary Tools
An overview of the availability and completeness of complementary
equipment in private dental clinic rooms in the South Jakarta area during the
COVID-19 Pandemic can be seen in Table 2 as follows:
Table 2 Availability and Completeness of PDGI Guide Supplementary Tools
|
Availability and
Completeness of Complementary Tools |
Number of Respondents |
% |
|
Incomplete (1 tool) |
3 |
10,0 |
|
Incomplete (2 tools) |
17 |
56,7 |
|
Complete (3 tools) |
10 |
33,3 |
|
Sum |
30 |
100 |
Based on Table 2 above, it is known that all clinics have the
availability and completeness of complementary tools, although some still need
to be completed. Namely, three clinics (10%) have incomplete availability and
completeness, only one tool available out of 3 complementary tools, most of
which are dental clinics only had one tool, namely air conditioner, 17 clinics
(56.7%) had incomplete availability and completeness. Namely, only 2 of 3 tools
were available: air conditioners and exhaust fans, air conditioners and HVE
aerosols, or exhaust fans and HVE aerosols. Then ten clinics (33.3%) have
complete availability and equipment, including air conditioners, exhaust fans,
and HVE aerosols. There is not a single private dental clinic that does not
have complementary tools.
Airflow Suitability Overview
An overview of air suitability in private dental clinic rooms in the
South Jakarta area can be seen in Table 3 below:
Table 3 PDGI Guide Airflow Suitability
|
Airflow Compliance |
Number of Respondents |
% |
|
Non-Compliant (0 tools) |
18 |
60,0 |
|
Less Suitable (2 tools) |
1 |
3,3 |
|
Compliant (3 tools) |
11 |
36,7 |
|
Sum |
30 |
100 |
Based on Table 3 above, it is known that the suitability of airflow in
private clinic rooms in the South Jakarta area, namely 18 clinics (60%), has
wrong airflow paths, namely, airflow that does not comply with PDGI guidelines
such as clean air from the operator's right or left, dirty air. Not sucked in
by an exhaust fan from under the patient's feet, one clinic (3.3%) had airflow
that was not under the guidelines, namely the criteria for airflow not flowing
from the top behind the head of the dental unit and dirty air flowing downwards
towards the patient's feet to then removed from the room using an exhaust fan,
the airflow does not flow from the top behind the head of the dental unit, and
dirty air does not flow downwards to the patient's feet. The air is removed
from the room using an exhaust fan, and the airflow flows from above the back
of the head of the dental unit. The dirty air does not flow down towards the
patient's feet to then be removed from the room using an exhaust fan, 11
clinics (36.7%) have airflow that is under the guidelines, namely airflow from
above behind the operator and air flowing towards the patient's feet to be then
removed using an exhaust fan.
CONCLUSION
There are 30 private dental clinics in the
South Jakarta area, most of which still need to complete the availability of
complementary equipment and the layout of complementary equipment under PDGI
guidelines. The criteria are very suitable. Still, less than 1/3 of the
respondents and 1/5 are very inappropriate. Some of its airflows do not comply
with PDGI guidelines.
BIBLIOGRAFI
Anfinrud, P., Ph, D., Stadnytskyi, V., Ph, D., &
Bax, C. E. (2020). Droplets And Aerosols In The Transmission Of Sars-Cov-2.
2009324. Https://Doi.Org/10.1056/Nejmc2007800
Aslam,
M. R., Suryawati, C., & Agushybana, F. (2020). The Importance Of
Prevention And Control Of Coronovirus Disease ( Covid-19 ) In Dental And Oral
Hospital. 11(July), 89�100.
Chen,
N., Zhou, M., Dong, X., Qu, J., Gong, F., Han, Y., Qiu, Y., Wang, J., Liu, Y.,
Wei, Y., Xia, J., & Yu, T. (2020). Epidemiological And Clinical
Characteristics Of 99 Cases Of 2019 Novel Coronavirus Pneumonia In Wuhan ,
China : A Descriptive Study. The Lancet, 395(10223),
507�513. Https://Doi.Org/10.1016/S0140-6736(20)30211-7
Fichman,
R. G., Kohli, R., & Krishnan, R. (2011). Editorial Overview�The Role Of
Information Systems In Healthcare: Current Research And Future Trends. Information
Systems Research, 22(3), 419�428.
Gurzawska-Comis,
K., Becker, K., & Brunello, G. (N.D.). Recommendations For Dental Care
During Covid-19 Pandemic. 19(June 2020).
Isha,
S. N., Ahmad, A., Kabir, R., & Apu, E. H. (2020). Dental Clinic
Architecture Prevents Covid-19-Like Infectious Diseases. Herd: Health
Environments Research & Design Journal, 13(4), 240�241.
Louisa,
M., Budiman, J. A., Suwandi, T., Pancasari, S., & Arifin, A. (2021). Pandemi
Covid-19 Pada Orang Tua Anak Berkebutuhan Maintainig Oral Health For Parents Of
Special Needs Children During Covid-19 Pandemic. 02(01), 1�10.
Lubis,
M. S. Y., Siahaan, E., Darmawan, S., Adianto, A., & Ronald, R. (2019).
Variation Of Cutting Parameters In The Process Of Turning Aisi 4340 Steel On
Surface Roughness. Sinergi, 23(2), 139�144. Https://Doi.Org/Https://Doi.Org/10.32793/Jrdi.V4i2.556
Muktawat, K. (2020). Dental Clinic Management In Between / After Covid-19 Pandemic. 6(3), 31�38. Amtha, R. (2019). Panduan Dokter Gigi Dalam Era New Normal. In Panduan Dokter Gigi Dalam Era New Normal. Https://Doi.Org/10.32793/Monograph.V1i1.601
Arsgmpi. (2020). Buku Panduan Manajemen Tatalaksana Praktik Rsgm Di Masa Covid-19 Arsgmpi 2020. 1�93
Cheong, K. W. D., & Phua, S. Y. (2006). Development Of Ventilation Design Strategy For Effective Removal Of Pollutants In The Isolation Room Of A Hospital. Building And Environment, 41(9), 1161�1170. Https://Doi.Org/10.1016/J.Buildenv.2005.05.007
Dhayanithi, J., & Brundha, M. P. (2020). Coronavirus Disease 2019: Coronaviruses And Blood Safety-A Review. Indian Journal Of Forensic Medicine And Toxicology, 14(4), 4906�4911. Https://Doi.Org/10.37506/Ijfmt.V14i4.12406
Himawati, M., Putri, R., & Fadilah, N. (2022). Pengaruh Persepsi Terhadap Minat Desain Tata Letak Ruang Klinik Praktik Gigi Swasta Pada Mahasiswa Profesi Dokter Gigi. 96. Https://Doi.Org/10.24198/Pjdrs.V6i2.36647
Harsas, N. A. Dkk. (2020). Penatalaksanaan Praktik Di Rskgm Fkg Ui Selama Masa Pandemi Covid-19.
Hudyono, R. Dkk. (2020). During And Post Covid-19 Pandemic: Prevention Of Cross Infection At Dental Practices In The Country With The Tropical Climate. Dental Journal (Majalah Kedokteran Gigi), 53(2), 81�87.
Isbaniah, F. Dkk. (2020). Pedoman Pencegahan Dan Pengendalian Coronavirus Disease (Covid-19) (No. 1; Revisi-3).
Kementerian Kesehatan Ri. (2020). Petunjuk Teknis Pelayanan Kesehatan Di Klinik Pada Masa Adaptasi Kebiasaan Baru.
Kementerian Kesehatan Ri. (2021). Kemenkes Tingkatkan Layanan Kesehatan Gigi Dan Mulut Yang Aman Dari Penularan Covid-19. Https://Sehatnegeriku.Kemkes.Go.Id/Baca/Umum/20210912/3338465/Kemenkes-Tingkatkan-Layanan-Kesehatan-Gigi-Dan-Mulut-Yang-Aman-Dari-Penularan-Covid-19
Kementrian Kesehatan. Ri (2014). Pedoman Teknis : Bangunan Dan Prasarana Fasilitas Pelayanan Kesehatan Tingkat Pertama Untuk Mencegah Infeksi Yang Ditransmisikan Melalui Udara (Air Borne Infection) (1st Ed.). Kementerian Kesehatan Ri.
International Journal Of Pedodontic Rehabilitation, 1(1), 37�41.
Lai, T. H. T., Tang, E. W. H., Chau, S. K. Y., Fung, K. S. C., & Li, K. K. W. (2020). Stepping Up Infection Control Measures In Ophthalmology During The Novel Coronavirus Outbreak: An Experience From Hong Kong. Graefe�s Archive For Clinical And Experimental Ophthalmology, 258(5), 1049�1055. Https://Doi.Org/10.1007/S00417-020-04641-8
Liasari, L. H. L. (2020). Studi Literatur : Pencegahan Penyebaransars-Cov-2 Pada Praktik Kedokteran Gigi.
Media Kesehatan Gigi, 19(1), 41�46.
Meselson, M. (2020). Droplets And Aerosols In The Transmission Of Sars-Cov-2. New England Journal Of Medicine, 382(21).
Satuan Tugas Covid 19, P. B. P.
D. G. I. (2020). Panduan Dokter Gigi Dalam Era New Normal (No. 1).
Palenik,
C. J., Trevor Burke, F. J., & Miller, C. H. (2000). Strategies For Dental
Clinic Infection Control. Dental Update, 27(1), 7�15.
