Dr. Gordon Christensen Joins Dr. John Meis and Wendy Briggs to Discuss Infection Control and PPE after COVID-19

John:                            All right. Good morning everybody and welcome to the Blue Diamond Retreat. This is a thrill of a lifetime for me to be here with Wendy and to, with her introduce Dr. Gordon Christensen. I've been in dentistry since I was about nine years old and for the last half of that I have been following and studying Dr. Gordon Christensen. He is, in my opinion, the voice of reason and he's always helped me with materials, making sure that we have good high quality materials at a reasonable cost. He's shared with me procedures, how to do them quickly, efficiently and with high quality. And one of the first things that I learned from you, Dr. Christensen, was how to utilize auxiliaries well. I had an old VCR tape and I wore that thing out showing that every new team member had to come in and they had to watch Gordon's video tapes. That tells you how far we go back, and I've had the pleasure of introducing you at conferences and I'm just excited to be here with you and Wendy. Thank you so much for joining us.


Dr. Gordon C.:               Thank you, John. And by the way, just call me Gordon. I've had several doctorates and I can't remember anything on any one of them.


Wendy:                        And of course I had the delight of recording a video with you last year when things were in a little bit more of a normal state, right?


Dr. Gordon C.:               Yeah.


Wendy:                        Yeah, Things are a little bit crazy right now. So this is one of the reasons we've never had a virtual retreat and we started putting our plan together and thought, "What would our members really need to know in the midst of this crisis?" Of course, we thought, how wonderful would it be if we could have Dr. Christensen join us. And because of a conflict, a scheduling conflict, we're recording this in advance and I know that our people will still be delighted to hear what you have to say.


Dr. Gordon C.:               Good, good. And we're ready to go?


Wendy:                        We're ready to go.


John:                            We're ready to go.


Dr. Gordon C.:               Let me pull the screen up and we will do it. Chair, there she'd be. And we'll pull up a full screen unless you see what we've got.


John:                            Beautiful.


Dr. Gordon C.:               Okay. I've got a rapid fire program for you, so stay awake. Those of you who are listening, I'm going to give you some things you probably don't know. Because even the federal government is somewhat behind on this. The CDC, the EPA research that we did, believe it or not, 25 years ago, and it was not listened to is now being re-validated. You're looking at the team that I work with, I have 50 full-time people. The white coats are the in vitro, the blue coats on the other end there are in vivo and we've done a lot of in vivo researcher. And that young lady sitting in the center is Dr. Rella Christensen, the one who's really done most of the research I'm going to talk about.


Dr. Gordon C.:               All the products I'll show you here have been to CR evaluations and they've been through some of our clinical evaluators. We have 450 clinical evaluators. The CR report goes into 100,000 practices internationally and the team that I just showed you is the group that does that. There are two websites and I'll show them to you here and I'll also show them when we end here in a few minutes. Cliniciansreport.org will give you research and education and a pccdental.com we'll give you lots of education. Dr Rella just did a three hour video that I'll lead you to when we're at the end of this on infection control, and I'm just giving you a few minutes here.


Dr. Gordon C.:               Plus our international study club we're in, we're in many, many countries with hundreds of dentists who see me on the internet for about five minutes all is every week, 50 times a year. I answer the question of that particular moment. And now we're on infection control today and what a miserable thing we've all been enduring. Unbelievable thing. I frankly don't know what to say. Now I've got my... There we go. Pathetic to see what's happening with the even children such as that little girl suffering was with COVID. I've lived through a number of crises during my career, including well as a child or first of all the second world war, the Korean war, I was in the Vietnam one myself. And then a half a dozen viruses. It's just unbelievable.


Dr. Gordon C.:               The mortality rate pretty obviously is not good for me. I'm on the far end of the scale. Most of you listening are somewhere in the middle of that scale. And the bottom line is good. As you look at the bottom of this and you see 99% chance of survival, be calm, be calm for crying out loud, dude. You probably going to have more risk of dying driving your car around to go to the grocery store. So I don't want to belittle it, but that 99% chance is pretty darn good.


Dr. Gordon C.:               How to treat it. This is emergency patients I'm going to show you in a minute. This is an active site, the cliniciansreport.org, if you subscribe to the CR report, you may get all of this free of charge. I'm going to pull it up right now. Assuming internet is going to work for me. Cliniciansreport.org, here it comes up, and all you've got to do is either say, read it now or you're going to go down here to the bottom of this thing and hit COVID-19 special report. And let's pull it up. And you will have the essence of what I'm going to be talking about.


Dr. Gordon C.:               One of the most major things with it is this report was last dated April 6, on a lot of the things that really are a frustration to me as I scroll down here always, there's a lot of hype right now on, this is right. That's right. Something else is right. It's really a real challenge. Go to this. That's free of charge for you. If you want the entire report, you may get it if you subscribe, let me turn the Safari off here. and we'll go right on... If you want the entire report, go on to cliniciansreport.org. If you subscribe, you go in free, if you don't subscribe you got to pay a little bit of money to get in. It'll give you the essence of what I'm talking about today.


Dr. Gordon C.:               Okay. We hope it goes away. Wow, do we. I'm going to see a few patients coming up in just a few days and I'm sure others will as well. Now, a lot of the stuff I'm going to tell you, you won't like and you'll say, "What?" There's your normal attire, and I understand a lot of your hygienists. Do you know what that really is? Scrubs or the underwear of a general surgeon. They have nothing to do with infection control. In fact you're carrying maggots all over your arms, all the bugs from the 20 or so patients a typical dentist would see in a day are crawling on you. So they're gone. And they always have been gone. It's just the dentist didn't adhere to CDC standards. CDC standards say, and I don't like it either. That's what they want you to wear. That's a long sleeve, high neck. There I am. And that is a good source for you. Landau been around for forever and you're saying, "Well, do they have the male, female, et cetera, et cetera?"


Dr. Gordon C.:               Yeah. And here are even some... This is not the same company doing disposable ones. You may want to get into something disposable or not that expensive and they'd look pretty decent. You want the long sleeves and the high neck and that is going to be mandatory. I don't know how are they going to really mandate it but they are. There I am all suited up with exception of a mask. If you're really treating a patient who is a high potential for having COVID or has it or had it, you need a hat on too because your hair gets just loaded with that junk. Now if I'm doing any surgery and I do a lot of it, I've got the hat on. And of course I would put the mask on.


Dr. Gordon C.:               And you'll notice, as you look at the sleeves, they're up over this disposable gown that I've got on. So take a look at clothing. We're doing it wrong. Now here is a major thing. Major thing. We have tested masks over and over and over and over again to stop the aerosol created by that. Any handpiece. So electric or air by that, that's a cesspool. The ultrasonic cleaner. If you don't put the lid on that thing, you have got bugs flying all over the office. That is one of the worst things that CDC would really prefer that we go to the dishwasher concept. But it costs $5,000 to $9,000 and a lot of dentists don't want to go there. But I suggest within five years, most of you will be using the sophisticated Miele and other dishwashers. Which disinfect, sterilize and basically you eliminate that miserable thing you're looking at. But now those of you who are hygienists, you're at major risk with the ultrasonic scaler.


Dr. Gordon C.:               I have stated to our hygienists that coming back now, I've said, "Put that thing in a drawer or wireless thing is in this crisis, we're not even going to use it." That is producing aerosol loaded with the virus if the person happens to have the virus. Lovely device, I love it and a lot of patients like it, but be very careful. That particular concept, well, I'm going to hit him again just so you got the three in your mind. That's the dentist problem generally. And it is a major problem. This is all of our problem in the laboratory. And what about this one? 


Wendy:                        I know Dr. Christensen, and I'm hearing from hygienists all across the country that are really stressed about that, right? They're really afraid of the risks. So I know that our listeners and our members are concerned. So that's really interesting to hear you say that at least while the crisis is going, it's not a good idea to use it at all.


Dr. Gordon C.:               We're not going to be using it at all during this crisis. Now, I'll say something most of you won't even like to hear, but it's very, very true. We dentists and hygienists have the most septic environment of all professions, including sewer workers. How do you like that statement? We're loaded with aerosols. The face mask must fit adequately. If the face mask, which we're going into in a minute, fits adequately, you're okay. Don't get excited. If you glasses on or side shields on the glasses, or also a face mask, you're okay.


Dr. Gordon C.:               This face mask, the AlphaProTech, I don't like the ear one. It pulls my ear forward. I look like Dumbo after a day, but they have straps on them as well. This face mask can be tightly fitted over the nose. It can be tightly fitted under the chin. You pinch it right where I have the cursor, and as you pinch it, it pulls it tightly down around your neck. It should not fit onto the nose holes. We've done many tests on there. This is one of the few facemasks that actually work, of all the face masks.


Dr. Gordon C.:               You can thumb through to Schein Patterson, Benco, Burkhart, whatever and you'll find... I'll bet you'll find 50 masks. There are only a couple that we can really promote. And this is one of them. It was invented during the second world war, during the gas problems when they were trying to kill people, gassing them. AlphaProTech it has been one of the better ones out there. Now, if you're treating a person who has COVID, or who you strongly suspect has COVID, you better get the N95, and I know what I'm saying is difficult because they're hard to get right now. But they just brought, just this morning, Fox News had thousands of them being brought into the Salt Lake area and that's happening in other areas of the country.


Dr. Gordon C.:               So that will be available to you shortly. Am I wearing it? No. You can't even breathe through the dump thing. Well you can, but I would suggest that ought to be used when you have a suspect patient. One you think, "Wow, this dude may be carrying it, may not." And as you remember, we all know from the statistics that have been coming out, we're seeing many of these people who carry the virus, but it's not evident. So if they look like it or if their temperature is higher coming into this new involvement with patients, we're doing the temperature right on the forehead. And if they're not in the normal range, we won't even let them in the building. We will not let them in the building.


Dr. Gordon C.:               And they fill out a little form that we've made up talking about, have they been traveling? Have they been around anybody? Have they been quarantine? Blah, blah, blah. We have a whole form if you're interested in get a hold of us. But that's before they get in the building. Then we're escorting them down the aisle into the office, into the operatory. They're not even seeing the front desk person. At least for a while until we get this thing under control. They go right into the operatory, which has got a barrier on the chair and we'll have all the normal barriers.


Dr. Gordon C.:               Fortunately, because I'm married to Dr. Rella Christensen who is one of the gurus internationally in infecting control, we've been on this thing for a long time. It's nothing new to us. We're just a little more fussy. So they're-


John:                            Dr. Christensen-


Dr. Gordon C.:               Yes, sir. Go ahead.


John:                            Dr Christensen, for most practices, if you have someone who's coming with a fever or if you have someone that you're highly suspicious of, most practices, unless there was some real emergency situation. Most practices would just wait two or three weeks, right?


Dr. Gordon C.:               Yeah, absolutely. Anything you can handle with an antibiotic or any other palliative situations. Some ZOE in the [inaudible] I was Vietnam war type and that's when the IRM was developed. There are a lot of ways to get them out of the office really fast.

John:                            So most practices really should need to have very few N95 masks.


Dr. Gordon C.:               Almost none. I could probably use one box over my multi years I've been practicing. So, not much. Now this one, I hope you're staying awake. I'm only going to be with you, what am I with you, another 10 minutes or so. So this one is singularly important. I hope you'll get that CR report where we go through all of this in detail. You're just getting a smattering of information. You've been taught the wrong thing. Are you awake right now? Wake up if you're asleep.


Dr. Gordon C.:               I want you to look at this chart which is out of the CR report in '17. And the green line indicates anything above that has been able to kill tuberculosis, which is a hard organism to kill. And also deactivate. As you know, viruses are not alive. They have to hang on to a microorganism or your lungs or something for their ability to exist. And what do we use there? We use poliovirus, which is a very hard one to kill. The CDC and some of the others are, I'm going to be critical, they're using organisms I could blow my bad breath on and kill. I'm not kidding you. Even this is very low compared to some other countries.


Dr. Gordon C.:               And I want you to see the most popular of all wipes. You're looking at it right now. Where is it? Toilet water would probably be considerably better. And I could say that about anything on this other end. You start to get... Now Lysol used to be good. I think I've got a picture of it. Lysol used to be good. When it had higher percentage of alcohol and ethyl alcohol. Rella proved this 25 years ago. That was when it had 80 semi percent ethyl alcohol. The Californians got upset because ethyl alcohol was in the air and they were breathing it. Of course, they'll go home at night and drink the dumb stuff. But the, "I don't want to breath the ethyl alcohol." And, I'm sorry, hygienists. There was mostly whining hygienists that didn't want to breathe that.


Dr. Gordon C.:               However, you go back to the other slide and what are they using? Yeah, toilet water. There are only two products, BioSurfing and GermXtra that will kill the organisms on a countertop and meet the standards that are really international with CDC who, and the rest of them grossly behind. And I can say that with no reservation, that one is only available, GermXtra in Canada. This one is available, well, they're both made in Ghana. They're way ahead of us and these are... CDC's recommending this. Wow. Your whole office smells like a nursing home. Stale cat pee. I'm not kidding. This one used to be available and that was high alcohol. Now it's gone down 20... 20% has gone down and you would have to sit Lysol on that counter top nine minutes.


Dr. Gordon C.:               Think that one over, to kill the organisms. That ain't going to happen. Now, this they're suggesting diluting it to the point where, good luck, where are we. BioSurf is in the high 80s of ethyl alcohol. It's in a bag, like a wine bag where no air can get to it. You open this and put it on to especially developed, they just got a new box for it. Especially developed cloth called the LeCLOTH. You make the countertop extremely wet and you, I hate to say this, I don't like it any better than you. You let it sit there for three minutes. Three minutes and then you wipe it. You've been taught the wrong thing and it's been taught by a, I'm sorry, a lot of hygienists who take these little courses and get involved with a company.


Dr. Gordon C.:               Do you know there are no federal controls over what the companies say. They can say anything they want. And the major organization out there that promotes this kind of stuff, they are indeed saying anything they want. They do their own research and they get registered, not evaluated, registered by the EPA and you're buying them thinking, "Oh, this works." The heck it does. Some of those things that are being sold rampantly throughout the profession are useless. Useless. Okay? LeCLOTH, three minutes. You've wiped off the debris with this. You have not cleaned it first, which you've been taught. Most say, clean off the blood and whatever. Are you kidding? You clean the blood off, you smear it all over the whole countertop. And then you got a bigger contaminated area. You make the cloth wet, you clean the debris off. Let her sit there three minutes and then believe it or not, you have to do it again. If you really want decontamination in six minutes, sorry folks. Sorry.


Dr. Gordon C.:               Air filtration. This is our biggest challenge. And for hygienists watching this, this is the major challenge. This is just one of the significant air filtration devices. This is the one we have in our office at the moment, but we're going to be doing some major tests on air filtration. It is our biggest problem in dentistry, and you hygienists are one of the major people who produce it. So when we get the droplets clean down to the point where they're adequate, you're going to be all right. This is pathetic here. Lab disinfection.


Dr. Gordon C.:               A little clip out of one of my videos. Watch this for just a couple of minutes. One of the most contaminated locations in many dental offices is the [inaudible 00:22:07]. Some dentists put the [inaudible] in there when they start practice and take it out 30 years later. There's every bug on earth living in it. The following technique is suggested to reduce the infection control challenge when polishing resins for dentists, splints, orthodontic appliances and other resin items. You're not going to like it. Listen to it. There it is. I'm just going to tell you about it. I don't have much time left.


Dr. Gordon C.:               Let's take some Reynolds wrap, aluminum foil or anything, and put it inside the [Permaspan], and I know you're polishing dentures, orthodontic appliances, sleep appliances and all kinds of things, if you're a normal hygienist, these have been sterilized, and basically the material that we're using is either flower [pharmas], which is probably one of the better ones. Or Dentsply has a product you can use there too. The flower pharmacists available from many sources and they basically moisten it well, most hygienists as they get out of school don't know how to do this at all.


Dr. Gordon C.:               You could actually destroy the appliance if you get too aggressive with it. If you get some of our videos, you'll get this in detail. Now, so what have we got that has to be changed. Every patient you do, one week come back, you're going to find dentists are going to take a lot more time. And we need to be, we literally need to be charging for the instructing control part of the practice as they do in hospitals. You don't go in a hospital and they throw in all the infection control stuff, you're charged for it. I'm going to be promoting that heavily.


Dr. Gordon C.:               This is gone. Falci, the guy the government's got working has said, we'll never shake hands again. I think he's probably right. I was director of a visitor center for the church of Jesus Christ and I had a thousand visitors a day for years. And I shook fans a thousand times on the average a day. When I would go back to my little apartment, I felt like that hand was... I should amputate it because you got wet hands, you got dry hands, you got hands with disease hanging all over. Unbelievable. Get rid of it. And these things, I hope you're cleaning those. We have somebody who goes through the office every morning and cleans them off and then does that during the day as well. They're carrying every bug you can imagine. Make sure the offices in which you're working have foot controls and you're not touching a bottle of junk. I'm just giving you a couple of examples.


Dr. Gordon C.:               Nitrile or state of the art, that's about the least expensive Nitrile. And notice it goes up over the sleeve. And something you may not have tried is polychloroprene. Polychloroprene is like the old diving suits. They're both non latex and excellent. Well, anything you want from us, you may get 20% off. If you go on our website, which is right there, PCs had done a lot. There's 70 major videos, they are an hour each. If you really want detail on this, and I suggest you do, Rella just had well over a thousand people in her seminar last week and now we've recorded that and it's available to you with pccdental.com and it goes through every detail of infection control thoroughly. Please take a look at that if you want more information, just excellent for staff education.


Dr. Gordon C.:               Well, where are we? Where are we? You can read that as well as I. We've got to change. We have to change. We've got the two videos. One of them is Rella. One is one I made to try to get a the dentist doing what CDC was saying, but still have time to practice. If you do everything CDC says, what do you do? I clean my office. That's about it. So I know that and I've made the video. That's this one. Made that video to try to still meet the standards. One more thing and I'll quit. What other things are we going to do?


Dr. Gordon C.:               The first one I've already said, and I really mean that, patients are going to demand it. The government has been extremely remiss. We can bomb everybody on the earth, but we're not taking care of our own people. Do you hear what I'm saying? Billions going into bombing people and almost nothing going into preparation for just what we're going through. That's why there are no masks. There's no infection control products. There's no toilet paper. What ever. Look on down that line. I'm not going to go through those in detail. Every aspect of dentistry is going to change. We're going to go back into practice as though we're starting and new practice.


Dr. Gordon C.:               Well, two websites for you. Take a look at them. We would be delighted to have those of you... Anyone of you who wants to, to comment to pCCdental.com. Get in our study club. We're on the web five minutes every week. Thanks for the opportunity to be with you for a few minutes. It's been my real pleasure.


John:                            Oh Dr. Christensen, the pleasure is all ours. I have always so appreciated the fact that you bring common sense to some of these challenges and when you listen to what's out there in the dental information age right now it's all extremes. And if there's nothing in these slides that we shouldn't be doing already.


Dr. Gordon C.:               That's right. We should have been doing them for the last 25 years. That's when... Rella did the initial research then and people didn't listen. People didn't want to. That was back when gloves were just coming in. Believe it or not.


John:                            Yeah.


Dr. Gordon C.:               Amazing. Okay.


Wendy:                        We really appreciate your time and we've been directing people, all of our members to your website to get your report for the last few weeks because there's just such an incredible information there. So it was a real treat to get to hear it live and to get some of your insights that we don't pick up on as you are reading the report, but there is such valuable information there. So again, thank you so much for taking time out of your incredibly busy schedule.


John:                            And beyond COVID-19 these the clinician's report and all the courses on PCC are absolutely excellent. And really beyond COVID-19 this should be something that you all take advantage of. Because they're extremely well done and they're extremely real world. That's what I love about them. It's, how do we go out and really do this and take care of patients and hopefully have a buck leftover when it's all over with.


Dr. Gordon C.:               Well, this is an ending thought. We tried to figure out how much each butt seat, if you will, cost. And right now in today's dollars, it's somewhat over $20 proceeding. So you start out $20 in the whole before you've done a single thing to the base.


John:                            Yeah. Yeah.


Dr. Gordon C.:               Okay.


John:                            Well, thank you so much Dr. Christensen.


Dr. Gordon C.:               Thank you again.