Implementing new safety measures before reopening our dental practices

When I put finger to keyboard three weeks ago I was sitting in my office after having seen an emergency patient at one of my company’s two Federally Qualified Health Center clinics in central Indiana. Two days later we decided to close that location and only see patients at the larger of the two clinics and cut back employee hours even more — including mine and my colleague’s.

Photo of Dr. Simpson

Dr. Simpson

What a difference three weeks makes. We are now prepping to re-open our clinics with vast differences in place.

Before COVID-19, my colleague and I would alternate weeks: one of us in office, the other at home on-call. One assistant did front office and assisting. We decided that our assistants would take a pano on new patients to the office, no longer taking intraoral radiographs to keep the assistants from needing to be in such close proximity to patients. We would diagnose as best we could from that, write a prescription if necessary and schedule the patient back for treatment. With patients of record, we called in a prescription as necessary so they wouldn’t have to come in.

When it comes to reopening, I can only discuss the changes that we are making at our two clinics. It’s really up to the individual dentist’s best professional judgment.

Over the past couple of weeks, numerous conversations have taken place between me, our dental director, the other dentist I work with, our manager and our staff regarding changes we are going to make moving forward. However, we will not reopen to see patients until our new measures are put in place first.

The list is exhaustive: a glass partition is being put up at the front to protect front office staff; patients will check in but will wait in their cars for their appointment if a room isn’t ready; we will continue taking temperatures when patients arrive (put in place during quarantine); we will start doing pre-treatment antibacterial mouthwash rinses before every patient; and patients will do their paperwork in the operatory instead of the in the waiting room.

N95 masks, surgical bonnets, different gowns to go over our scrubs are to become the norm.   We are changing how we schedule, with 15-minute blocks between patients to allow for plenty of time for room turnover, alternating treatment rooms, adding doors or some sort of partition to each operatory to be able to contain aerosols in the rooms better, changing isolation units, etc. These examples are what I can think of off the top of my head. There are still more changes we are implementing.

Is all of this really necessary? I think the better question is, why risk it?

Hopefully we will be able to relax some of these measures eventually, but maybe these will be the new norm. The more discussions the staff had, the better I felt personally about going back to work because I feel like, from the top down at our dental practice, they care about the safety of the employees and patients.

I think an unknown consequence of all this will be how it affects patient experience. We are in a profession which makes many people nervous, and we do so many things to create a positive experience for them — an experience that makes them spread the word about our offices. We all need patients (more and more patients) to come in so we can stay afloat and thrive.

One of the things that we all do to make our offices more appealing and patient friendly, whether public health offices or private practices, is decorate.

In the past week, our manager removed the magazines, many of the pamphlets, and even some of the chairs from our waiting area. She had a couple of chairs in pairs and others about a foot-and-a-half away from each other. It looks quite sterile to be honest, and it made me a little sad.

That’s when I started thinking about our patients — how they will feel to come into a sterile (both in the sense that the office is clean, but also in the figurative sense that it will be bland esthetically) office, possibly sit and wait in their car, be ushered back, have their temperature taken, do a pre-procedural rinse, blood pressure taken like normal, and then closed off in a room to be worked on by people shrouded up in gear that looks more made for general sedation in an operating room than for having a filling.

We know it’s for safety, but it’s intimidating nonetheless.

We are entering into a time when now more than ever we must pull out all the stops in bedside manner. We will need to explain our process before patients come in. We’ll need to spend more time, once they are in the chair, to discuss the changes, maybe even getting their input on how they felt about the experience.

Can you imagine how a nervous patient who hasn’t been to the dentist in years will feel with the new look our offices will have? This new era calls for creativity and ingenuity in creating a positive experience for our patients. I think it is just as imperative that we seriously consider if we have prepared our offices enough, safety wise, to re-open as it is to consider patients’ feelings about their own safety and overall satisfaction.

It’s a new era and I am ready to thrive in this.

Dr. Elizabeth Simpson is a New Dentist Now guest blogger. She grew up in Indianapolis and graduated from Tufts University School of Dental Medicine in 2010. Liz is a general dentist working full time for two Federally Qualified Health Centers in Anderson and Elwood, Indiana. She is a member of the American Dental Association Institute for Diversity in Leadership program and has started a toothbrushing program at an elementary school in Indianapolis. When she’s not working she enjoys reading, going to the movies, traveling and spending time with her family and friends.

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