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Questioning our role in health care in response to COVID-19

It feels strange to say, but I feel very lucky right now. In the face of an unprecedented pandemic ripping apart the fabric of our society, workplaces, and daily lives, my life has resumed largely as if nothing changed. My family is healthy, and my office is perhaps busier and more productive than before COVID-19 took hold, only now I wear a mask when I enter the office in addition to when I’m working. Reopening our office has been, for the most part, uneventful.

Photo of Dr. Fisher

Dr. Fisher

When I began reflecting on our reopening, it wasn’t the day-to-day minutiae that felt important to me. This has been an eye-opening, scary, unclear time for everyone, and for me the expectation was always that we should return to work as a pillar of safety for our community. We pride ourselves on being true community-based health providers, many of us developing long-lasting relationships with our patients. What keeps coming up as the most important consideration of being an early career dental provider in a pandemic-present world is: how can we better serve our community?

One of the things I’ve struggled with at times, as I’m sure many others have, is garnering the respect of patients. We all want patients to recognize that although we’re relatively new to the profession, we are their doctors. Some of us wear a white coat with their degree plastered on our chest, while for others, we grow a COVID-quarantine mustache in the hopes that no one asks if you’re old enough to be a dentist anymore (just me?). But the more you practice, the more you realize that ultimately, the respect comes from doing the right thing and being an active participant and educator in the oral-systemic health decisions of our patients. Now, more than ever, I think it’s important that we consider all aspects of health.

In April it was announced that the ADA was advocating for the federal government to grant liability immunity to dental providers when performing COVID-19 tests. While many providers have shied away from becoming testers, this brings about a natural, important progression of duties as dentists. We tend to see our patients with far more regularity than primary care physicians. We are at a much higher risk for transmission based on the use of our high-speed handpieces, cavitrons, and working in the oral cavity. Why shouldn’t we be testing?

And this leads to broader questions regarding the scope of our practice. We are all aware, as dental providers, that we have a responsibility to perform oral cancer screenings routinely for our patients. Knowing what we know regarding HPV and its link to rising oropharyngeal cancers, would it be appropriate to begin administering HPV vaccinations in our offices? I think it’s a logical next step. And is it enough to tell patients to cut down on sugar intake, or should nutritionists and dietitians play a role in our general offices for nutritional counseling?

It’s very easy to stick to what we know in our line of work. The demands of working in or running a dental office are massive and keeping current with dental continuing education, new technologies, and treatments could be a job unto itself. But maybe the pause in our normal operations can be a perfect opportunity to reconsider what exactly we can provide to our patients. Where can we do more? Right now, it’s important to be a resource for our patients, to inform them of their oral health in the era of COVID-19. It’s important to stay current on the latest guidelines, and to be sympathetic to patient’s concerns and questions. It’s important to lead our teams, and to reinforce the science of why we do the things we do. Moving forward, hopefully we can find a way to exercise a broader scope of dentistry that incorporates a more systemic approach to health care.

Dr. Alex Fisher is a New Dentist Now guest blogger who graduated from Rutgers School of Dental Medicine in 2017. He is an associate general dentist, and the sole clinical provider, in a private practice in Montclair, New Jersey. He is an active ADA, AGD, and AACD member, and continues his learning with preeminent higher dental education programs. When not practicing dentistry, he enjoys taking on home improvement projects for which he has neither the skillset nor temperament, going on long strolls with his wife, Chelsea, and their dog, Mack, and purchasing T-shirts at breweries across the U.S.

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