Uncharted times: First week of reopening amid the COVID-19 pandemic

What if I told you that I had lived a lifetime in one week — would you believe me? As of May 17, there are forty states open for dentistry in the United States. Last week, my home state of Nevada reopened dentistry amid the COVID-19 pandemic. After a six-week pause, we were able to open our doors.

Photo of Dr. White

Dr. White

However, not everyone was excited. Many of us had fearful staff, and some were not wanting to come back to work. Then, there was the patient; I don’t believe no one truly understands the mindset of our patients or the public as a whole.

For the past six weeks, many offices prepared to reopen by communicating with staff, obtaining necessary loans, and plotting financial forecasts for survival. Every practice had the same goal, to come out of this pandemic alive. Each of us strayed away from everything we once knew, to a new normal. Essentially re-birthing our practices if you will.

In the weeks leading up to reopening, we as dentists talked about everything we could to prepare for this new normal. There were no sim-labs, no mannequins, and there certainly was no predoctoral clinic where we could practice implementing these new procedures.  Upon our first day, I felt as if I had just stepped out of dental school, but everything was different. We hadn’t practiced with our new assessments, our new PPE, nor had we practiced this psychology of patient education. I truly felt like a new dentist practicing in uncharted territory.

The Monday of opening week was unlike anything that I’ve ever known. We opened our doors without a hygienist and our team was not whole. Although I have had our team working together for quite some time, it was as if everyone was reliving their first day on the job. We immediately noticed the PPE was exceedingly cumbersome and hot. By mid-day, the staff was begging for level 3 masks instead of N95s. We examined each patient through our new face shields and reassured them these new protocols allowed us to provide them the level of care they deserved. By days end, we had only a fraction of our normal schedule. Yet we were more mentally and physically drained.  I consider this stage to be birth and infancy due to the new experiences encountered.

Monday and Tuesday, I traveled to my rural office in Elko, Nevada, where the main industry of mining was still operating regularly. Although this environment felt quasi-normal, we continued our new strategy, new PPE armamentarium, and lower patient volume. The mindset of this customer felt more familiar, yet we still struggled to get comfortable. After returning to this environment, I realized that I was too quick to rely on policies and procedures. I came to find that when you have a systemic and abrupt change of this magnitude, we must revert to people first and systems second. I had gone wrong in my infancy stage by instituting a broad overarching policy instead of understanding the mindset of my staff. It took a few days to learn, grow, and shift back to the people, but when I did, I walked with a new stride. I consider these two days as teenage years and early twenties because as we make adolescent mistakes, we learn from them, and true growth occurs.

Slowly but surely, our new path began to reveal itself. Relying on people and not systems, I have become more confident with the small improvements we make daily. I am sure that my team will become more comfortable with our new normal. By Thursday, I felt that I was in the golden years of this life. My team had adjusted well, began to laugh more, and patients had become more familiar with our new protocols. As a team, we are better communicators. Instead of being stressed and exhausted, we are happy and energetic which has translated well to the patients.

On Friday, we conducted our weekly Nevada Dental Association webinar. I was eager to engage in dialogue with my fellow dentists about their experiences during their first week back at work. Many doctors reported struggling with several of the same issues. Some offices did not bring back hygiene while others did. Some offices had staff that refused to come back, while others happily returned to work. I discovered that we all made the same crucial mistake of emphasizing too heavily on the return date.

Early on in this pandemic, many felt a sense of urgency to accomplish three tasks: shut down office operations, talk to vendors to prevent further bleeding of cash flow, and gain all necessary grants and PPP loans. Many of us believed that our saving grace would be our individual state’s anointed return date. Once that date was released, everything would return to the way it was.  The only sure thing we learned during this week was that everything was uncertain.

Saturday morning, I checked in with Nevada as well as the country as a whole, discovering the devastating news that one of our colleagues had taken their life.  I was shocked and in utter disbelief. I sincerely believed that after receiving the PPP loan and start date, stress would diminish. As an industry, we worried about mental health early in the shutdown. As we approached a start date, the mental health aspect of this pandemic veered away from many of our mainstream thoughts. This event should be a wakeup call proving we are not out of the woods yet. The future is still uncertain. We must get back to the people aspect of our industry. Not only with our patients and staff, but with our colleagues as well. A simple “How are you doing?” or “How is everything going?” could start a conversation that can make a world of difference. I feel guilty for losing sight of the fragility of our mental health and believing that the start date was the ultimate solution.

In the first week of reopening my office and experiencing our new normal, I felt every emotion and experience from birth to the end of life. Just because our opening date arrived, does not mean that we should assume that we are all okay. We must continue to band together and rely on our fellow dentists as well as believe in and care for one another. We can do this by talking less, questioning more, and above all, listening to each other. Moving forward, I am going back to where it all began; to the people. I will continue to care for all those involved in my practice as well as amplify my concern for each dental practitioner in my state and country.

Dr. David White is a general dentist who graduated from the University of Michigan School of Dentistry and currently practices in Nevada. He currently owns two private practice general dentistry offices. He is past president of the Nevada Dental Association and currently serves as the vice chairman of the ADA Council on Government Affairs, and is chairman of the Nevada Council on Government Affairs. In addition, he holds adjunct faculty positions at the University of Nevada, Reno and the University of Las Vegas School of Dental Medicine, where he works with Pre-Dental Students and Admissions. He has enjoyed participating in the ADA Success program for years and has always been passionate about mentoring. When away from dentistry he values adventurous outdoor activities with his young children. He welcomes any and all of your questions/comments and can be reached at whitedav@umich.edu or visit davidwhitedds.com.

8 comments

  • Steve Geiermann DDS

    David…thanks for sharing your “real life” experience. Reading guidance documents is a good start. Walking in someone else’s footsteps can offer the assurance truly needed to start the journey again! Bravo!

  • Sorry to hear about the loss of your colleague.

  • People over systems. Great write-up, even better perspective.

  • Just wondering how you address or prepare your office with PPE , Aerosol, and other requirements. Working as general dentist in California and still waiting for the green light to re-open. Any insight specially the aerosol issue will help.

  • Good job at capturing the confusion and the lack of knowing exactly what to do. My experience has been a mirror image of what you went through. I naïvely thought it would be much more simple than it was. After two weeks I feel like we are just now getting some of our momentum back. Given my locale I have many patients who are hard of hearing due to too many years around heavy equipment. Communication has been a real challenge as I now realize many of them are used to reading my lips to understand me. It’s also been an eye-opener to realize that the liability has ultimately gotten passed on from the top all the way down to dentists. My dental Association in Washington state has been incredible. Thanks for sharing your experience you are not alone.

  • Maxine Feinberg

    David thank you for your article!
    We’ve been back three weeks and it is getting a little mor”normal” every day.
    There have been a few patients that were not on the same page but for the most part people are grateful that we’re here for them!

  • Covid-19 has created difficulties for everyone around the world. I hope all is well.

  • Thank you for sharing your thoughts and experience. We are hoping that this pandemic will end very soon.

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