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Keeping Our Guards Up on the Road to Recovery

Posted Sep 15th, 2020 in the wire, thought leadership, 2020

Julian Perez, Vice President of Risk Management & Compliance, dentalcorp

Today, dentists are faced with the “new normal”: the post-COVID-19 era that they have been adapting to over the past few months. But change doesn’t come easy, and it certainly isn’t free.

Humans are creatures of habit, and for those who have practiced for decades, adjusting to a new normal is easier said than done. For those willing to adapt, cost remains a potent barrier.

Despite having (hopefully) traversed the worst of this pandemic, dentists should not forget the important lessons they have learned, nor can they let their guards down. If they have been lucky enough to practice dentistry for a few months without being impacted by a COVID-19 cluster, the temptation to relax some of the measures will grow. Now, more than ever, dentists must be wary of two common decision-making biases: optimism and amnesia. Optimism is the tendency to underestimate the chance that losses will occur, and amnesia is the tendency to forget too quickly the lessons of past disasters (1). These two traits can be valuable in certain circumstances. However, when dealing with a low probability, high-risk event like a global pandemic, these biases can cause dentists to make decisions with dire consequences.

We are still in the midst of a global pandemic, where a short while ago dentistry was thought to be the most at-risk profession and, already, the chorus of voices calling for a return to the old ways is audible. Here are just a few of the potentially dangerous sentiments that have been expressed in dental chatrooms and on social media.

Frustrations with new PPE requirements

  • It is too difficult to conduct consultations while wearing PPE.
  • It is uncomfortable and hard to breathe in all this PPE.
  • There is not enough PPE to go around and it is far too expensive.
  • Wearing a face shield is only “strongly recommended” — it is not required.
  • Changing PPE takes too long. I will reuse my gown instead of changing between Aerosol-Generating Procedures (AGPs).
  • Throwing out PPE seems wasteful and isn’t environmentally friendly.
Complaints about new administrative controls
  • Daily staff monitoring forms are awkward and they constantly remind staff about COVID-19.
  • My team is stressed enough. I think these forms are overkill.
  • Performing additional environmental cleaning takes too much time, I can skip it today.
  • We are behind schedule and leaving for lunch is time-consuming — our entire team can just gather in the staff room and eat together. We need to bond anyway.
  • A family of five showed up 30 minutes early, I should ask them to wait outside, but will any harm come if I let them hang out in the waiting room? They’re all in the same bubble anyway.
 Dissatisfaction with clinical care modifications and engineering controls
  • Teledentistry is too limited. I want to see all of my patients in person.
  • Placing a dental dam is time-consuming, and I’m not used to it.
  • Hydrogen peroxide is hard to find. I’ll use a standard mouthwash instead.
  • I’m supposed to take extraoral X-rays when possible, but my intraoral unit is more convenient.
  • There are ways to cut down on AGPs, but my wrist is sore. I’ll just scale the way I always have.
While understandable, the line of thinking inherent in the above statements can lead to a slippery slope. Disregarding safety controls when they have worked to prevent the spread of COVID-19 in dental offices is akin to throwing away your umbrella in a rainstorm because you are not getting wet. Have no doubt, COVID-19 is still here, and will rebound if given the opportunity.

Despite encouraging signs that dentistry’s collective efforts are working to flatten the curve, dentists must remain committed to safety and demonstrate that the profession knows how to prevent and control the spread of infections. The profession is being watched and no one can take a day off. Dentists have long treated patients with infectious diseases — that is true — but going back to the “old way” is not good enough. Until this pandemic is behind us, dentists must continue to go above and beyond. Although dentists should be happy with the market’s rebound thus far, it is still premature to celebrate success. Instead, what dental teams need is discipline, resolve and perseverance.

What happens today, tomorrow, and next week will determine whether governments and regulators view dentistry as a safe activity or a dangerous one. If dentists succeed in keeping COVID-19 out of dental offices, health authorities will be more likely to allow dental offices to remain open when a second wave arrives, even if other sectors of the economy are re-closed.

The worst may be behind us, but COVID-19 is far from over. Adhering to infection prevention and control protocols and procedures has never been more important for the dental profession. It is dentists’ shared responsibility to keep their guards up on the road to recovery.

Republished with permission of the Ontario Dental Association and Ontario Dentist, 2020. 


1. Meyer R, Kunreuther H. The ostrich paradox: Why we underprepare for disasters. Philadelphia: Whar- ton Digital Press; 2017.

About the Author

Julian Perez is the Vice President of Compliance & Risk Management at dentalcorp and is responsible for the development, implementation, and oversight of company-wide standards, programs, and systems to support practices in the delivery of optimal patient care. Julian has a robust legal background having worked for a Wall Street law firm in Manhattan as well as a professional liability program providing malpractice defense to over 10,000 dentists. Julian holds a bachelor’s degree from Yale University and a juris doctorate from Columbia University’s School of Law.

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