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Dentistry in a Time of Covid: What to Expect in the “New Normal”

Posted Oct 26th, 2020 in the wire, thought leadership, 2020

Elaine Powell, RDH, Director of Regulatory Compliance Programs, dentalcorp; Jaime Robertson, RDH, Manager of Regulatory Compliance Programs, dentalcorp; Michelle Schwarze, CDA, Manager of Operations and Compliance, dentalcorp

Dentistry has faced more challenges in the last six months than in any similar span of time in history. A torrent of information about COVID-19 has overwhelmed not only practice teams, but all of society. Patients and dental team members alike have concerns about the safety of providing and receiving oral health care. Variations in infection prevention and control (IPAC) standards between the provincial regulatory bodies and public health authorities have sown further confusion. Every day, new information becomes available and more research is released. As a result, it seems Canada’s Chief Public Health Officer’s recommendations change day-by-day. Oral health professionals have had to learn to live and work in a state of uncertainty.

While we cannot be sure of what the future holds, certain things have become evident in 2020. We have highlighted a few things you can expect as you embark on your new career in the COVID-19 era of dentistry.

Heightened IPAC protocols and procedures

For those who have been in the profession for many years, we talk about a “new normal”. For you, many things that were very rare until recently will be normal. In terms of IPAC, this means that you will do some or all of the following:

  • Screen all staff and patients for signs and symptoms of upper respiratory infection;
  • Ask patients to wait in their cars or outside instead of in the waiting room;
  • Understand and know how to use multiple levels of personal protective equipment (PPE), depending on a patient risk assessment and what tasks you are performing;
  • Practice donning and doffing different combinations of PPE to minimize cross-contamination;
  • Work in enclosed operatories when aerosols are created;
  • Pay attention to aerosols and utilize engineering controls to contain them such as high-volume evacuation (HVE) modifications, HEPA filters, dental dams and four-handed dentistry;
  • Stay home if your sense of smell or taste is off;
  • Get fit tested for respirators; and
  • Be prepared to respond to “exposures” in the clinic by self-quarantining or calling public health.
The above changes affect everyone from the newbie dental hygienist on his/her first shift to the seasoned dentist who can remember life during the influenza pandemic in 1968. Indeed, administrative team members are the first to manage risk by screening patients prior to their appointment (and again upon arrival at the clinic). Dentists and dental hygienists will rely on their support teams more than ever to provide information about patients’ health status and to help them assess the procedure required and aid in the selection of the appropriate level of PPE.

Many of these tasks are new to administrative team members, and clinicians in positions of leadership in a clinic will have to ensure that, when new team members are hired, the appropriate onboarding and education takes place.  Because intraoffice communication has become essential in preventing the spread of COVID-19 within a dental office, morning huddles have taken on a new level of importance during this pandemic.

Effective communication with patients will be key

Now, more than ever, the ability to effectively communicate with patients and team members is critical. As our faces must be covered by masks at all times, tone of voice and body language play a key role in keeping patients calm and feeling at ease. It's important to remember that patients can still “hear” a smile behind a mask. When your mouth is covered, smiling with your eyes can go a long way in connecting with and comforting patients. It’s important not to let the human aspect of oral healthcare suffer as a result of the changes that have occurred.

Showing compassion is fundamental to helping reduce patients’ stress and anxiety. Take the time to listen to patients’ fears and concerns and offer them your undivided attention. Encourage patients to ask questions and take the extra care to reassure them that their safety is your top priority. Practices across Canada have noticed that patient appointments take longer than they used to. While this can be frustrating, slowing down isn’t always a bad thing.

Effective communication does not end with the patient. It is crucial to implement standard communication across your practice to send a consistent and reassuring message. Team members must be able to remain calm and professional with one another when treating patients during this time. Developing scripts and role-playing can help the team prepare for most scenarios and react accordingly. Practicing speaking at a level where team members can be clearly heard and understood through their PPE will further aid in effective communication at the practice.

Moving forward in the “new normal”

With the looming threat of a second wave, we must not let our guards down. Strict adherence to infection prevention and control protocols and procedures will be paramount. A heightened level of vigilance, caution, and discipline will define the era that you enter practice.

The increased cost of delivering safe and effective care in the COVID-19 era of dentistry will undoubtedly have an impact on a practice’s bottom line. However, we must keep in mind that developing strong relationships with our patients and teams leads to improved patient care and stronger team development, and as a result, patients will see that your practice is prepared to provide the care that they require.

In many ways, you are fortunate to be starting your careers today. You’ll start your career with some of the best IPAC habits that have ever existed in healthcare. Today’s enhanced focus on health and safety and the extensive research being conducted around the safe delivery of oral care will benefit you and your patients for years after this crisis has passed.

As originally published in Oral Health's Student Issue

About the Authors

Elaine, Jaime and Michelle work closely on the regulatory compliance programs at dentalcorp. Together they bring over 100 years of oral health care experience in clinical, regulatory, and educational capacities. They are passionate about infection prevention control and assisting practices in providing safe and effective patient care.

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