Maintaining a Safe, Healthy, and Viable Practice

As dental practices continue to weather the COVID-19 storm they must focus on ensuring not only the continued safety of all employees and patients but also the viability and health of the practice. This can be done through meritocracy-based innovative thinking and paradigm changes.

Teams must feel safe. Employees must believe that their doctors and management view safety as the sine qua non of practicing. To help ensure this, practices can: (1) have a qualified third party do a virtual walkthrough and N95 fit tests to ensure protocols are effective, appropriate technologies are installed, and necessary PPE is provided; (2) regularly review and reinforce all protocols and check mask fit; and (3) incorporate equipment and protocols as new information becomes available.

Any team member who does not feel safe should leave the practice. With demand for employees currently outpacing availability due to people choosing to stay at home because of safety or childcare concerns, employment opportunities abound for qualified individuals.

Patients are afraid to visit dental offices. To combat patient fear, practices should send regular communications assuring patients that the practice is open and detailing the safety protocols that have been taken. Every missive should include words of encouragement. As of August 2020, there had not been a single confirmed case of COVID-19 transmission as a result of a dental visit. This fact should be stressed to patients.

Specific efforts that can be taken include: (1) sending emails to the complete patient base detailing the safety steps the practice has taken; (2) laminating and posting these safety measures in the check-in, reception, and front desk areas; (3) having the hygienist and/or assistant, in the course of conversation with each patient who is seated, re-emphasize the technologies that have been installed, and the doctor should do the same before beginning treatment. Efforts also should be made to relax patients, making visits as enjoyable as possible while still acknowledging the pandemic.

Patient fears threaten delivery of comprehensive, interdisciplinary care. Patients' reluctance to visit additional offices or have multiple treatment visits has become an obstacle to patient health and practice viability. There are solutions: (1) Practices can establish a teledentistry network. Referring partners can connect with the practice in real-time while the patient is in the chair, and even send over intraoral views of areas of concern. The doctor can speak with the referrer and the patient via a tablet or phone, with concerns being discussed, necessary therapies explained, and treatment appointments scheduled. While not practical for highly complex cases, this approach eliminates the need for in-person consultations much of the time. (2) Practices can reduce the majority of in-person postoperative visits by having the patient send the practice a photograph of the treated area. The practice can respond to these correspondences, either digitally or by phone, in due time depending on the situation. (3) Practices can perform more comprehensive care at each treatment visit.

Practice viability is under siege. In this trying time, practices may need to make a number of adjustments, such as: (1) All processes and business presuppositions must be assessed and modified as necessary. (2) The intraoffice team must become more efficient and streamlined. (3) All team members must be actively involved in identifying patient needs and emphasizing the value of comprehensive care, as evidenced by the establishment of a new post-pandemic hygiene paradigm. (4) The treatment team must be expanded to include not just dentists and their teams, but physicians and other therapists as well. Telemedicine is invaluable in this effort. For example, orthopedists can now obtain a preliminary opinion of patient homecare, etc, and schedule appointments as necessary for preoperative medical clearance with the dental office. (5) Treating dentists must adopt comprehensive care, which must evolve to include treatment of parafunction and sleep concerns and include interactions with all treating physicians. The pandemic actually assists in this effort, as in times of crises people tend to reassess their value systems and focus on their health and that of their families. The willingness to embrace overall health efforts increases. The result is better treatment outcomes and improved practice viability and profitability.

Dental practices must redefine success in all aspects and regularly measure these outcomes. Although practices may be facing monumental challenges, they can be overcome with new standards and fresh thinking.

About the Authors

Paul Fugazzotto, DDS
Co-founder, Dental Market Direction Consortium (DMDC) (dmdconsortium.org); Private Practice,
Milton, Massachusetts

Gino DeSimone
Co-founder, Dental Market Direction Consortium (DMDC)