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Plan For Re-opening Your Practice with Teledentistry

“Re-emergence from the depths of the pandemic will take time and defining a “new normal” for our lives and our practices. No one is really sure of what the end of this pandemic will look like, so we can only try to do our best to craft a safe and effective practice environment. Further, because of the novelty of this crisis, how we approach renewal of our practices will be a mix of application of existing science, interpretation of new findings, and creativity and common sense. Until more is known about transmission, testing, and immunity, as well as the effectiveness of mitigation efforts, recommendations are, at best, merely guideposts, not definitive.”

-American Academy of Pediatric Dentistry

How are Dentists Planning to Re-open?

Based on preparation examples from general and specialty dental practices, and guidelines to reopening from the ADA, we have compiled bullet points you may want to consider in planning your own re-opening strategy.

Before Opening 

  • Follow infection control guidelines from the ADA, CDC, OSHA and stay up-to-date on any updates 
  • Stay in touch with your PPE providers to ensure adequate supply
  • Update website, social media, phone message, etc. with re-opening details
  • Make sure waiting room no longer has magazines, books, toys, etc. that are difficult to sanitize
  • Create a routine office cleaning schedule (ex. tables, chair arms, doorknobs, light switches, hangers, and anything else with which people come in contact)
  • Consider air control mechanisms (i.e. Air Purifiers, Aerosol evacuation units or negative pressure rooms)
  • Consider added treatment room barriers (ex. Barriers in open-bay or treatment rooms without doors)
  • Consider placing temporary acrylic barriers for open reception desk and provide PPE to protect receptionist(s)
  • Develop protocol for if staff member tests positive for COVID-19
  • Encourage sick employees to stay home
  • Consider having a COVID-19 assigned team for positive patients
  • Staging of missed recall/new patients
  • Determine which dental procedures can be accomplished without creating aerosols and designate these as “dry appointments” all other appointments would be considered “wet” and higher risk
  • Consider having scheduling separate aerosol procedure days and non-aerosol procedure days to allow cleaning/disinfection time for aerosol producing procedures
  • Calibrate staff on all re-opening protocols 
  • Become familiar with potential payer coverage for teledentistry, and new codes for COVID-19 testing

Re-opening Strategies

Pre-Appointment

  • Use teledentistry to triage (for COVID-19 and dental complaints) and to have patients fill out paperwork prior to coming to the office 
  • Referral options identified for patients who have a positive COVID-19 test results
  • Due to PPE shortage consider requiring patients to arrive at office with a “face cover” and provide mask only if/when necessary

In-Office

  • Provide hand sanitizer for patients upon entering the office 
  • Limit or restrict use of in-office restrooms
  • Consider taking temperature of all patients as a part of in-office screening
  • Limit paperwork completed in-office
  • No physical contact outside of dental treatment (i.e. hand shakes)
  • Consider increased time between appointments to control number of people in the office at one time 
  • Limit access to the operatory to the patient only, when possible
  • Keep staff level in operatory to the minimum required
  • Consider mouth rinse to reduce viral load
  • Use professional judgment to employ the lowest aerosol-generating armamentarium when delivering any type of care. (ex. Use rubber dam for restorative, limit use of power scalers for hygiene)
  • Maximizing treatment per visit or length of visit to reduce numbers of visits
  • Consider the use of teledentistry to complete patient exams to reduce contact between patients and providers, in- office

Post-Appointment 

  • Launder all staff scrubs, gowns, etc. worn during the workday in-office 
  • Follow-up on emergency patients seen via teledentistry
  • Post-op instructions should include a reminder to report any signs or symptoms of COVID-19 within next 14 days
  • Many patients will have been financially impacted by COVID-19 so you may need to talk to patients about any incentives you’re offering or third-party financing

What is your practice doing? Let us know …

Have suggestions to make to add to these bullet points for your fellow practices and dental professionals? Please let know.

Register for Webinar with Dr. Scarlett:

Teledentistry for What’s Next: Mitigating Risk and Navigating a New Normal.

How teledentistry is becoming a necessity

Communication with your dental team is key to re-opening. One article by the ADA encourages dentists to communicate with their team before reopening so all members are on the same page and comfortable with returning to work. Utilizing synchronous video chat teledentistry allows you to meet together as a team to discuss team members’ concerns and calibrate on new COVID procedures and protocols. You can also utilize asynchronous teledentistry team messaging to share collected data and treatment plans to collaborate on upcoming cases.

Good communication will also make your patients feel comfortable with coming back to the office. Let your patients know that you are taking all the necessary prevention measures to keep them safe during their visit. Utilizing asynchronous teledentistry patient messaging allows patients to communicate their concerns and fill out all necessary paperwork before the appointment. It also may be used to communicate that the team is ready for their appointment as the patient waits in their car to avoid unnecessary contact with the waiting room. To allow for appropriate social distancing, (or “social dentisting!”) in-office teledentistry is also an option. Asynchronous teledentistry can be utilized to provide patients with dental exams whereas the dental hygienist collects all appropriate data and sends it to the dentist for review and treatment planning.   

Utilizing synchronous teledentistry, the dentist can triage patients for COVID-19 and dental complaints before they come into the office. This will shorten the time the patient spends in the office, therefore mitigating the risk of infection spread.

Not all teledentistry solutions have the full range of features needed to help navigate the new normal.

TeleDent allows you to communicate with your dental team and patients in real-time through video calls or when it is convenient through messaging to ensure that everyone is comfortable with re-opening. Reception staff can easily add patients to TeleDent and schedule virtual or in-person appointments through messaging. The data collection and review features can help calibrate your team on cases you triaged during the stay-at-home order, upcoming in-office cases, and even perform properly social distanced dental exams. Patient messaging and video calls can also be leveraged to perform follow-up exams and check on patients who recently visited your office for dental treatment. TeleDent has many features you can utilize to optimize the re-opening of your dental practice and keep your staff and patients safe. Here are 12 questions you should ask teledentistry companies.

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