Personal Protective Equipment (PPE) Challenges
There have been many changes to dentistry operation over the past few months, including the recommendation of additional personal protective equipment (PPE) for dental providers as thy prepare for resuming non-emergency dental care. While these recommendations represent safety best practices, it also means further increased overhead and supply and stocking issues for dental practices already facing huge challenges.
While the ADA issued a statement on third party reimbursement for the increased costs of PPE, some offices are beginning to charge a PPE offset fee to patients. How will your practice manage the additional overhead cost of PPE? Are there ways to reduce PPE use without further reducing the number of billable appointments?
How much PPE will your practice burn each month?
A big question for providers as they prepare to return to work is how much PPE they need and how long it will last them and their staff. The Centers for Disease Control and Prevention (CDC) published a PPE burn rate calculator. It is designed to help healthcare facilities optimize their use of PPE during the pandemic when supply is critical. You can use the spreadsheet tool to calculate the “burn rate” of your current PPE supply by type (i.e. N95 masks, gloves, gowns). This can help you plan your schedule of patients based on how much PPE you have and will burn per patient.
The chart below shows how much PPE and associated costs a dentist with 2 RDHs seeing 8 patients a day would have over the course of a month if the dentist was performing a limited or periodic evaluation at chair for each patient (and therefore burning one set of PPE). It does not include face shields, glasses or bonnets:
| PPE Type | Per day use ($) | Per week use ($) (5 days) |
Per month use ($) (4 weeks) |
| Disposable gown | 24 (~$20) | 120 (~$100) | 480 (~$400) |
| Disposable gloves | 48 (~$5) | 240 (~$25) | 960 (~$100) |
| N95 mask (no-reuse) | 24 (~$45) | 120 (~$225) | 480 (~$900) |
| Total Cost | ~$70 | ~$350 | ~$1400 |
Teledentistry Strategies
The use of teledentistry can help reduce the PPE burn rate and manage costs and stock management while improving patient experience and safety at the same time.
Virtual Consultations are Now the Face-Face Option
Connecting with your patients virtually means that you don’t have to wear PPE. This means seeing your patient face-to-face for relationship and trust building now will be happening online via teledentistry. That can even be the case when the patient is still in the office, using intraoffice applications of teledentistry. (See below.)
1st Strategy: Remote Consultations
PPE use is reduced when you provide care to patients outside the office. That means chair-time (and PPE) is used efficiently for appointments that require it. For example, you can triage dental concerns and provide limited examinations through live video consultations. Or, provide post-procedure check-ins. Scheduling and collecting payment using teledentistry also potentially keeps the patient out of the office for those tasks as well.
2nd Strategy: Intraoffice Teledentistry
Another option is to use teledentistry when the patient is at your office to keep the dentist from needing to be chairside for an evaluation or case presentation. For example, a dentist can provide an in-office exam from a different room with the hygienist managing a live video and intraoral camera feed with the patient. The dentist has access to all x-rays, charting and documentation in addition to the visual intraoral camera feed and hygienist’s presence with the patient to complete the exam.
Or, this can be performed asynchronously: the dental hygienist collects all needed data during the appointment, such as x-rays, charting, and intraoral photos and the dentist completes an asynchronous exam either later at the office or at a different location.
Benefits of Virtual Case Presentation
In both cases, using a teledentistry platform that supports visual case presentation and a patient portal, the patient can receive a visual treatment plan outside the office. And a case presentation could happen via video with either the patient in the chair, or at home. Both options reduce the dentist’s PPE burn rate by not having to use additional PPE to do exams on hygiene patients or provide chair-side case presentation.
Does Teledentistry Pay for Itself Just with PPE Burn Rate Reduction?
The table above represents costs with 1 dentist and 2 hygienists with 8 patients per working day. Many offices will have costs multiple times this base amount. Even at this base amount, a modest reduction in burn rate of 15% would cover the monthly fee for TeleDent.
The Big Picture of Risk Mitigation with Teledentistry
Teledentistry changes office workflow to provide a safer experience for providers and patients. Risk of administrative staff exposure can be reduced by using teledentistry to message about appointments to eliminate waiting rooms and front-office and patient interaction. Treatment plans can be sent digitally to patients instead of presenting treatment needs in full PPE chairside. Substituting an in-person consultation with a virtual one when patient needs can be met with a virtual consult can also reduce exposure risk. Pre-screening patients for covid can help to reduce infection vectors.
PPE Is Really the Last Option for Risk Mitigation
Best practices for hazard control have been extensively studied for many years. The “hierarchy of controls” chart summarizes the priority that should be given to each type of risk mitigation (and it shows PPE as the last step, rather than the first, in mitigating risk).
What does this mean for risk mitigation for a dental practice, and how can teledentistry be leveraged for each of these kind of risk controls?
- Elimination: Using teledentistry, pre-screen patients for covid to eliminate risky office visits.
- Substitution: Substitute virtual consultations for office visits when patient needs and clinical needs can be met with a virtual consult.
- Engineering: Intra-office, intra-team use teledentistry to provide dentists with patient and exam data to review asynchronously or synchronously without direct patient contact.
- Administrative: Use teledentistry messaging to eliminate waiting room and front-office interaction and to send digital case proposals to patients instead of case presenting in full PPE at the chair.
- PPE: Above use of teledentistry in 1-4 will reduce the need for PPE.
“Teledentistry” is Another Way to Spell “Flexibility”.
Whether in a very specific use case of reducing PPE burn rate, or more widely mitigating risk, or in using teledentistry to improve patient experience and meet the rising expectation for telehealth options, teledentistry adds to how adaptable your practice can be to changing needs. And you don’t have to bend over backwards to see how it can be practical for you. Schedule a free consultation where you can also see a demo of how TeleDent works.