Dental assistant on the computer, wearing a mask.

This article was originally published in the Q3 2020 edition of Magazine.

It has been amazing what we have seen in the dental profession over the past three months. From the shutdown of all offices, to the mighty restart that has been experienced across the nation, dentists and their teams have experienced an emotional roller coaster.

At Practice Solutions, we have seen everything from teams coming back completely fractured to teams that are closer than they have ever been. It has been a time full of challenges that, at times, can seem exhausting. The dental profession needs to rally around one collective vision so that we can get our energy back and get our teams aligned.

We NEED to unite behind the most common vision we all see for our dental offices, and that is to help patients achieve optimal oral health. There is no doubt that can come off as cliche, but there is a new reason that is driven by COVID-19. Now more than ever, we need dentistry as a profession to rally together. The dentist, hygienist, dental assistants, front office, and all other supporting staff need to ensure that we come together to protect the cohort of the population deemed by the Centers for Disease Control and Prevention (CDC) to be at risk. The CDC has defined that cohort as those who are 65+ with a pre-existing condition.

When you think of that cohort, it is a group that consists of our parents, grandparents, leaders in companies, teachers, friends, and many others. If we are thoughtful as a profession, we can do our part to ensure three key things happen when it comes to their dental care:

  • Key 1: Keep them safe with the proper safety measures (personal protective equipment [PPE], sterilization, etc.).
  • Key 2: Help them avoid pain and complications.
  • Key 3: Minimize their time in the office and maximize their oral health.

Key 1

The three keys really start with something we have always done – ensure we observe universal precautions. This means we will wear the PPE necessary to protect them from any possible transmission route in the office. We have seen the addition of face shields and N95 masks to enhance our universal protocols.

Key 2

The second key is one that we all know but sometimes don't express to the patients. We all know as clinicians that dental issues left to time and further degradation will likely end up in a more progressed state. Many times, this is what triggers the unpredictable event of a dental emergency. As clinicians, we know how to stop this from happening; it is just what we do. The only things that get in the way of helping these patients are:

  • Our inability to get through to the patient to show the importance of the care
  • The cost of the treatment
  • The time it takes to complete the treatment.

There has never been a time before now that has forced the dentist and the patient to level with each other and say here is what you need to keep your oral health predictable. Many times, the patient could argue there is an ulterior motive, which we have all heard in the past. Today, it is all about people helping people. It is the reason we all do what we do. So now that you have removed your own barriers to talking with the patient and they see that you are genuine in your reasoning for their needs, what is next?

Key 3

Key 3 is how we as a profession can really help ensure we are doing the most efficient dentistry possible. As CEREC® dentists, we have always thought that it was ideal if we have two teeth next to each other it would be best to complete treatment at the same time for a multitude of reasons (restorations made together fit better, have better shade match, etc.). Now, it has everything to do with time in the office. For the at-risk group of patients, you now need to explain how they can minimize their time in the office yet maximize their oral health. Since you have the technology to leverage (CEREC), you have the means to achieve this more than a dentist who has yet to adopt CAD/CAM. Let's use an example of a patient needing three crowns to drive the point home:

As I said, the key is to help minimize time and maximize oral health. The way we do this is by ensuring we group treatment together so we minimize trips to the office. For the patient who needs the three crowns, they have the choice to come into the office three separate times or one time to get all three crowns down at once.

First, let's focus on what it looks like to do each crown separately. This would take three trips to and from the office (let's assume a 20-minute commute). There would be three 1-hour appointments to prepare the tooth for the crowns and then three 1-hour appointments to place the crowns.

To office travel: 3 x 20 minutes = 60 minutes
From office travel: 3 x 20 minutes = 60 minutes
Preparation and placement time of 3 crowns x 2 hours each = 6 hours
Total time: = 8 hours

Now let's focus on what happens if we do all the crowns at the same time. For CEREC users, even more efficiency is built in.

To office travel: 1 x 20 minutes = 20 minutes
From office travel: 1 x 20 minutes = 20 minutes
Preparation and placement time: 1 x 2.5 hour = 2.5 hours
Total Time: = 3 hours 10 minutes

As you can see, we are able to decrease travel and exposure time by over 60%. The bottom line is the more the patient can do at one time, the more they can decrease the time in the office. With the proper sequencing and financial options, the patient can work with your office to find a way to minimize time and maximize oral health.

The dental profession has the challenge to target July through October to complete a very difficult feat. That is to ensure a part of our patient base is taken care of. The focus is on having patients age 65+ with pre-existing conditions stable in regard to their oral health by Fall. If we can do this, we can protect the profession from another complete shutdown.

As we have all read and now understand, this virus is very targeted at the part of the population that is more advanced in age and has a more complex health history. For those who are younger and healthy, the virus behaves in a predictable manner.

The great profession of dentistry has the chance to treat at-risk patients in such a way that allows them to predictably be away from a dental office for the next six to 12 months. This group of patients can safely move about their life without being forced from their homes for dental emergencies. It also allows dentistry to remain open for business when and if the second wave of the virus hits and if the CDC says we can stay open but not see at-risk patients. As dental professionals, we have an opportunity to do our part to help our patients get and stay healthy. The group of doctors best positioned to do this are those who have CEREC.

The most important place to start getting aligned on verbiage and workflow is with your hygiene team. Keep learning, keep leading, and good luck helping all of your patients.

Mitchell Ellingson, D.D.S., is a member of Spear Resident Faculty and Vice President of Practice Growth for Spear Practice Solutions.