ADA president: Reopening dental practices needs a team approach

As some dental practices begin plans to reopen and provide nonemergency care — as some states reopen following the direction of their state — the Association is urging dentists to have robust communication and engage their dental team members to address any concerns related to returning to work amid the COVID-19 pandemic.
Photo of Dr. Chad P. Gehani
Dr. Gehani
“Good communication is the key to making patients and the dental team comfortable as they return to our offices,” said Dr. Chad P. Gehani, ADA president. “Dental team members who are confident that their office is keeping up with all appropriate prevention measures will convey that confidence to patients.”
Dr. Gehani’s message comes as dental team members, including national leaders with the American Dental Hygienists' Association, voice concerns over the potential high risk of transmission of COVID-19 due to the nature of their profession.
“We are aware many states are preparing to reopen the economy, including some dental offices, as early as this week,” according to an April 21 ADHA Action Alert encouraging its members to advocate in continuing postponement of elective and nonurgent visits. “We need to unite and ensure our governors step up to support dental hygienists and ensure their access to appropriate [personal protective equipment] should their employer dental offices reopen.”
The availability of and access to PPE is of paramount concern, said JoAnn R. Gurelian, RDH, Ph.D., chair of the ADHA Task Force on Return to Work.
“ADHA members are concerned that all dental team members, as well as patients, are safe, given the high-risk situations dental practice settings pose,” Dr. Gurelian said. “Particular attention must be paid to aerosol production and ability to maintain social distancing given the varied designs of dental offices. It is important that there is open dialogue among the full dental team and responsiveness to these imminent safety concerns.”
Dr. Gehani said dentists and all their team members should meet via video communication and discuss these concerns.
“The ADA has been working hard to create scientifically-based guidelines to help offices as they begin to transition back into fulltime practice,” Dr. Gehani said. “The safety of everyone, including patients, dental team members and our families are all equally important.”
To help address concerns over safety for dentists, their staff and patients, the ADA’s Advisory Task Force on Dental Practice Recovery developed a toolkit to help dentists who choose to return to more normal practice operations as some states reopen.
The Return to Work Interim Guidance Toolkit focuses on the management of dental practices. This include considering implementing a soft launch for their practices with their dental teams, and the discussion and practice of new strategies before welcoming patients. The toolkit also includes interim guidance on the personal protective equipment recommended to practice during the COVID-19 pandemic and minimize the risk of virus transmission. It will be updated as more information becomes available.
Some state associations are also taking the dental team into consideration as they consider a path forward. The California Dental Association has assembled a COVID-19 Clinical Care Workgroup, co-led by the California State dental director, to develop the resources and guidance California dentists need as they prepare to provide more essential dental care during the pandemic. The CDA workgroup is comprised of a diverse array of dental specialties and includes leaders from both the California Dental Hygienists’ Association and the California Dental Assistants’ Association. CDA believes representation from all parts of the dental team is integral to ensure the development of comprehensive clinical guidance.
“Team members must feel comfortable that sensible precautions are being taken in the dental office, and they must be comfortable explaining to patients what is being done on their behalf,” Dr. Gehani said. “This crisis underscores how every member of the dental team is important and must be respected for their unique roles.”
Dr. Gehani, who practices near the epicenter of the COVID-19 crisis in New York, said he and his wife, Dr. Rekha Gehani, have met virtually with their dental team members regularly to listen to their suggestions and concerns.
“Be candid with all team members,” Dr. Gehani said. “Tell them what you know as fact and what is more speculative. Explain what changes will be made moving forward, and if their job responsibilities will be amended.”
It’s important, Dr. Gehani added, to allow staff members address their individual concerns and give them due concern.
“Assure them as best as you can that you are committed to the practice and to your team,” he said. “A dental practice is not an address. It is a team of dedicated professionals with shared goals, working to make lives better.”
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