Understanding the New Normal

Dental practice operations after COVID-19

Dental professionals are facing new challenges today as we try to adapt to the reality that the COVID-19 pandemic will change the way we practice. Change is always difficult, and this particular change involves a significant amount of fear. We are fearful for our responsibility to protect the health and safety of our patients, our team and ourselves. We wonder how we can function in a world where a simple cough may be assumed to be a deadly disease. We worry how the new protective guidelines will affect our productivity and profitability. This is unknown territory, and the best way to face it is to put one foot in front of the other and move ahead.

This is not the first time that a global pandemic threw dentists into a panic. In the late 1980s the revelation that a dentist with AIDS was reported to have transmitted HIV to a young patient in Florida caused great apprehension among the general population. At the time, exposure to the human immunodeficiency virus was considered a death sentence. If one dentist could pass the virus onto a patient, was visiting any dentist safe?

Before the AIDS epidemic, many dentists practiced without gloves, masks or eye protection. When I was a dental student, I was taught that because dentistry involved an invasion of personal space, the wearing of masks and gloves would make our patients uncomfortable. I did wear glasses, however, as did most of my colleagues. Mask and gloves were reserved for procedures designated as oral or periodontal “surgery.”

In 1989, the U.S. Occupational Safety and Health Administration proposed new regulations that would reduce exposure to both patients and health care workers from blood and other bodily fluids. These “universal precautions” included wearing gloves and masks as well as heat sterilization of our instruments and handpieces.

At the time, universal precautions were not exactly universally accepted. Many dentists feared the increased cost and time required and that handpieces would not hold up to the heat of the autoclave. And they worried that patients would not be comfortable receiving treatment from a dentist wearing a mask and gloves.

Today, of course, all of those fears proved to be unfounded and seem ridiculous. No patient or practitioner would want to return to the days before the protections of universal precautions.

As we look ahead to dentistry’s “new normal” in the era of a deadly respiratory pandemic, let’s remember a few things we learned from our last major deadly bloodborne pandemic:

1. Patients can smell fear (many are actually feeling it themselves).

Proceed boldly and with confidence as you implement the new changes in your office. Educate your patients along the way and encourage them to ask questions.

2. Visibly implement (or exceed) all current recommendations proposed by the Centers for Disease Control and Prevention, OSHA and American Dental Association.

Look to the ADA for leadership in interpreting these recommendations. Don’t hesitate on this. Your team members and your patients need to trust that you are doing everything you can to keep them safe. Make sure you communicate this to them frequently. Every communication should scream, “I’ve got your back!”

3. Be patient.

Remember that technology, the marketplace, fee schedules and office design will catch up to meet the demands of the new recommendations and realities.

4. Stay creative and connected.

Have fun with your team and patients as you adjust to the new realities. Host a mask-making contest, include fun sheltering stories on your website, or offer curbside coffee to those who wait outside. Show you care.

The future is no less rich in possibilities in 2020 than it was in 1990. Work through that fog of uncertainty and approach each new day with excitement and vigor and pass that sentiment on to your patients and team. Find the defining feature of our new normal and own it.

New skills will be required so help your team be in the front of the line to learn them. There may be some volatility ahead, but put aside your fears and show your character. In the words of former President Jimmy Carter, “You can do what you have to do, and sometimes you can do it even better than you think you can.”

Just do it!

A photograph of Kimberly A. Harms, D.D.S.

About the Author

Dr. Harms practiced dentistry as an enlisted officer in the U.S. Public Health Service, as a dental associate and for most of her career as co-owner of a private practice in Farmington, Minnesota. She was the first woman president of the Minnesota Dental Association, chair of the ADA Council on Communications and member of the ADA Council on Government Affairs representing the 10th District. A former grief counselor and a civil mediator, she is a published author and national speaker focusing on major life events and conflict that can create shock, grief and coping struggles while practicing dentistry. Learn more at drkimberlyharms.com.