Plexiglass barriers, less physical contact, and limited views of people’s facial expressions are all part of a new world that we will learn to navigate as future dental professionals. As dentists, we rely heavily on being able to read people’s body language and facial expressions in order to provide context to conversations about priorities in a patient’s oral health. In the world of COVID-19, face coverings and layers upon layers of PPE add yet more barriers that we will have to navigate in order to serve and provide our patients with quality care.
I worked at an eight operatory suburban private practice for a few weeks, and my experience felt like an amalgamation of what was expected and unknown territory. Coming into the office in the morning, the team would still have routines such as morning huddle, prepping the operatories, etc., but there were also many changes. The waiting room was now empty in an effort to maintain social distancing. Instead, when patients scheduled their appointments, they were advised to call the office to inform the staff of their arrival, and wait in their car until they were called into the operatory. To accommodate patients who could not wait in their car, the waiting room was devoid of items that could not be easily sanitized such as magazines, newspapers, and children’s toys. They were also advised not to bring any additional people to their appointment in an effort to reduce the amount of contact. There was constant sanitation of surfaces, phones, keyboards, and writing utensils. The clinical staff geared up after the morning huddle in long sleeves, washable reusable gowns, cloth masks underneath surgical masks, goggles or loupes, face shields, and gloves. It took extra dedication to connect with patients due to the inability to see our faces and expressions. Operatories were wiped down with Cavicide twice over and there was increased use of plastic disposable barriers. The presence of air purification systems in each room added another level of reassurance.
With all of these measures in place, there is an increase in the amount and use of PPE and such supplies. The shortages being faced across the healthcare field means that the cost of finding and obtaining PPE is rising. It is becoming increasingly difficult and nearly impossible to acquire proper PPE. Supplies that are ordered do not arrive on time and when they do, orders are underfilled. With this in mind, the need for quadrant dentistry is more important now than ever. At this particular private practice, longer appointments are being achieved by the use of non-IV oral sedation. More procedures can be completed by the provider in one sitting, while still being cost effective with available PPE, and saving the patient time and discomfort. But can patients finance it? This is a question that will be challenged in today’s economic climate.
As a rising fourth year dental student, it will be interesting to observe the changes that this pandemic will bring to our profession. Reinventing the business model and making it worthwhile to complete procedures for each patient will be crucial, while still keeping in mind that money is tight because of the current economic situation.
A 6:30 AM alarm, a cup of coffee and my favorite scrubs was how I used to start my day. As my new normal I now add a hair net, double masks, and gloves to volunteer at the Tufts Dental School of Medicine. One morning I was in the main lobby of the Tufts Dental School when an eight-year-old boy and his mother came in for an emergency. I noticed the mother’s difficulty describing her son’s toothache, therefore I offered to help as Spanish was her first language. She was relieved to be able to fully explain her son’s situation, as he had been complaining of a toothache for about a week. Because of the coronavirus, she was scared to bring him in until the pain got unbearable. The young boy had a left submandibular abscess and was later admitted to the hospital emergency room to be operated on under general anesthesia. Two days later after the surgery the patient came back for a follow up appointment, both happy that the pain was gone
It was impossible to ignore the differences in the dental school building since day one. The uncertainty that unfolded with the COVID-19 crisis was scary and unsettling. However, the unknown was not a barrier that our community would let interfere in the treatment of our patients. Faculty, staff and volunteers at the Tufts Dental School of Medicine enthusiastically created new plans and protocols to ensure safe visits for emergency patients. The main entrance team worked tirelessly to triage the patients to the right department by measuring body temperatures and surveying patients on their symptoms. The emergency room team then examined each patient to efficiently diagnose and propose the most appropriate treatment plan to aid their acute pain. The ability of the faculty to adapt and face an unpredictable pandemic has been admirable, inspiring, and vital to my education as a future dental provider.
Volunteering at Tufts Dental School of Medicine during a pandemic has taught me lessons far beyond dental diagnosis and treatment. The commitment and empathy of the dental community throughout the pandemic – a group of professionals who were present every day with full enthusiasm and commitment – was a reassurance of the love each of us have for this profession. I will forever be impacted by the gratefulness and humbleness of patients whose pain was no longer there. I have learned important strategies of how dental providers can react and adapt to a public health crisis. I am proud and fortunate to be part of the Tufts School of Dental Medicine and Dental community as a whole. As we transition to a new normal, we need to address the impact of the pandemic on dentistry while remaining devoted to taking care of our patients, regardless of the circumstances. As I start my last year in dental school, I look forward to continuing the work and commitment shown by this group of essential workers whose doors remained open during some of the most difficult times. It has been an honor and I’m humbled to have been part of this group.