Deerfield Beach, Fla. — Dr. Katie Champion is still working on her “smize” — smiling with only her eyes.
“But it just doesn’t feel the same,” said Dr. Champion, an associate dentist. “I’m a very face-to-face dentist and value having conversations with my patients about their overall health and oral health.”
Covering her face with a mask and face shield is just among the changes her practice has implemented since reopening on May 8, her first day back to working full-time after Florida lifted its mandatory emergency-only dental order due to the COVID-19 pandemic.
Since reopening, the practice is also checking temperatures, asking patients to wait in their cars until their appointment, transitioning to primarily hand-scaling, and using air purifiers that can help filter out viruses and bacteria.
“I’ve heard from other dentists that you can’t practice without ‘XYZ,’ and there are people who are quick to point out flaws,” Dr. Champion said. “But we have done everything in our power to make sure our office still feels like the safe and friendly space it was before the coronavirus, and I hope it will continue to be, long after this pandemic passes.”
Dr. Champion remembers having just arrived at Lake Tahoe, California, for a family vacation in early March when she first heard about the impending closures in Deerfield Beach, including her dental practice, due to COVID-19.
“I remember my sister commenting at our first dinner that this was a ‘historic event,’ and I brushed it off thinking that the widespread panic would subside,” she said. “It did not.”
Their resort and nearby businesses closed the following morning, and Dr. Champion and her husband found themselves hastily finding flights back to Florida amid a snowstorm.
“My disappointment at a vacation cut short was quickly turned into a nervousness about what was going to happen to me, my patients and the practice I worked at,” she said.
Dr. Champion said she called the partner owners of her practice — Drs. Joseph Ortlieb and Michelle Rivera — and made plans to come into the office when she returned to figure out the next steps to take.
Based on the ADA recommendation to provide only emergency dental care in March, that’s exactly what Dr. Champion’s practice did.
Normally, the eight-operatory practice has three assistants, four hygienists, and three full-time front desk personnel, including the office manager.
“It was an exceedingly difficult time, and heartbreaking to tell most of our employees that they would be furloughed for the time being and would need to apply for unemployment,” Dr. Champion said.
The practice had to scale down, keeping a core team in the office for emergencies, including their office manager, two assistants, and two doctors.
“As an associate, my position was precarious, and I had originally volunteered to come in an on on-call basis,” she said. “I knew I had a responsibility to continue treating my emergency patients.”
Staying in touch
Shortly before the practice closed except for emergency-only treatment, the practice started utilizing a patient communication service, to update patients with what was happening with the practice. Via email blasts, patients were informed about updated personal protective equipment protocols, and what the practice was doing to keep patients safe when it was time to reopen.
Through a group chat with the entire dental team, the practice owners and Dr. Champion also provided updates on how the practice was proceeding amid the pandemic.
“The members of the team that were furloughed knew that May 8 was the tentative reopening date,” she said.
The doctors also kept everyone up-to-date on the changing personal protective equipment and sterilization guidelines and also keeping them informed about the changes made regarding taking notes and charts.
The ADA, especially its Return to Work Interim Toolkit, and other resources have been instrumental in helping guide their reopening, Dr. Champion said.
“We are lucky to have such an understanding team who were both active participants in conversations about infection control and a great support during the many changes we were implementing,” she said.
Every team member, Dr. Champion said, could voice their concerns about certain aspects of re-opening.
“We did our best to alleviate their valid anxieties,” she said. “We had two hygienists who chose not to return at all, which was eye-opening for me to see how seriously worried they were about their own safety. I knew that we were being diligent and taking all necessary precautions, but I wanted our team and patients to feel the same.”
Louder than words
The first day back in the office was a little nerve-wracking for Dr. Champion, despite only having four patients on schedule.
“I wanted to be sure we were all doing our best to keep the office disinfected and a safe environment for everyone,” she said.
Before reopening, the practice sent its patient a “Welcome back” reassurance letter, outlining the new safety precautions.
These include utilizing the ADA medical pre-screening forms before and at appointments, providing sanitizers at the front desk and taking each patient’s and dental team’s temperatures. In addition, everyone in the office would be wearing masks at all times; decreasing the amount of paper passing hands; spreading out the scheduling system to allow for more disinfection time between patients; and keeping doors closed during aerosol procedures.
“We are utilizing air purifiers in each operatory and one in the waiting room to help prevent the spread of infection from aerosols,” she said.
Each day, the team has met to discuss finding new and better ways to best serve their patients and keep everyone safe.
“No one on our team is shy about speaking up for change if it seems warranted,” Dr. Champion said.
But of all the changes, the inability to show her face and expressions to her patients, nor shake their hands, was the biggest challenge.
For now, Dr. Champion has to settle on conveying her interest and concern for each patient through her eyes.
“They say actions speak louder than words, but facial expressions really do go a long way in patient comfort and trust,” she said. “And I hope my actions and words can make up for the lack of expressions.”