American dental practices are coming back soon, but it won’t be common. Expect social distance, layers of protective equipment, and a new approach to some procedures to protect against coronavirus.
Dental practices are largely closed, except for emergency care, after the Centers for Disease Control and Prevention recommended in March to postpone electives such as teeth cleaning and cavity filling.
In April, only 3% of dental practices were open to non-emergency care, according to Marko Vujicic, chief economist at the American Dental Association’s Health Policy Institute.
Survey data shows that about two-thirds reopened in May, and Vujicic expects it to be 97% by the end of June. He estimates that only 1% of dentists will eventually sell their practice, retire or file for bankruptcy.
“They seem to have survived the storm,” said Vujicic.
Dentists say government loans helped some of them survive the shutdown, and demand for their jobs is forcing them to reopen quickly.
“The need for even routine dental care has never disappeared,” says Dr. Terri Tiersky, who runs a small practice in Skokie, Illinois. “We had to go back to our patients … and of course our employees had to return to work.”
In mid-March, Tiersky closed her office for almost all emergencies. She then helped arrange donations of Chicago Dental Society personal protective equipment to health professionals treating COVID-19 patients.
She opened in early June after buying air purifiers and stocking up on protective gear.
“We bend over to make sure our offices are ready and safe,” said Tiersky, who wears two masks when she sees patients.
Nickolette Karabush was one of the first Tiersky patients to return after breaking a tooth while eating popcorn. The 58-year-old resident of Highwood, Illinois has an autoimmune condition and has been at home since the COVID-19 hit.
“The thought of going to a dental office really scared me,” she said.
Karabush sat down after seeing everyone in Tiersky’s office wearing masks and no one else in the waiting room.
“Everything was very clean,” she said. “It felt like a very safe environment.”
Tiersky and other dentists have taken several precautions, such as removing waiting room sheets and asking patients about COVID-19 symptoms before receiving care.
Dr. Kirk Norbo has an employee stationed in the foyer of his dental practice in Purcellville, Virginia to take the temperature of visitors before entering the waiting room.
Then there is the equipment.
More of a “Star Wars look with the face shields and the mask and stuff and the dresses that many offices hadn’t used,” says Norbo, who remembers not even wearing gloves at the dental school decades ago.
Some practices charge an additional fee to cover the cost of that additional equipment. Neither Norbo nor Tiersky say they do this.
Dentists have also changed their practice. Coronavirus is primarily spread from person to person through airborne droplets when someone with an infection coughs, sneezes, or talks. Therefore, masks and social distance are encouraged.
Dental work requires tight spaces and can generate a saliva of water and saliva. Norbo and other dentists have returned to using hand tools for procedures such as cleaning teeth instead of tools that do the job faster but create more of that spray.
Norbo said a salary protection loan of about $ 250,000 helped him return and pay his staff until the company caught up after reopening its office in early May.
Exercises climb out of a large hole as they reopen. Personal spending on dental services declined 61% in April compared to the same month last year, according to nonprofit health research firm Altarum. That is double the decline in the entire healthcare sector.
It may take a while for all companies to return. Altarum economist Ani Turner noted that much dental care is discretionary and can be delayed, and patients will still be concerned about exposure to the virus.
“People tend to postpone procrastination about cleaning and maintenance anyway,” she said.
Norbo said those who have returned to his practice so far are happy to be back. He thinks the visits make people feel like they are “starting a normal life again”.
“It’s much more than just dentistry,” he said.
Follow Tom Murphy on Twitter: @thpmurphy
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