Practice Closures, Redundancies, Layoffs, Threats, Bullying, Salary Cuts

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We live exceptional times. We all live exceptional times, not just us dental professionals. But it might feel like we are alone in this, when the measures we must take are drastic and have huge impact on us.

At times like these, I would hope to see solidarity, compassion and charity amongst people more than ever before. The rich giving help to the poor. The healthy giving help to the sick. This is already happening to some extent.

I am happy to notice that the healthy are helping the sick – offering to do food shopping for them etc. But when it comes to finances, it seems to be so, that only the poor is giving help to the poor, giving out form the little they have even though they are also struggling. Is this how it should be?

Now would be the time for the rich to spend money, keep the small businesses running, help out the single parent families. A small deed might mean a world to someone.

How about in dentistry?

I recently asked dental professional tell me how the coronavirus have affected their practice. I also did some research on internet forums and facebook groups. It’s quite fragmented when it comes to the policies and procedures the dental practices have taken.

Most likely the trade unions are to blame. They have not provided adequate and prompt advice to their members. Matters around coronavirus have developed faster than the responses from professional bodies in different countries (BDA, ADA etc.)

This has forced the dentists to take the matters in their own hands. Some dentists have decided to close their practices for couple of weeks. Some have concentrated on seeing patients that need urgent treatment. Some have not done any changes.

Behind these decisions are many difficult questions. How about the supportive staff? Can they be allowed to work? What should be done, so that they are protected from the virus? Surgical or N95 masks? Full face visor or safety glasses? Are they taking their holiday leave if the practice closes. Or are they laid off with less money or no money at all?

And even more serious questions. How long will this epidemic last? Will my practice survive this? The bills keep on coming despite the circumstances.

These questions do not necessary have a right answer. Maybe that is why there has been both overreactions and underreactions.

Ugly side of our profession

I have written about dental practice’s hierarchy in my previous posts (part I, PartII, Part III) and how between different professions in dentistry there is not always equality. This whole business with coronavirus has raised again that questionable side of our profession where the dentists are deciding for the nurses in the matters of health.

There’s been downright threatening about nurses loosing their jobs if they didn’t comply with the dentists’ decisions to keep the practice open. There’s been bullying in a form of shouting (there should be no shouting at any workplace). Some dentist let the nurse take a time off but without any salary. The dentists themselves carry on working.

What I am afraid of is that our profession is not using this downfall to strengthen the teams they work in, but to increase the division between different dental professions. Now would be the time for solidarity, compassion and understanding. From everyone. But it cannot be one-sided.

Single-Use Masks

Some practices have found creative ways to guarantee that they won’t run out of face masks. Some have told they autoclave used masks that do not look soiled. Some have told they use the same mask all day long. Some think that surgical mask will protect you. Or wearing a surgical mask on top of the other will provide extra protection.

Thankfully all the above are just isolated cases and majority of the practices follow the standard of care we are supposed to. But just to remind everyone – single-use means single-use. The mask should be changed after each patient and disposed carefully. Used mask should not be autoclaved under any circumstances.

Some facts. Even though the surgical mask filters the airborne viruses, there is leakage from the sides of the mask when person wearing the mask inhales. So airborne viruses will enter through the sides. Therefore N95 masks are the only ones that provide close to 100% protection from the airborne viruses and all the dental staff should wear N95 masks when they perform treatments that produce aerosols (remember that even air-water syringe does that). Even if you are treating only seemingly healthy patients, you will never know if the patient has contracted the virus and not showing the symptoms yet. He is nevertheless spreading the virus already. That is why dental staff should wear at least N95 masks, full face visors, protective disposable coat and a hat for all procedures that produce aerosols.

Have look at this link, where the difference between the surgical mask and N95 mask is explained in detail.

We are in this together

It’s thankfully not all that gloomy. There are stories about practices pulling together. Doing the right thing. Everyone in consensus. That’s how it should be. If it isn’t, somebody is not listening. Somebody is using one’s power in nonconstructive way.

Money is important to everyone. To the dentists, the hygienist and the nurses. Money is probably the reason why different views collide. We all are worried about financial effect of the situation. Everyone should be prepared to downsize in life style to get over this difficult period. Owners of the practices will need to make difficult decisions over salaries. Hopefully these decision are made with solidarity and respect. I know stories of restaurants where they have started to provide take away food with delivery and all the revenue they make, goes towards the employee’s emergency fund.

If the owner or a dental practice has been wise and farsighted, he has put some money on side for emergencies. Hopefully this money covers the bills and if there’s any leftover, it is used to help the employees. By doing that, practice owners make sure their employees stay loyal to the practice and highly motivated towards the work after this difficult period has passed. Motivated and loyal staff is a great asset to the practice and the patients will notice the good vibe and spread the word. So by taking care of the employees financially, you are actually putting money into marketing. That if anything is a win-win situation.

Dental Practices – Tell Everyone How Coronavirus Affects You

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Dental professionals are in a high risk group of contracting the coronavirus due to the nature of their job. Many dental practices all over the world need to make changes to their way of working to slow down the spread of the coronavirus, to protect the patients and employees and to guarantee that they won’t run out of e.g. face masks in the next months to come.

I would like to know, what changes you have made in your work place and how the coronavirus has affected your practice.

I want to share your story. The story can be long or short. Only thing I would like you to include in your story is the country you are working (as I have readers in every continent). Only your story and the country will be published. Your story might help your colleague on the other side of the world. So please share your story!

You can use the contact form below to send your story or you can write an email and send it to dentalrevelations(a)

Continue reading “Dental Practices – Tell Everyone How Coronavirus Affects You”

The Reason Dentist Tilts You Upside Down

chair clean clinic dental care
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Don’t like when the dentist chair goes down? Well, you are not alone. When sitting on a dental chair and your dentist begins to tilt the chair down, you feel comfortable to the certain point. But when the seat keeps on going down after you think that surely it cannot go any further and you feel like you are going to slide off the chair, you clutch the chair handles (if there is any – mine doesn’t). You might state that you feel like you are upside down. You might ask the dentist to lift the chair more upward position, or to adjust the head rest so that you feel more comfortable.

Guess what we think at that point? Well, normally we might feel slightly annoyed because you might be the dentist’s fifteenth patient that day and her back and shoulders are aching from the difficult working positions. Nevertheless the dentist might lift the chair more upright. Some might not even tilt patients low enough in the first place to avoid complaint that we have heard gazillion times before.

Neither of these ways is good practice because these dentists and hygienists who are trying to fulfil patient’s every wish, risk their future as dental professionals. Keeping the patient chair in too upright position means that it is practically impossible to work ergonomically. Working ergonomically as often as possible guarantees that we will be working on our dream job (?) until we retire.

Of course there are patients that we need to leave upright position by default. These patient are e.g. heavily pregnant ladies, obese people, people with heart condition and elderly people. But the normal patients can be tilted to the position that is best for dental professionals posture. By normal I mean patients that are healthy or do not have severe medical conditions.

Request for the Patients

Next time you visit your dentist, make her happy by not saying anything about the position of the chair. They will not let you fall. Also you will get better quality of treatment when the dentist can see better to the difficult areas of you mouth. And you don’t need to swallow so much of water when the nurse is able to see the back of you mouth.

Advice for the Dental Professional

But what to do when a patient complains about the chair position? Well, the key to keeping patient happy is to be one step ahead of the game.

First thing you can do is to take the chair down gradually. Taking it all the way down in one go will most probably make your patient complain.

If I hear a complaint even though I’be been tilting the chair down slowly, I reassure the patient by saying

I know you feel like you are going to slide off the chair but so far no-one has. You will get used to the position soon. This position helps me to keep my posture and to see your upper teeth properly.

Patient is often fine during the treatment. When the session is over and I lift the chair up again, some patients state that they feel dizzy when getting up. Tell them to sit still and that there’s no hurry to leave the patient chair (well, you need to make the notes anyway, so it does not require extra time). It is best to sit still, well supported and wait for the things to settle.

If you face a difficult patient that insists to lift the chair more upright even though there is no medical reason for it, tell them that you will do so if the patients feels it is necessary but that you cannot guarantee the best possible result of e.g. scaling because you won’t be able to reach the upper back teeth in a right angle. And if you do still need to lift the chair too upright, it is best to stand up to be able to have as good posture as possible.

If It Really Is Your Dream Job – Important Tip for You

I’ve noticed that it is often the dentists and hygienists that have just graduated that too easily work in non-ergonomic way. It probably is because they still feel invincible. I know, because I did so too! Now having been on this profession for over 20 years and having had both of my shoulders operated (successfully!) due to work related conditions in both of them, I really need to focus on better posture with each patient. And still I get back ache almost every day. But I’m no longer in despair because I have found a cure for the back ache. So keep on reading because I’m going to share the best tip for keeping you going day after day, week after week, year after year in this profession.

I’ve known for a long time that there are these foam rollers that you can buy to exercise at home. Even my gym has had them for ages. But I never really knew how or why to use it until one day I tried one for my back. I placed it between the floor and my back, placed my hands on my shoulders (left hand to right shoulder and right hand to left shoulder) and by using my legs rolled the foam roller slowly up and down my spine like in the picture here. You can also find a good video of using the roller here.

This really keeps me going and I wonder why no-one has told me about it before!? That is why I’m telling you.

Before you start using the foam roller, there is one thing you need to keep in mind. My physiatrist emphasised that if you are going to use a roller, it needs to be a foam roller. Too hard roller will not be good for your spine.

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