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”

Climate Change and Dentistry

Dental Revelations Blog-18

The Climate Report in 2018 wasn’t much fun to read. In fact it was rather depressing and raised many worries over the future of our children and their children. We might even face a situation where many adults living today will face the consequences of polluting our Planet Earth. We’ve all seen the warning signs – natural disasters, unusual weather like long heatwaves in countries where it is normally mild weather, extreme dryness causing crops to die just to name few.

Despite the fact that the report was worrying and depressing, I hope that all of you have read it. Hiding your head in the sand will not make it go away or change the fact that it is going to affect you as well.

We should all participate in saving the Planet Earth. Participating in saving ourselves and our children. That can be done by thinking what changes you can do in your everyday life to help in this cause. There are plenty of choices we make every day that can make a difference to the world’s future.

You can choose a product in the food store that use minimum amount of packing. For example choose muesli which has simple paper bag packaging and which is locally produced (or in your home country). Choose fruits and vegetables that have simple packaging or no packaging at all (there are re-usable fruit bags available).

Choose local fruits and vegetables or the ones that are not shipped from the other side of the world.

Reduce the amount of red meat in your diet or become a vegetarian (I’m not vegetarian but I have almost stopped eating red meat) ‘cos plant-based diet it is far more environmentally friendly than meat-based diet. Think about how large area of fields are needed to herd livestock and to grow food for them when these areas could be used for growing plant based food for humans or for growing trees that help the Planet to get rid of the carbon dioxide – it is a gas that is the largest contributor to the climate change.

Also, once you’ve done your environmentally friendly food shopping, do not use plastic bags to pack your stuff. Instead take a re-usable bags with you when you go food shopping. And why not use them the with all your shopping? Do we really need to tell everyone that we’ve been shopping at Harrods or Louis Vuitton? When the climate change reaches the point that our lives are at risk, these status symbols have very little meaning. So have one re-usable bag always tucked inside your LV hand bag, car, rucksack or pocket.

There are plenty of things we can do differently as long as we think we can make a difference. If everyone would think that it makes no difference if you buy these passion fruits that are shipped from the other side of the world or that it makes no difference if you recycle or not, we are doomed.

Together we can make a difference and you can change the way you do things in every aspects of your life, including your professional life. Personally speaking, I have noticed that I feel more and more guilty over the fact that dentistry is so very environmentally unfriendly.

Single-use materials

We produce massive amounts of waste every day. We have many disposable materials that we throw away after each patient. Many of the disposable materials are made of plastic. There’s no way going around it as disposable, single-use materials are the best option when it comes to cross infection control.


Also, have you ever thought about how much water we use everyday? We wash our hands many times a day. Our rotary instruments require water, our instrument maintenance cycle requires water, our aspiration system loooves water (this is how one maintenance guy for the dental units expressed it) so we suck water into it in the morning, between every patient and in the evening. Well, at least this is how it should be done to prevent the backflow.

Backflow means bacteria and viruses travel towards the patient inside the suction tube. When patients close their mouth and form a seal around the tip of the saliva ejector, a partial vacuum occurs. Blood, viruses, saliva, bacteria, debris might travel as far as into the patient’s mouth. If you don’t believe me, read this. This of course means the patients should not close their mouths around the suction.

I have tried to change my way of using water by closing the tap (with my elbow) while I rub my hands together with soap – you know this should last 15 seconds for the soap to kill e.g. norovirus that is causing Winter Vomiting Disease. In that 15 seconds lots of water is wasted if you keep the tap on. The surgery should have taps that are easily operated without using fingers – the tap should be long enough (medical tap) for you to be able also open it with you elbow. There are also sensor-operated taps that will stop the water flow when hands are moved away from the tap.


We use many different chemicals that are bad for the environment. There’s no way going around this one either. Unless the manufacturers are trying to develop chemicals for disinfection that are more environmentally friendly.

Oral Hygiene Recommendations

On top of everything else we recommend products to our patients that are made of plastic. That’s why the wooden triangle-shaped tooth pick has become a product I recommend more and more (I have written about it in one of my previous posts). Of course it’s not suitable for all the patients, but for those that it is, it will make a difference in the amount of plastic waste.


There are not many things we can change in practising dentistry. But even the smallest changes matter. So please everyone, think about what change you can make and challenge your colleagues and friends to participate in saving the Planet.

Lets make it a norm rather than an exception to re-cycle and to live sustainable life.

Lets do it for our children.

Dental Revelations Blog-17