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Upcoming October webinars on Provider Tools

Learn the tips and tricks to speed up your mastery of Provider tools! This October, sign up for a few webinars that show the best ways of using Provider Tools. The webinars will also show you how you can talk to your patients about safely returning to the dentist and answer any additional questions you might have about reopening your practice.

Attend a Provider Tools webinar to learn:

• How to use Provider Tools to manage your patients
• How to talk to your patients about teledentistry and safe in-office visits
• Where to find resources and information about re-opening your practice
• And more!

Don’t miss out — register today!

Get assistance communicating with patients who don’t speak English

Do you have patients who speak languages you don’t? Whether your patients don’t speak the same languages as you and your staff, or if they’re just most comfortable speaking in their native tongue, being able to successfully communicate is essential in delivering the care your patients need and deserve.

Fortunately, that doesn’t mean you have to take the time to learn a whole new language (although doing so is certainly a worthwhile endeavor!). Delta Dental offers interpreters via telephone, on-site interpretation services and more through our Language Assistance Program (LAP).

LAP is here to help

Delta Dental’s Language Assistance Program is an invaluable tool when it comes to communicating with patients who may not share any languages with you or your staff. LAP is available free of charge to all Delta Dental enrollees and includes the following benefits. We strongly encourage you to refer your patients to the LAP page on our website.

• Customer Service phone assistance in over 170 languages
• Professional interpretive services, including in-person interpretation
• Written materials in non-English languages (and accessible formats)
• And more!

Providing care to Spanish speakers

Did you know that, after English, Spanish is the most commonly reported language spoken by Delta Dental enrollees? More than any other language, a non-English-speaking patient of yours is likely to speak Spanish. That’s why we’ve put together extra resources to help you communicate with these patients.

• The Delta Dental website is available in Spanish is available in Spanish
• We’ve even got an English-to-Spanish phrase book!

Steps you can take to boost your skills

There are steps you and your staff can take to make communication easier and to create a more welcoming environment for your patients. We recommend these strategies:

• Attend classes and continuing education courses that address the social customs among your patients’ different cultures.
• Document your practice’s protocols for working with cultural differences and make sure all of your staff are familiar with it.
• Allow time to make sure that your patients understand you and the care you recommend for them. Be ready to answer questions and don’t be afraid to ask some of your own.
• Familiarize yourself with professional interpretive services and resources available in your community to assist your patients.
• And finally, ask your patients and their accompanying relatives and friends how you can create a more comfortable environment.

Reopening: A success story from Modesto, California

The coronavirus pandemic has been difficult for everyone, but it has been particularly tough on the dental industry. In mid-April of this year, for instance, almost 95% of dental practices reported being either closed completely or open only for emergency patients, according to an American Dental Association (ADA) survey. Most practices reported that their practice volumes were less than 5% of usual, and collections were also down dramatically.

While the pandemic continues, many practices have been able to reopen successfully. And their patients are returning. But reopening hasn’t been without its struggles.

Dr. Ray R. Rodig, DDS, owner of the Vintage Dental practice in Modesto, California, talks about the process of reopening, some of the challenges — both expected and unexpected — and offers some tips and best practices for others in the same situation.

For how long was your practice closed?

Almost 11 weeks.

When did you reopen?

Why did you decide upon that date?

We had done all of our research into what would keep our patients and team members healthy and safe at the office. We had a couple of “practice runs” the week before to work out our new patient flow to make sure it was workable, safe, complete and comfortable for patients and team alike. While hard to get, we had all the PPE we needed, our air purifiers and sneeze guards were in place — we were ready to go back to work, and the ADA said it was safe.

What challenges did you face initially?

The fear and uncertainty of both patients and team members — some patients are still not comfortable returning and have appointed out into November and December. There’s also a balancing act with moving our patients through the office, making sure there’s no “traffic jams” — no one coming in contact with each other in the office. And finding and ordering PPE was very difficult. Thank goodness for our local Stanislaus Dental Society! They really helped and kept us in the loop.

Which was the most difficult to address?

Some people — very few — are just put off by having to wear masks. We explain that they’ll only need them entering and leaving the office and that we’ll even provide them, but some folks just don’t want to accept this. We’re patient and understand completely, but we just need to keep everyone safe. No exceptions.

Did you encounter any challenges that you weren’t expecting or that surprised you?

The heat and stress of wearing the extra PPE really surprised us. Just breathing takes so much more energy — learning to breathe with N95s, wearing both scrubs and full-length gowns together. It creates a lot of heat and stress that we didn’t even think about before we started back.

Which challenges have been resolved and which are ongoing?

The biggest challenge we seem to have is letting our operatories sit empty for five minutes. We need a bit more time to turn over the operatories now, which creates a scheduling issue. We’ve resolved this by revamping the schedule, but it continues to evolve daily, as no day is ever the same, and turning over the operatories and taking the extra time to complete a thorough sterilization is a challenge.

I’d also say closing our reception area has been a real process. It’s yet another scheduling issue involving the flow through the office, but our patients understand what we’re doing and why, so it’s really become a non-issue.

And we’re getting used to the hot PPE, but I’m sure hoping this doesn’t become the “new normal.” It’s sure hard to visit with our patients now.

How did your staff react to returning to work? Did any refuse?

Thankfully, our team was ready to come back to work — not one person refused. Some voiced safety concerns in our team Zoom calls prior to reopening, but we answered their concerns, and everyone came back.

What additional precautions have you had to take in your office?

We closed our reception area, and our patients must call and wait in their cars for their appointments — this was very odd for us since we like to visit with our patients, but they seem to understand. We also don’t allow extra persons to come with them unless they have appointments, too. All patients need to answer a series of questions, sanitize their hands and have their temperature taken before we’ll take them to their operatory. Temperatures of all team members are taken as they enter and as they leave each day.

Our team members in the back office wear two masks (one being an N95), a face shield, scrubs and a full-length surgical gown, and most like to wear bouffant caps. Before COVID, we only wore level 3 masks, face shields and lab coats.

We have limited the use of the cavitron, and have external vacuum machines to help suction any aerosols away while in treatment or hygiene; we use Isolites as well.

Our front team wears masks and are stationed behind large sneeze guards, and they’re constantly sanitizing all pens, files, countertops, etc. There’s hand sanitizer everywhere. The office is fogged daily, and we have air purifiers in every operatory.

Additionally, we started using a COVID-19 testing program weeks ago through Pathnostic. We have kits on hand, and if someone isn’t feeling well, has a cough or fever, or has come in contact with someone they think (or know) has been ill or had COVID-19, we have kits in the office that are simple to use, comfortable, and we get results back in a couple of days.

I highly recommend these for safety and peace of mind, and they’re not scary, painful tests. There’s no cost to the office or the person being tested. We’ve tested team members, family members, friends, patients — and everyone is surprised at how easy they are to do, and how fast we get the results back. It’s comforting to know we can find out quickly if there’s a problem.

Have you had to discontinue use of certain equipment or purchase new equipment?

We have limited the use of cavitrons — the hygienists have external suction machines to limit aerosols in addition to air purifiers in their operatories, so we leave it up to the hygienists to decide whether to use it. As far as equipment is concerned, we have really only purchased air purifiers for each operatory and a fogger we use daily at this point. Our office has always been very sterile and safe, so we didn’t have to change or add much.

What kinds of additional expenses have you faced as a result?

The professional installation of sneeze guards was a bit pricey but certainly necessary, and the cost of PPE went through the roof — that’s quite an expense right there.

How do ask your patients to prepare for a visit?

Our front office will call our patients the day prior to their appointment and ask all the same questions that we will ask when they arrive for their appointment. We don’t want them to show up and not be able to see them due to travel, or fever, or coming in contact with someone who may be sick. We ask that they wear a mask, arrive at the time of their appointment, call us from their car when they arrive, and we call them back to let them know when to come inside.

What do ask your patients to do when they arrive?

Our reception area is locked; when they call to let us know they’ve arrived, we let them know that we will call them back when they can enter. Once their assistant or hygienist is ready, we call and ask them to come on in. Our team opens the door, so patients don’t have to touch the door handle.

How have your patients responded?

Some have been a bit confused at first, but 99.99% of our patients are happy we’re working hard to keep them safe and healthy. The .01% that are unhappy about wearing masks are still appreciative of our efforts. Some are pretty amazed at all the precautions we take and have taken some of our ideas to implement in their homes.

Have your patients had any concerns? How have you addressed them?

Their concerns seem to center around safety. Once we walk them through the process over the phone, they understand that each patient is carefully screened and put through the same process they’re going through, as well as our team members. Most are confident by the time they get here and are definitely confident when they leave.

What is your current situation in terms of patient volume? Collections?

We were very surprised at how busy we were right from time we reopened and we’ve continued to stay busy — new patients, patients coming back for treatment diagnosed prior to closure, past patients with new treatment needs — people seem to be excited to be able to get back to keeping their teeth healthy. Our collections have exceeded our expectations, as has the patient attendance. We were pleasantly surprised.

How has this changed since you initially opened?

Our patient flow is much more of a rhythm now — at first it was disconcerting implementing all the new steps, but now it’s a habit and much easier. I’m also blessed with a great team and great patients.

What advice do you have for other dentists in a similar situation?

I’d say everything can be really overwhelming at first, but as the old saying goes, “How do you eat an elephant? One bite at a time.” Do your research, figure out what works best for you and your team, find out what is working for other professionals in your local dental community and emulate them.

We thought it would be very hard to reopen, and while it seemed very challenging at the beginning, it became easier sooner than we anticipated. And let your patients know what you’re doing to keep them safe — they’ll appreciate that.

Is there anything you’d caution other dentists about or recommend that they look out for?

I’d make sure that your team knows how important it is to everyone that they practice social distancing in the office.

We protect ourselves from our patients, but once the PPE comes off and we’re with our “office family” we can’t forget that we need to keep our distance from each other. This isn’t the easiest thing to do — we have staggered lunches, plenty of room in our breakroom and wear masks when not eating.

And remind your team about social distancing and wearing masks away from the office. We need to protect each other.

Dentist spotlight: Dr. Marc A. Cirelli

Meet Dr. Marc A. Cirelli, DMD, our Dental Health Partner of the Month. Dr. Cirelli is a Reno, Nevada-based dentist whose passion for carpentry and home improvement seamlessly blend with a compassionate approach to helping veterans with dental care, free of charge.

Why did you become a dentist?

I majored in biochemistry, Spanish and history while in college. I found that I really liked dealing with people more than laboratory work. I was also fortunate that my parents owned rental properties. I quickly learned how to become proficient in all of the trades with respect to home improvement. I especially liked framing and other areas of carpentry work. It turns out dentistry is a lot like being a carpenter, but there is still an artistic approach to it.

How long have you been practicing dentistry?

I’ve been practicing dentistry since 2007, graduating from Oregon Health and Science University. When I returned to my home state of Nevada, I worked for three years in a public dental clinic, followed by two years as an associate in private practice. I then purchased my dental practice in December 2012.

What are some of the challenges facing dentistry?

Getting people to recognize the importance of oral health and how it affects other systems of the body is one of the greatest challenges facing dentistry today. I like to use the analogy of a person with severe acne. You see the effects it does to your skin, and you want to clear it up, so you go to a dermatologist. With an oral cavity, people aren’t aware of what happens in the mouth, so they don’t see a dentist until they have a toothache.

We take intraoral photos in an effort to educate patients about the importance of regular dental care. This has been a great motivator for better hygiene and preventive treatment.

What do you do in your spare time?

In my free time, I enjoy running, hiking, skiing, target shooting, martial arts and, of course, home improvement projects.

Tell us one of your funniest stories from the dental office.

As every dentist knows, esthetic cases can be the most challenging. You not only have to meet the patient’s desires but those of their significant other.

In one such case, the patient was in the office for a complete maxillary denture. Esthetics were great: The patient liked the shape, size, form and, most importantly, function of the denture. He’d even provided us with a picture from before he lost his teeth.

We ended up meeting the demands of the patient, but his wife had us redo the denture to meet her demands. She wanted him restored into her ideal husband! I still remember going through the wax try-in and he gave me a look that said, “I like the first, but I need to satisfy her, so go with the second!”

What is most rewarding about your career?

Seeing the results of your work and how it changes a person. Our office works with a program called Adopt a Vet. Since most veterans are not eligible for treatment through the VA, we see veterans on a volunteer basis and do all of their treatment at no charge. They come to the office in pain, and some can’t even chew. We get them out of pain and restore their dentition, often completing dentures so that they can smile and enjoy a good meal again. To me, that’s what dentistry is about.

We’d like to take a moment to congratulate Dr. Cirelli and thank him for the work he does for his community.

To find out more about Dr. Cirelli, visit cirellifamilydentistry.com or check out his Facebook page. You can also learn more about the Nevada Adopt a Vet program.

5 tips for PPE use during COVID-19

With COVID-19 still affecting many communities, the continued health and safety of you, your employees and your patients is of paramount importance. And when it comes to avoiding COVID-19 in the workplace, that means proper usage of protective personal equipment (PPE).

1. Make sure you have the right PPE

The American Dental Association released an interim guidance form that recommends dentists wear a respirator with both goggles and a transparent face shield in addition to gloves and full coverings on exposed skin.

As always, make sure your wear appropriate protection for the level of risk. Check the ADA hazard assessment checklist (an ADA member login is required) and choose your defenses wisely.

The ADA recommends two types of respirators for COVID-19: N95 and N95 equivalents (KN/KP95, PFF2, P2, DS/DL2, Korean Special 1st). If you’re having a hard time finding N95 masks, the FDA put out a list of approved manufacturers of N95-equivalent masks. The Centers for Disease Control and Prevention recommend N95, an N95 equivalent or higher for any aerosol-generating dental procedures.

2. Know the right order for PPE

Take care to follow the proper PPE sequence, according to the Centers for Disease Control and Prevention. PPE should be put on in the following order:

1. Gowns should cover your torso from neck to knees and wrists. Tie behind the neck and waist to secure.
2. Mask/respirators should be secured to the back of the neck and center of head. Flex band should mold around the nose, and the bottom should be below the chin.
3. Goggles/face shields are pretty simple. Cover face and eyes, making sure they fit.
4. Gloves should go over the wrists of your gown. Rolling them farther up the arm will aid in taking them off safely later.

When you finish, carefully remove all PPE before exiting the patient’s room, only removing your respirator after leaving the patient room and closing the door.

3. Watch out for dry mouth

Wearing masks for extended periods of time can also lead to increased mouth respiration, followed by dry mouth and a resulting increased risk of caries. Use the CAMBRA risk assessment protocol, and check your salivary pH levels with pH strips to make sure your mouth stays protected from more than just COVID-19.

4. Don’t reuse PPE

While the CDC has relaxed some guidelines on mask reuse, please don’t reuse PPE. Single-use items are not designed for extended and repeated use. Cleaning and reusing items not designed for either could lead to damaged items that no longer offer their full protection.

5. Get your reimbursement when you treat Delta Dental enrollees

Delta Dental is offering a supplemental reimbursement program to help alleviate the additional pandemic costs for each qualifying evaluation or consultation code. PPE and infection costs cannot be passed along to your patients.

To stay up to date on the latest announcements, be sure to subscribe for FYI email notifications.

How to talk to patients about returning to your office

As a dentist, you know that regular office visits are essential for your patients’ oral health, but your patients might have questions and concerns during the COVID-19 pandemic. According to the American Dental Association, 98% of dental practices are open for business, but less than 50% are seeing the same number of patients as before the pandemic.

The ADA has also found that most people are ready to return to their dentist’s office (although some of them may need assurances that they’ll be safe) even if there are COVID-19 cases locally, and that the Centers for Disease Control and Prevention and the ADA are the two most trusted sources of information about whether or not it’s safe to go to the dentist. With all of that in mind, here are some tips on how to get patients back in the office, reassure them of their safety and keep them coming back.

1. Put new safety procedures and practices in place

Reassuring your patients of their safety is an essential first step in encouraging them to return. Dentists’ offices have long been kept meticulously clean to prevent the spread of bloodborne illnesses. The spread of COVID-19, though, has required new practices to address potential infection through saliva droplets. Highlighting these new practices is an excellent opportunity to make your patients feel safer.

For example, these practices may be worth implementing:

• Have patients wait for their appointments inside their cars rather than inside your waiting room, even if you have the space for them to socially distance.
• Put up a clear plastic screen between the front desk and the waiting area. This helps to prevent a stray cough or sneeze from spreading saliva droplets when patients are checking in or paying their bill.
• Install equipment that helps remove germs from the office, such as medical-grade air purifiers.
• Check patients’ temperature with an infrared thermometer upon their arrival. You’ll want to use a thermometer especially made for use as a wellness device (infrared thermometers that aren’t explicitly made for medical use may be inaccurate when used on the human body.)
• Have patients do their part, too, such as by performing a peroxide rinse before getting into the chair.

2. Effectively communicate with and listen to your patients

One of the biggest contributors to feelings of fear and uncertainty is a lack of reliable information from a trusted source. When it comes to their oral health, you are your patients’ primary subject matter expert. Explain not just what changes you’re instituting at the office to keep patients safe, but also why you’re making those changes and how they keep patients safe.

It’s important to create opportunities to interact with your patients so that you can keep them informed of the latest changes and persuade them to return when they’re ready. The ADA has found that patients prefer to be communicated with via email, text and phone, in that order.

If you’re using software to communicate with your patients via email or text, let them know:

• Your office is open for business
• You’re following new procedures to ensure everyone’s safety
• You’re available to talk if they have questions or concerns (offering teledentistry appointments is a great way to interact directly with your patients!)

If you’d rather emphasize a human touch, you could have office staff directly call your patients to remind them not to forget check-ups and see if there’s anything your office can do for them.

Also, don’t forget to be an active listener. If you ask your patients their concerns, make sure you indicate that you’re listening attentively and taking their words under consideration.

3. Think outside the box

Finally, when it comes to persuading patients to return and attracting new patients, don’t be afraid to think outside the box! Encourage patients to leave reviews and feedback on social media. A positive review and a description of safety protocols on Yelp or Google can go a long way towards assuring would-be patients that your office is a safe environment.

Similarly, consider updating your practice’s website if you haven’t done so recently. Adding customer testimonials is a good idea, and you can also add photos that highlight changes throughout your office. If you’re feeling especially ambitious, you could also create a video walkthrough of your practice to serve as a virtual tour of the office! Or, add videos that highlight new safety practices and equipment you’ve implemented, such as peroxide rinses or medical-grade air purifiers.

We also suggest updating your current office hours in Provider Tools to help your patients access care in your office. Patients often use the dentist directory when looking for contact information, so making sure that your information is up to date and that it matches the info available in other locations (such as your website or Yelp) can help eliminate confusion. Fortunately, logging in to your profile in our Provider Tools and update your office hours is simple!

The ADA’s Health Policy Institute has also found that nearly three out of four people who visited the dentist in 2019 would be comfortable returning right now. Another 11% would be willing to return to the dentist if they had some kind of assurance that their visit would be safe while the remaining 15% are waiting for a vaccine. That means that if you’re seeing fewer than 85% of the patients you were before the pandemic, you might be able to bring more back to your practice. Follow the steps above, and you might get the extra bump in business you need to make the new normal a little more like the old one.