September/October 2020

Cover Story: Tarek Aly | Great changes, great opportunity

Best Practice: Developing a PPO Participation Strategy

Dental Growth Model: How to take your dental group organization from fragile to unshakeable.

DEO Case Study: Timber Dental – How discarding more traditional models for growth and rethinking their approach to the business side of dentistry has led to success for one dental group practice in the Pacific Northwest.

Safest Dental VisitTM: OSAP Announces New Board of Directors

Infection Control: Universal Source Control – What does it mean for dentistry? 

Sponsored : Align Technology | Utilizing the iTero Element intraoral scanner across the entire practice

Equipment: Post-Pandemic Equipment Planning – Teledentistry, patient communication software may be at top of the list

Leadership: Facing Down Fear – How to quiet fear and step into the boldest version of you 

Trends: ADA to WHO | Dentistry is Essential

Health news and notes

Windshield Time: Automotive-related news

Quick Bytes: Technology news

Dental News

Dental News

Cantel Medical names Peter Clifford as President and COO

Cantel Medical Corp. (Little Falls, NJ) announced that Peter Clifford, currently EVP and COO, was promoted to president and COO. Clifford’s primary responsibilities will include continued oversight of Cantel’s overall business operations, close partnership with divisional and regional leaders to drive commercial results and the implementation and success of Cantel2.0. Clifford previously served as Cantel’s EVP and COO, and prior to that over 4 years as EVP and CFO. Prior to joining Cantel, he served as VP of Operations, Finance, and Information Technology of IDEX Corporation, and held various senior financial positions for General Electric.  Clifford will continue to report to George Fotiades, CEO, and be based in Little Falls.

Smile Brands receives multiple of Comparably’s Best of 2020 Awards

Smile Brands Inc. announced that the company and its CEO Steven Bilt were recognized for leadership across multiple categories in Comparably’s Best of 2020 awards. The organization was honored as a place where leaders inspire, encourage, and support diverse voices and contributions. Bilt was highly ranked in the list of Top Large Company CEOs for Diversity and Women and the organization was honored for professional development and leadership. To determine the list, Comparably analyzed anonymous survey feedback from employees working across 60,000 U.S. companies large and small. The ranking is based solely on sentiment ratings given by these employees, from how they rate their CEOs to other workplace culture factors that inspire trust in their employers.

Delta Dental foundation awards $40K in grants to Del. Nonprofits

The Delta Dental Community Care Foundation has given grants totaling $40,000 to three organizations in Delaware to provide relief amid the COVID-19 pandemic. Delta Dental says that the unrestricted grants were “intended to help the foundation’s nonprofit partners continue to provide vital services to the most vulnerable members of their communities.” Organizations that received funding include: Hope Medical Clinic in Dover, La Red Health Center in Georgetown, and Ministry of Caring in Wilmington. The grants in Delaware are only a fraction of the Delta Dental Community Care Foundation response. In total, the Foundation has given roughly $11 million to more than 250 organizations across 15 states and Washington, D.C. and plans to make an additional several million in funding available in the coming months to respond to emerging needs as the pandemic continues.

Windshield Time: Automotive-related news

Car-buying tools

Buying a vehicle has long required in-person communication, often followed by a request to fill out a customer survey a few miles long. Over the past few months, Volkswagen has tackled both of those challenges amid a pandemic with two new tools. Volkswagen of America and VW Credit have worked with CDK Global, Inc. to launch Sign Anywhere, a digital signature tool that’s among the first of its kind in the U.S. auto industry, according to the auto manufacturer, allowing vehicle buyers to finish their financial paperwork with a participating dealer without having to visit the dealership.

The other step is a new system of customer surveys that ditches a long list of multiple-choice questions for a few open-ended questions that gives customers the power to give detailed feedback and post their review to VW.com and the dealer’s website.

The Sign Anywhere tool developed by CDK Global allows customers to remotely and securely digitally sign financial documents with their own computer or mobile device. While digital signatures are common in many industries, many laws and state regulations governing financial documents in vehicle buying have usually required in-person or “wet” signatures.

Volkswagen began planning to roll out this tool two years ago, but the COVID-19 pandemic sped up the deployment, and more than 400 Volkswagen dealers now have access in states where laws allow it.

“Customers are asking for flexibility and looking for peace of mind especially during this time, and Sign Anywhere helps provide that.” said Anthony Bandmann, President and CEO of VW Credit, Inc. “Planning to implement this technology began two years ago but since this pandemic took hold, we’ve accelerated our plan to make this a permanent tool for our dealers.”

Mazda, Toyota partner in U.S. manufacturing technologies

Mazda Toyota Manufacturing, (MTM), a new joint-venture between Mazda Motor Corporation and Toyota Motor Corporation, recently announced an additional $830 million investment to incorporate more cutting-edge manufacturing technologies to its production lines and provide enhanced training to its workforce of up to 4,000 employees.

Total funding contributed to the development of the state-of-the-art facility is now $2.311 billion, up from the $1.6 billion originally announced in 2018. The investment reaffirms Mazda and Toyota’s commitment to produce the highest-quality products at the facility, according to a release. It also accommodates production line enhancements made to improve manufacturing processes supporting the Mazda vehicle and design changes to the yet to be announced Toyota SUV that will both be produced at the plant. The new facility will have the capacity to produce up to 150,000 units of a future Mazda crossover vehicle and up to 150,000 units of the Toyota SUV each year. MTM continues to target up to 4,000 new jobs and has hired approximately 600 employees to date, with plans to resume accepting applications for production positions later in 2020.

“Toyota’s presence in Alabama continues to build excitement about future opportunities that lie ahead, both for our economy and for the residents of our great state,” Alabama Governor Kay Ivey said. “Mazda and Toyota’s increased commitment to the development of this manufacturing plant reiterates their belief in the future of manufacturing in America and the potential for the state of Alabama to be an economic leader in the wake of unprecedented economic change.”

“Mazda Toyota Manufacturing is proud to call Alabama home. Through strong support from our state and local partners, we have been able to further incorporate cutting-edge manufacturing technologies, provide world-class training for team members and develop the highest quality production processes,” Mark Brazeal, VP of Administration at MTM said. “As we prepare for the start of production next year, we look forward to developing our future workforce and serving as a hometown company for many years to come.”

Hyundai launches new Elantra N Line sedan

Hyundai Motor Company announced the launch of the new Elantra N Line in August. The new model is designed and engineered to deliver more enhanced driving fun to the bold new Elantra that launched in April. The N Line model, characterized by N specific design and performance-enhancing elements, offers an attractive entry point to the Hyundai’s high-performance N Brand lineup and will expand Elantra’s appeal to a broader range of customers.

Elantra N Line delivers a spirited driving experience, powered by a 1.6-liter GDI turbocharged engine with six-speed manual or seven-speed Double Clutch Transmission (DCT) that produces up to 201 horsepower and 195 lb-ft torque. Hyundai engineers implemented several mechanical improvements to Elantra’s suspension to increase stiffness for a gripping performance, aided by 18-inch alloy wheels, multi-link independent rear suspension and larger front brake rotors.

Driver-oriented features, such as paddle shifters and Drive Mode Selector system, enable a racing-inspired experience behind the wheel. Interior design elements, including a leather-wrapped perforated N steering wheel with metallic spokes, N sport seats with leather bolsters, gearshift with metal accents and leather inserts, and alloy pedals, complement Elantra’s sporty exterior styling.

Infection Control Universal Source Control

By Katherine Schrubbe,  RDH, BS, M.Ed, PhD

What does it mean for dentistry? 

When was the last time you learned a new word, term, or phrase? As adults, dental clinicians, and science-based individuals, there is likely a set of favorite verbiage you use in daily conversation with family or friends, and another set you use in the clinical dental setting with colleagues, team members, and patients. It has been a long time since there was a new term introduced to dentistry, but with the onset of SARS-CoV-2 and COVID-19 disease, Universal Source Control is a need-to-know essential medical term and its implementation is critical to mitigate the spread of SARS-CoV-2 in dental settings and as a global pandemic. 

What it isn’t…

Although some may assume so, universal source control is not synonymous with universal precautions. On Dec. 6, 1991, the Occupational Safety and Health Administration (OSHA) promulgated the Bloodborne Pathogens (BBP) standard; designed to protect workers from the risk of exposure to bloodborne pathogens, such as the Human Immunodeficiency Virus (HIV) and the Hepatitis B Virus (HBV).1 The BBP standard introduced the term universal precautions, which is an approach to infection control where all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other bloodborne pathogens.2 Justification for this concept is based on the inability to easily identify patients who may be infected with HIV, HBV or Hepatitis C (HCV)3; but this is not what universal source control is all about. 

In 1996, the Centers for Disease Control and Prevention (CDC) introduced the term Standard Precautions by blending major features of universal precautions and body substance isolation practices to be used with all patients at all times; this included three transmission-based precaution categories: airborne, droplet, and contact.4 Standard precautions apply not just to contact with blood but also to 1) all body fluids, secretions, and excretions (except sweat) regardless if they contain blood, 2) nonintact skin and 3) mucous membranes3; but this is not what universal source control is all about either.

Universal source control

What does this new term have to do with the current SARS-CoV-2 pandemic? The most up-to-date Interim Infection Prevention and Control Guidance for Dental Settings During the Coronavirus Disease 2019 (COVID-19) Pandemic was on Aug. 28, 2020 and lists universal source control as a key concept.5 Universal source control refers to use of cloth face coverings or face masks to cover a person’s mouth and nose to prevent spread of respiratory secretions when they are talking, sneezing, or coughing. Because of the potential for asymptomatic and pre-symptomatic transmission, source control measures are recommended for everyone in a healthcare facility, even if they do not have symptoms of COVID-19.5,6

As an integral part of the healthcare team, dental health care personnel (DHCP) have been wearing face masks and other appropriate personal protective equipment (PPE) for many years, and especially since the BBP standard.2 In training and education program, DHCP are taught to practice under the premise that any patient in the chair is potentially infectious – it is one of the practices they do best – wear PPE appropriately and consistently. So, what is different now? 

CDC Dental Guidance

As a key concept for DHCP during this COVID-19 pandemic, the CDC states that DHCP should wear a face mask or cloth face covering at all times while they are in the dental setting, including in breakrooms or other spaces where they might encounter co-workers. This is a change for all DHCP who are used to donning PPE primarily for patient care, however the CDC provides distinct directives for this new practice in dental settings:5

  • When available, surgical masks are preferred over cloth face coverings for DHCP; surgical masks offer both source control and protection for the wearer against exposure to splashes and sprays of infectious material from others,
  • Cloth face coverings should NOT be worn instead of a respirator or facemask if more than source control is required, as cloth face coverings are not PPE,
  • Respirators with an exhalation valve are not currently recommended for source control, as they allow unfiltered exhaled breath to escape. If only a respirator with an exhalation valve is available and source control is needed, the exhalation valve should be covered with a facemask that does not interfere with the respirator fit,
  • Some DHCP whose job duties do not require PPE (such as clerical personnel) may continue to wear their cloth face covering for source control while in the dental setting,
  • Other DHCP (such as dentists, dental hygienists, dental assistants) may wear their cloth face covering when they are not engaged in direct patient care activities, and then switch to a respirator or a surgical mask when PPE is required,
  • DHCP should remove their respirator or surgical mask, perform hand hygiene, and put on their cloth face covering when leaving the facility at the end of their shift.5

Included in this new practice of universal source control is the dental patient, who will now need to be informed and educated on the rationale for wearing a face coverings or mask to and from their appointment. The CDC along with the American Dental Association (ADA) outlines the new protocol for patients stating patients and visitors should ideally, wear their own cloth facemask covering (if tolerated) upon arrival to and throughout their stay in the facility. If they do not have a facemask covering, they should be offered a facemask or cloth face covering, as supplies allow.5

  • Patients may remove their cloth facemask covering when in their rooms or patient care area but should put it back on when leaving at the end of the dental treatment,
  • Facemasks and cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or anyone who is unconscious, incapacitated or otherwise unable to remove the mask without assistance.5,7

Anecdotally, there are stories and social media posts of patients, as well as DHCP who do not feel that following the protocol of universal source control is important, however, at this time, the CDC, ADA and other safety organizations such as the National Institute for Occupational Safety and Health (NIOSH) have set this guidance as a best practice to minimize the spread of the SARS-CoV-2 respiratory virus.5,7,8

Respiratory protection vs. source control

As stated, for a DHCP, donning a surgical facemask (or respirator) for the purpose of respiratory protection during patient care is second nature, but this is different than source control. Respiratory protection protects the wearer and refers to respirators, which are protective devices that cover a person’s nose and mouth or the entire face or head to help reduce the wearer’s exposure from breathing in air that contains contaminants, such as small respiratory droplets from a person who has COVID-19. This type of protection can include filtering facepiece respirators (FFRs), like N95 respirators.8

Source control protects others and refers to the use of masks to cover a person’s mouth and nose and to help reduce the spread of large droplets to others when the person talks, sneezes, or coughs which can help reduce the spread of SARS-CoV-2 by someone who is infected but does not know it.8 For DHCP, this means a face covering even when they are not involved in any patient care activities.

According to NIOSH, the purpose of wearing masks is to help reduce the spread of COVID-19 by reducing the spread of the virus through respiratory droplets from asymptomatic individuals and is recommended as a barrier to help prevent large respiratory droplets from traveling into the air and onto other people when the person wearing the mask coughs, sneezes, talks, or raises their voice.8  Studies show that masks help reduce the spray of droplets when worn over the nose and mouth.9,10 Together with social distancing, masks are most likely to reduce the spread of COVID-19 when they are widely used by people in public settings.8 

Why is universal source control important in the dental setting?

Providing safe dental care and maintaining team health and safety is an ongoing challenge each day in the dental setting, but nothing compared to carrying out these daily activities during a pandemic. DHCP and patients must learn and implement new protocols and need time to adjust, but there is not always time as infections of SARS-CoV- 2 continue to rise.11 What happens if a member of the dental team is exposed to a patient, visitor or another DHCP who reports that they are now positive for COVID-19? The CDC Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19 updated on June 18, 2020 provides a table with answers and demonstrates the importance of compliance to universal source control. As seen in the table, if DHCP are exposed and were not wearing any type of face covering, they are considered high risk and would be required to stay home from work, quarantine for 14 days and monitor themselves for symptoms.12,13

The CDC guidance also clarifies that an exposure of 15 minutes or more is considered prolonged, and states that any duration should be considered prolonged if the exposure occurred during performance of an aerosol generating procedure; also as far as the definition of close contact, it is defined as being within 6 feet of a person with COVID-19 or having unprotected direct contact with infectious secretions or excretions of the person with confirmed COVID-19.12

Summary/Conclusion

The importance of universal source control is quite clear in the dental healthcare setting to mitigate the spread of the SARS-CoV-2 virus. This is the new safety and infection prevention term for dentistry! Share this new term and its meaning with colleagues, team members and patients and practice what you preach, not only in the dental workplace setting but in public venues as well. The best way to prevent COVID-19 illness is to avoid being exposed to this virus. In addition to wearing a mask and practicing universal source control, the CDC recommends everyday preventive actions, including staying home if you have been exposed or are sick, staying at least 6 feet apart from others, and hand hygiene in order to help prevent the spread of respiratory diseases.8

ExposurePersonal Protective Equipment UsedWork Restrictions
HCP who had prolonged close contact with a patient, visitor, or HCP with confirmed COVID-19HCP not wearing a respirator or facemask HCP not wearing eye protection if the person with COVID-19 was not wearing a cloth face covering or facemask HCP not wearing all recommended PPE (i.e., gown, gloves, eye protection, respirator) while performing an aerosol-generating procedure1Exclude from work for 14 days
after last exposure Advise HCP to monitor themselves
for fever or symptoms consistent
with COVID-19 Any HCP who develop fever or symptoms consistent with COVID-19 should immediately contact their established point of contact (e.g., occupational health program) to arrange for medical evaluation and testing.
HCP other than those
with exposure risk
described above
N/ANo work restrictions Follow all recommended infection prevention and control practices, including wearing a facemask for source control while at work, monitoring themselves for fever or symptoms consistent with COVID-19 and not reporting to work when ill, and undergoing active screening for fever or symptoms consistent with COVID-19 at the beginning of their shift. Any HCP who develop fever or symptoms consistent with COVID-19 should immediately self-isolate and contact their established point of contact (e.g., occupational health program) to arrange for medical evaluation and testing.

References:

1. Occupational Safety and Health Administration. Bloodborne Pathogens Standard 1910.1030. Frequently asked questions. Available at https://www.osha.gov/laws-regs/standardinterpretations/1993-02-01-0#:~:text=On%20December%206%2C%201991%2C%20the,Hepatitis%20B%20Virus%20(HBV).  Accessed September 14, 2020.

2. Occupational Safety and Health Administration. Bloodborne Pathogens Standard 1910.1030.  Available at https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030. Accessed September 14, 2020.

3. Miller CH, Palenik CJ. Infection Control and Management of Hazardous Materials for the Dental Team. 5th ed. St. Louis: Mosby Elsevier; 2013;82.

4. Centers for Disease Control and Prevention. Infection Control. History of guidelines for isolation precautions in hospitals. Available at https://www.cdc.gov/infectioncontrol/guidelines/isolation/appendix/history.html. Accessed September 14, 2020.

5. Centers for Disease Control and Prevention. Interim Infection Prevention and Control Guidance for Dental Settings During the Coronavirus Disease 2019 (COVID-19) Pandemic Available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html. Accessed September 15, 2020.

6. Centers for Disease Control and Prevention. Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic. Available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html. Accessed September 15, 2020.

7. American Dental Association. Return to Work Interim Guidance Toolkit. Available at https://pages.ada.org/return-to-work-toolkit-american-dental-association.  Accessed September 15, 2020.

8. Centers for Disease Control and Prevention. NIOSH Science Blog. Respiratory Protection vs. Source Control – What’s the difference? Available at https://blogs.cdc.gov/niosh-science-blog/2020/09/08/source-control/. Accessed September 15, 2020.

9. Konda A, Prakash A, Moss GA, Schmoldt M, Grant GD, Guha S. Aerosol Filtration Efficiency of Common Fabrics Used in Respiratory Cloth Masks. ACS Nano. 2020 Apr 24. PMID: 32329337

10. Ma QX, Shan H, Zhang HL, Li GM, Yang RM, Chen JM. Potential utilities of mask-wearing and instant hand hygiene for fighting SARS-CoV-2. J Med Virol. 2020. PMID: 32232986external icon

11. Centers for Disease Control and Prevention. CDC COVID Data Tracker. Available at https://covid.cdc.gov/covid-data-tracker/#cases_totalcases. Accessed September 15, 2020.

12. Centers for Disease Control and Prevention. Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19. Available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html. Accessed September 15, 2020. 

13. American Dental Association. Protocols to follow if a staff or household member is COVID-19 (+). (Members only document). Updated July 21, 2020.

Dr. Katherine Schrubbe, RDH, BS, M.Ed, PhD, is an independent compliance consultant with expertise in OSHA, dental infection control, quality assurance and risk management.  She is an invited speaker for continuing education and training programs for local and national dental organizations, schools of dentistry and private dental groups. She has held positions in corporate as well as academic dentistry and continues to contribute to the scientific literature. Dr. Schrubbe can be reached at kathy@schrubbecompliance.com.

Trends: ADA to WHO | Dentistry is Essential

In August, the American Dental Association (ADA) released a statement saying it respectfully yet strongly disagrees with the World Health Organization’s (WHO) recommendation to delay “routine” dental care in certain situations due to COVID-19.

“Oral health is integral to overall health. Dentistry is essential health care,” stated ADA President Chad P. Gehani, DDS. “Dentistry is essential health care because of its role in evaluating, diagnosing, preventing or treating oral diseases, which can affect systemic health.”

Dr. Gehani added that in March, when COVID-19 cases began to rise in the U.S., the ADA called for dentists to postpone all but urgent and emergency care in order to understand the disease, consider its effect on dental patients, dental professionals and the greater community.

Both the ADA and the U.S. Centers for Disease Control and Prevention (CDC) then issued interim guidance for dental professionals related to COVID-19. The ADA’s guidance calls for the highest level of PPE available – masks, goggles and face shields. The ADA’s interim guidance also calls for the use of rubber dams and high velocity suction whenever possible and hand scaling when cleaning teeth rather than using ultrasonic scaling to minimize aerosols.

Dr. Gehani concluded, “Millions of patients have safely visited their dentists in the past few months for the full range of dental services. With appropriate PPE, dental care should continue to be delivered during global pandemics or other disaster situations.”

State dental associations also backed ADA in the disagreement with WHO’s classification of dental care as non-essential during a pandemic. The Georgia Dental Association and the Minnesota Dental Association, among others have come out in support of the ADA’s recommendation not to delay oral care.” Delaying dental care may put your oral and overall health at risk,” states GDA President Annette Rainge, DMD. “If oral disease is allowed to progress, small problems can escalate to larger problems requiring more extensive treatment. In addition, signs of other diseases and medical conditions, for example oral cancer and diabetes, can appear in the mouth. Regular dental visits can help detect problems early.”

Health news and notes

A golfer’s guide to low back pain

Golf is often thought of as a low-impact sport, but it can be associated with several musculoskeletal injuries due to its repetitive nature, according to U.S. News and World Report. One of the most common complaints reported by golfers is low back pain, with reported rates varying from 26% to 52%. Low back pain is also a major health issue among adults in the general population. Given the high prevalence and high cost of low back pain care, it’s worthwhile to consider how to prevent golf-associated low back pain.

While the golf swing seems like a relatively easy motion, it is actually an extremely complex series of motions that involve most of the muscles and joints in the body. As with all things, the golf swing’s frequent repetition – compounded over years of playing the sport – places significant stress on those muscles, joints, and tendons. Over time, this may result in injury.

Understanding the mechanics of the golf swing, along with education and training, can help prevent golf injuries. It’s important to use proper posture and proper sequencing, and not to over-swing. Swinging too hard may increase the stress placed on the spine and surrounding structures…

Read the full article at: https://health.usnews.com/health-care/for-better/articles/a-golfers-guide-to-low-back-pain.

How to safely sanitize every type of face mask

Face masks reduce the spread of COVID-19 because they provide a barrier that catches the virus-containing respiratory droplets that are released when people cough, sneeze, or talk.

Being a barrier between the virus and the wearer means that the mask becomes contaminated instead. While the greatest danger is from inhaling virus-filled respiratory droplets from those around us, if a person touches a contaminated mask and then touches their mouth or nose, they might also contract an infection.

Like all medical devices and equipment, face masks need to be properly cared for in order to be safe and effective. But not all face masks are the same; different kinds of masks need to be sanitized in different ways depending on the type of material they’re made out of.

It’s important to apply the correct method to each type of material, or else you could wind up making the mask harder to breathe through and less effective!

Fortunately, Healthline has created an easy-to-follow list of the common types of face masks, how to safely disinfect them for reuse during the pandemic, and how to handle medical-grade masks that can’t easily be cleaned properly outside of a medical setting.

Check out the list at: www.healthline.com/health-news/how-to-safely-sanitize-every-type-of-face-mask#Proper-care-of-cloth-face-masks.

Make these simple travel snacks to eat like a health pro on the road

Whether you’re planning to take a short, safe vacation; just “going for a drive” (who doesn’t need a brief change of scenery?); or on the road for a meeting, you should try to avoid fast food and C-store fare. A post from U.S. News and World Report has a few simple recipes for easy-to-make and easy-to-eat snacks to take along with you the next time you hit the road. The quick recipes include:

  • Vegetable rice paper rolls.
  • Yogurt parfait with wild blueberries.
  • No-bake energy bites.
  • Fruit with squeezable nut butter.
  • Popcorn.
  • Prepackaged portions of mixed nuts, jerky and dried fruits.

Read the full post at: https://health.usnews.com/health-news/blogs/eat-run/articles/healthy-travel-snacks-for-car-and-road-trips.

Equipment: Post-Pandemic Equipment Planning

Teledentistry, patient communication software may be at top of the list

Even as patients returned to dental practices this past summer for routine checkups, uncertainties surrounding the coronavirus pandemic led some dental service organizations to prioritize their spending. “While spending on equipment may slow down in the short term, we may actually see increased spending on teledentistry and patient communication software – two areas designed to help drive patient engagement and appointment scheduling,” says Dr. Eric Tobler, National Director of Clinical Affairs, Mortenson Dental Partners.

“More so than technology, dental practices [currently] need reliable access to basic personal protective equipment, surface disinfectant and other sterilization equipment,” Tobler continues. “Prioritizing access to these basic and essential supplies for healthcare workers should be a significant national focus.” Indeed, infection prevention has always been a priority for dental professionals, he adds. Since the onset of the coronavirus pandemic, however, there has been heightened awareness among patients. “Our clinical staff now uses additional PPE during their engagement with patients, adding a higher level of protection,” he points out. “Additionally, we are using high-volume evacuators, which reduce the amount of aerosols released during procedures.” In addition, some DSOs, such as Mortenson, have considered adding air filtration systems.

Communication a constant

In recent years, many dental practices have learned to stay connected with their patients through their websites and social media. This year, patient communication has become more important ever, notes Tobler. “Since the beginning of the pandemic, communication with our patients has been a critical element for success,” he says. “During the restricted period last March and April, it was important to communicate that we were still open for essential care services to keep local hospital beds free for coronavirus patients. As we reopened, regular communication was paramount to emphasize that we were available for routine care again, and that team and patient safety was our highest priority.”

While team and patient safety has always been a priority for dental practices, as patients began returning for dental care, they were especially interested in what those safety measures were, and how dental service organizations were responding to the pandemic. “We developed a page on each of our brand websites to remind patients that we’ve always followed standard safety protocols recommended by the ADA and state dental board, and listed the extra precautions we added as a result of COVID-19,” Tobler explains (See sidebar). Mortenson’s COVID-19 precautions include taking patients’ temperatures, asking pre-screening questions, implementing more frequent sterilization practices, limiting visitors and asking patients to wait in their cars until an operatory is available.

“In some regions, we incorporated videos from our doctors to showcase these safety measures,” he adds. “We communicated these messages in a variety of ways, such as social media, email and blog posts, always linking to our safety information page. Using primarily digital methods has been an efficient and cost-effective way to highlight these changes during such an unprecedented time.”

All things considered

With the onset of coronavirus, there was much discussion regarding what constitutes emergency and essential dental care, notes Tobler. The positions of the American Dental Association, the Centers for Disease Control and Prevention, the Occupational Safety and Health Administration and other organizations have varied and evolved over time, he points out. “As a company, Mortenson has worked diligently to comply with regulations and proactively seek out the best scientifically credible information available to lead our decision making.

“During the highest level of restrictions in March and April, emergency dental care included situations where the patient was in pain or experiencing infection, severe decay and swelling, as well as patients who otherwise felt they needed to be seen urgently to decrease overflow to local emergency rooms,” he continues. “Since restrictions have been lifted, our volume of patient care has returned to normal, with routine care being delivered as usual, with some adaptation.

“While there undoubtedly will be some patients who postpone their treatment, our experience has been that the pent-up demand of patients returning to their dentist occurred this past summer,” he says. “I believe the population understands the importance of regular and thorough dental care and that many health conditions can be prevented with good oral hygiene. Overall, we have seen a very strong desire for patients to resume taking care of their oral health.”

Mortenson Dental: How We’re Keeping Patients and Teams Safe

Following recommendations from state dental boards and the ADA, we have resumed all dental care services in our practices.

Practices in all of our regions have always followed standard safety protocols issued by the state dental board and American Dental Association to help protect our patients and team members from communicable diseases like the coronavirus. We have also implemented the following additional measures and screening procedures to ensure their health and safety:

Personal Protective Equipment

  • All clinical team members wear
    • N95, KN95 or Level 3 surgical masks with face shields
    • Eyewear with side shields
    • Gown or lab jacket 
  • All non-clinical team members wear reusable or surgical masks.
  • All patients are given protective eyewear.

Social Distancing and Screening

  • Patients are asked to wait in their car as opposed to entering the welcome area. 
  • Visitors are limited to patients and, if necessary, one parent, guardian or translator.
  • The following health and safety screening is conducted prior to every patient appointment:
    • Have you been sick in the past 3 weeks?
    • Have you had close contact with an individual diagnosed with COVID-19 or experiencing symptoms?
  • Frequent temperature checks are conducted: 
    • All patients’ temperatures are taken upon arrival.
    • All team members’ temperatures are taken daily.
    • Sick team members remain at home.
  • Team members maintain a 6-foot distance from each other.

Sterilization and Disinfection

  • All team members wash hands frequently. 
  • Food items, magazines, books, toys and other clutter have been removed from common and clinical areas.
  • Countertops, door knobs, tables, chairs and other common surfaces are wiped down often.

Source: https://mortensondentalpartners.com/covid19safety/

Quick Bytes: Technology news

We’re all Zoomed!

America experienced a collective cry of sorts when Zoom reported widespread outages Monday, August 24. Classrooms and boardrooms that had come to rely on the videoconferencing platform were panicking as the company worked to address the issue. But it was a reminder of the perils created by a reliance on technology to facilitate conversations that used to be face to face only months before.

iMac gets an upgrade

Apple recently announced a major update to its 27-inch iMac. It now features faster Intel processors up to 10 cores, double the memory capacity, next-generation AMD graphics, superfast SSDs across the line with four times the storage capacity, a new nano-texture glass option for an even more stunning Retina 5K display, a 1080p FaceTime HD camera, higher fidelity speakers, and studio-quality mics. Whether composing a new song with hundreds of tracks, compiling thousands of lines of code, or processing large photos with machine learning, the 27-inch iMac, with the latest 6- and 8-core 10th-generation Intel processors, has pro-level performance for a wide range of needs. For pros who need to push iMac even further, the 27-inch iMac has a 10-core processor option for the first time, with Turbo Boost speeds reaching 5.0GHz for up to 65 percent faster CPU performance. And when working with memory-intensive applications, iMac features double the memory capacity for up to 128GB.

For customers using their iMac more than ever to connect with friends, family, and colleagues, the FaceTime HD camera now features 1080p resolution, while the Image Signal Processor in the T2 Security Chip brings tone mapping, exposure control, and face detection for a much higher quality camera experience. To complement the improved camera, the T2 Security Chip also works with the speakers to enable variable EQ for better balance, higher fidelity, and deeper bass. In addition, a new studio-quality microphone array enables users to capture high-quality audio for improved FaceTime calls, podcast recordings, Voice Memos, and more, right on their iMac. Prices start at $1,799 (US)

Digital shopping gets a boost

As the COVID-19 pandemic reshaped our world, more consumers have begun shopping online in greater numbers and frequency, according to Tech Crunch. According to new data from IBM’s U.S. Retail Index, the pandemic has accelerated the shift away from physical stores to digital shopping by roughly 5 years. Department stores, as a result, are seeing significant declines. In the first quarter of 2020, department store sales and those from other “non-essential” retailers declined by 25%. This grew to a 75% decline in the second quarter. The report indicates that department stores are expected to decline by over 60% for the full year. Meanwhile, e-commerce is projected to grow by nearly 20% in 2020.

BlackBerry hardware making a comeback

OnwardMobility announced agreements with BlackBerry Limited and FIH Mobile Limited, a subsidiary of Foxconn Technology Group, to deliver a new BlackBerry® 5G smartphone, powered by Android™, with a physical keyboard, in the first half of 2021 in North America and Europe. “BlackBerry is thrilled OnwardMobility will deliver a BlackBerry 5G smartphone device with physical keyboard, leveraging our high standards of trust and security synonymous with our brand. We are excited that customers will experience the enterprise and government level security and mobile productivity the new BlackBerry 5G smartphone will offer,” said John Chen, Executive Chairman and CEO, BlackBerry. Under the terms of the agreement, BlackBerry grants OnwardMobility the right to develop, engineer, and bring to market a BlackBerry 5G mobile device. Working closely with BlackBerry and FIH Mobile, OnwardMobility will ensure the world-class design and manufacturing of these devices.

Say ‘Hi’ to Polaroid’s new pocket-sized printer

Polaroid has launched a new pocket-sized printer for printing snaps taken with your phone, according to Tech Radar. The Polaroid Hi-Print produces 2.1 x 3.4-inch prints (credit card-sized), with sticky backs for attaching your shots to a variety of surfaces, such as notebooks, lockers and scrapbooks. The Hi-Print is the first instant digital product to be announced since Polaroid’s rebranding exercise back in March. It ditched the ‘Originals’ from its name in order to appeal to those familiar with the brand’s extensive heritage. Retail price is $99.

Safest Dental VisitTM: OSAP Announces New Board of Directors

The Organization for Safety, Asepsis and Prevention (OSAP) has announced the members of the 2020-2021 OSAP Association Board of Directors.

“As we begin our new fiscal year in the middle of a pandemic, we are fortunate to have Doug Risk, DDS, ABGD as our new Board Chair for the 2020-2021 year. His dental infection prevention expertise and passion for the dental industry is just what we need as OSAP continues to be the go-to leader in dental infection prevention and safety”, shared OSAP’s Executive Director, Michelle Lee, CPC. “The depth of our Board is remarkable. I have the utmost confidence that our newest board members will also be strong contributors as we continually meet the ongoing challenges in these uncharted waters.”

Dr. Doug Risk served in the US Air Force and attended the Advanced Education in General Dentistry Residency at Lackland Air Force Base. Dr. Risk has experience in clinical practice, command and headquarters assignments, and deployments. His career culminated as the Director of the Dental Evaluation and Consultation Service. Since retiring in 2017, he has provided consultation services to private practices, manufacturers, and the Department of Defense. He is currently in clinical practice in Southern Maryland and serves as Compliance Director for 6 practice locations.

Eve Cuny, MS was elected as Vice-Chair and Chair-Elect for the Association. Cuny moves into this role after serving as Secretary and a Director. Cuny is the Director of Environmental Health and Safety and Associate Professor of Diagnostic Sciences at Pacific Dugoni School of Dentistry. Cuny is a member of the National Occupational Research Agenda Council. She has lectured nationally and internationally, published extensively on the subject of infection control and patient safety and has worked globally with government agencies, universities, and nonprofit organizations to develop best practices in infection prevention and safety.

David Kierce, Global Platform Leader for Dentsply-Sirona’s Infection Prevention Product Line, serves a consecutive term as Treasurer. Kierce has been on the Dentsply-Sirona team for more than 25 years. He started with Dentsply Ceramco in June 1993 as a Territory Sales Representative. From there, his career has grown to include leadership roles in special markets, merchandising, and marketing.

LCDR Matthew R. Ellis, MPH, CIC, REHS was elected Secretary. LCDR Ellis serves as the U.S./DHHS- Indian Health Service (IHS) Infection Prevention and Control Program Manager, assigned to the IHS HQs Office of Quality. LCDR Ellis is co-Lead and an architect of the regional healthcare accreditation readiness team and served collaterally as the Public Health Emergency Management Coordinator. He is a United States Army infantry veteran and has completed healthcare infection control and safety position tenures with a private healthcare consulting firm, University of Kentucky Medical Center, and the Veteran’s Healthcare Administration.

Newly elected board members include Steve Geiermann, DDS, Julie Lynch, MS, BSN, RN, and Raleigh Wright, DDS.

Dr. Steve Geiermann, a retired Captain in the U.S. Public Health Service, serves as the Senior Manager addressing access, community oral health infrastructure, and capacity within the American Dental Association (ADA). He served as a dental director in the Indian Health Service and Federally Qualified Health Centers as well as being an HRSA regional dental consultant and project officer within the National Health Service Corps and the HIV/AIDS Bureau. He served on the Board of Directors of the National Network for Oral Health Access (NNOHA) and was an expert advisor for Safety Net Solutions seeking to improve the financial stability and productivity of health centers. He currently serves on the advisory committee for the Oral Health Progress and Equity Network (OPEN) and the board of the American Institute of Dental Public Health (AIDPH).

Julie Lynch is the Director of Clinical Development for American Dental Partners, Inc. Her focus is on supporting all American Dental Partners affiliated dental group partnerships in the growth of quality management and improvement endeavors such as Accreditation Association for Ambulatory Health Care (AAAHC), professional development, provider credentialing verification, and regulatory matters. Lynch came to oral health care passionate about patient and team member safety after serving more than 20 years in a large healthcare system in both direct patient care and leadership roles. She received her Bachelor of Science in Nursing from Concordia University Wisconsin and her Master of Science in Healthcare Administration from the University of St. Francis in Joliet, Illinois.

Dr. Raleigh Wright is currently the Chief Clinical Officer for Lane & Associates Family Dentistry, the largest group practice in North Carolina. A 1994 University of North Carolina School of Dentistry graduate, Dr. Wright has spent his entire tenure with Lane. Dr. Wright feels strongly about supporting outreach dental organizations, has volunteered for multiple Mission of Mercy dental clinics and dental buses, and currently serves on the Board of Directors for Wake Smiles Community Dental Outreach. He was recently elected to the NC Board of Dental Examiners, is currently an Examiner with CITA – Council of Interstate Testing Agencies, and attends many Continuing Education events to maintain a comprehensive knowledge of current trends and technology in dentistry.

Other Association Directors include Marguerite Walsh, Immediate Past Chairperson, Aaron Pfarrer, Theresa Mayfield, DMD, and Jessica Wilson, MPH.

About OSAP

The Organization for Safety, Asepsis and Prevention (OSAP) is a growing community of Individual dental clinicians, group practices, educators, researchers, consultants, trainers, compliance directors, policymakers, and industry representatives who advocate for safe and infection-free delivery of oral healthcare.

OSAP focuses on strategies to improve compliance with safe practices and on building a strong network of recognized infection control experts. OSAP offers an extensive online collection of resources, publications, FAQs, checklists, and toolkits that help dental professionals deliver the safest dental visit possible for their patients. Plus, online and live courses help advance the level of knowledge and skill for every member of the dental team. For additional information, visit www.osap.org.

Leadership: Facing Down Fear

By Lisa Earle McLeod

How to quiet fear and step into the boldest version of you 

In the last several months, many have faced (and continue to face) an unprecedented level of ‘unknown.’ Ambiguity can give rise to our deepest insecurities, and left unchecked, has the potential to fill us with fear.

Being afraid is natural. But when you let fear take over, the world misses out on the bravest and brightest version of you. And that’s no good for anyone. Here are three tips to help you quell the fear and step into bold action:

No. 1: Disrupt negative thought cycles in their tracks 

If you’re about to give a big presentation, pitch an idea, or do something courageous, the onslaught of “what ifs” will have no problem keeping you awake at night. Sure, we have to assess potential risk. The challenge is, we tend to default to the negative “what ifs” when it comes to being vulnerable and putting ourselves out there. The potential of shame is more initially jarring than the upside.

If you find yourself starting to think “what if it goes terribly and they hate it,” interrupt that thought cycle, and challenge your brain to think “what if it goes awesome and everyone loves it?” Pointing your brain towards the payoff (instead of the risk) helps you be more confident and courageous before bold action.

No. 2: Understand your body

When you’re afraid, your amygdala (aka lizard brain) goes into overdrive protection mode. You become hyper alert, your heart rate rises, your pupils dilate, and unfortunately, your critical thinking goes out the window. While your lizard brain does have your best interest of survival at heart, it’s not always the most holistic, strategic counsel. The lizard brain has a hard time determining a threat to your life and a threat to your ego.

When you understand why your body is reacting to fear the way it is, it’s easier to become objective in the face of it. When you recognize an oncoming wave of fear, ask yourself, is this my lizard brain thinking?

Take a step back, inhale a big deep breath, and remove yourself from that fight or flight brain space by breathing, moving your body, and practicing mindfulness.

No. 3: Don’t take yourself too seriously

Try to remember a time when you said or did something embarrassing. Is your skin crawling now? Ok, now, try to remember a time when someone else said or did something embarrassing…harder to recall? You likely can’t think of times that people misspoke during a meeting, made a crucial typo, or even spilled their coffee.

High performers are their own toughest critics. When you start to feel anxious, remind yourself, you’re likely the only one looking at your words and actions through the microscope of judgement. People make mistakes, most other people don’t remember or even notice those mistakes, and life moves on.

Stepping into the murky waters of growth and vulnerability can be scary. It’s also incredibly courageous. 

Lisa Earle McLeod is a leading authority on sales leadership and the author of four provocative books including the bestseller, “Selling with Noble Purpose.” Companies like Apple, Kimberly-Clark and Pfizer hire her to help them create passionate, purpose-driven sales organization. Her NSP is to help leaders drive revenue and do work that makes them proud.