Volume 7 • 2020 • Issue 5

out periodically as needed and each staff member has multiple sets that are disinfected and rotated. I expect to see innovative solutions coming into the marketplace that will help keep costs low and a number of manufacturers are beginning to invest in the dental market. These innovations will be part of how we all reimagine our practices. We will, collectively, have to reimagine how we work. Q How do I do recalls? Will I be able to step away from one operatory to visit the next and then go back again? AB: At this time, it isn’t feasible in all parts of Canada, most notably inOntario. Youwouldbegoing thougha tremendous amount of PPE. Right now, we have to re-imagine our patient flow. I imagine half a day being dedicated solely to recall appointments. I could see some dentists doing their own hygiene as well. Maybe we’ll be doing more combined appointments where we do multiple procedures. Maybe patients will come in and only see the hygienist. We are in a non-air polishing, non-aerosol generating procedures type of world at the moment. We’re likely going back to hand scaling. We’re probably not going to be polishing teeth because that produced aerosols and splatter. We don’t know for how long we’ll be practising under the conditions of the pandemic. It’s a new virus with an unpredictable and unknown timeline. Q What kind of changes should we expect to dental care for children? AB: I work at a public practice. Children are a lot of fun to work with. The first time they come in, usually there are tears or screams because I’m a new person. In our particular environment, we’re using a lot of silver diamine fluoride. We also use a lot of glass ionomer products. This is one way we can practise without creating aerosols and use the PPE that our little ones are used to. With children, I feel that oral health care is about stabilizing them and building a relationship, a rapport. It’s one of our challenges right now as we are still limited in the care we can provide and we are not seeing children for the kind of preventive care and work with parents that is really critical. It’s a struggle figuring out how we are going to recover this part of the practice as well as meet the needs of our children with special needs or on the autism spectrum. Q As a follow-up to treating pediatric patients, how do you deal with parents who insist on being in the operatory? AB: We currently allow one parent to come in. And we spend a lot of time walking them through the experience that is far different than before. They now have to stand where there were chairs before and they can’t bring anything with them into the operatory. As well, parents have to be screened to come into our practice. In our case, the parent has to go through the same protocols and checks as the patient does. They are escorted in to the operatory and the door is closed. We remind them about not touching walls or banisters and hand sanitizer is used by everyone and masks are worn while in the clinic. At our public practice, we have many medically vulnerable people, so we are very vigilant about them coming to the practice, looking at their transportation and what is needed to ensure they are able to go directly home from their appointments. Q Is there any other advice you can offer dentists at this stage? AB: In the operatory, dentists and staff are very mindful about infection prevention and control. We have extensive experience with it. We are very good at it. As we all get used to being back in our offices and the intensity and uncertainty of the first weeks wears off, we need to make sure we continue to be vigilant with social distancing in places like washrooms, hallways, break rooms, or lunch rooms. It has been a tough adjustment but we no longer have a lunch room and minimize our movements to other parts of the clinic. When things begin to feel normal, it’s easy to go back to behaving the way we once did. But the threat isn’t over. We need to protect ourselves and each other by adhering to social distancing best practices. With children, I feel that oral health care is about stabilizing them and building a relationship, a rapport. It’s one of our challenges right now as we are still limited in the care we can provide and we are not seeing children for the kind of preventive care and work with parents that is really critical. The views expressed are those of the author and do not necessarily reflect the opinions or official policies of the Canadian Dental Association. 19 Issue 5 | 2020 | CDA at W ork