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Non Aerosol Procedures in the Orthodontic Office – Best Practices for Growth
The new world of dentistry and orthodontics is here. As offices come back online there is a unique sense of fear, concern and uncertainty that hasn’t existed in my 20 years of practice and most likely hasn’t been part of anyone’s dental practice in modern times. Orthodontic practice has now been divided into 3 very different types of procedures and each is deserving of a fresh look. The division is between procedures that involve aerosolization and those that don’t and the third category is online services. Clearly, procedures that involve creating an aerosol are more dangerous. They are so dangerous that OSHA has categorized dentistry as High Risk because of that aspect of our practices. These procedures require additional PPE, physical space to separate these procedures from other patients, and additional equipment including High Speed Suction, HEPA filtration, UV Air purifiers and more.
OSHA has categorized Dental Procedures as High Risk
In orthodontics there are many important and profitable procedures that don’t involve creating aerosols. On the fixed braces side there are wire changes, wire adjustments, and removable and fixed appliance adjustments. On the clear aligner side there are even more options. In clear aligner therapy, only the placement and removal of attachments involve aerosols. It turns out that one of the most powerful tools in the orthodontist’s office is the 3D scanner. The process of taking a scan may be one of the most productive yet least likely procedure to endanger assistants and doctors. The tip of the scanner is disposable and the scanner itself and the area around the scanner can generally be cleaned and disinfected to a safe level in a short time. The number and variety of procedures achievable with a 3D scanner are growing. Orthodontists are using the scanner for record taking, clear in house aligner creation, removable and fixed appliance creation from outside labs, and Invisalign treatment. It’s safe to say that in the COVID-19 age, it’s time to say goodbye to alginate and PVS impressions in the orthodontic office. Although there may be some cost savings, the risks and dangers of an impression along with the potential for inaccuracy make this procedure antiquated and even dangerous – especially when there is a better, safer solution. Online services are a new and exciting way to service your patients that involves zero exposure risk, zero PPE, and a high potential for patient appreciation and profitability. Online consultations are a simple and convenient service that are easy to add to an existing schedule. The quality of video calls using HIPAA compliant software has improved and patients are able to spend time with the doctor as well as a treatment coordinator. The ability for an office to leverage the positive aspects of this service and inject their creativity and marketing expertise is open territory and very exciting. Online treatment progress monitoring from companies like Dental Monitoring allow offices to follow up with patient progress without the need to bring them in to the office. How many times in the pre-COVID environment has a patient come in to your office for an aligner progress appointment only to be told, “Your are doing great! Keep going”? These appointments take up chair time in your schedule and cause patients to spend time away from school, work, or the family to show up at your office. In the COVID age, this could unnecessarily expose your patients and staff to exposure risk. Online treatment progress monitoring is a safe, effective way to service an important group of patients while freeing up valuable time in your office. The same could be said about orthodontic retention visits. A few photos taken by the patient along with a doxy.me or Zoom call to a treatment coordinator could easily triage patients into 3 simple groups:1) Doing great, no need for immediate follow up; 2) Need motivation to improve behavior; or 3) Need to return to the office for either an updated 3D scan or evaluation for re-treatment. Sticking to the traditional method of seeing patients in the office for periodic retainer visits is not only unnecessary, inconvenient, and not profitable but now also potentially dangerous. Retainer Club allows patients to regularly replace their retainers and have them shipped to their homes. This services an important group of patients in your office – the patients who want to maintain their results and who understand that long term retention is the best way to do that. These are the ‘good’ patients in your office and forcing them to return to your office for visits is not productive or seen as a value to the patients. In the current environment our patients now have an expectation to be able to receive online services from everything from education for their kids to medical appointments for their family. One way to look at all of the changes being faced by dentists and orthodontists is that it is an exciting opportunity. The way we service our patients in the near future will not be the way it was before COVID. Looking for ways to maximize non-aerosol procedures will lead to improved patient experiences while enhancing the safety of our teams. We have an amazing opportunity to look at the patient experience with a fresh set of eyes, utilize the technology tools that are at our disposal and embrace a future for our offices that is bright!