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Dentists in the UK and other parts of the world are still adapting to the new normal in dentistry. (Image: Dani Navarro/Shutterstock)

Thu. 1. October 2020


One of the lessons we have all observed in recent months is that the effects of COVID-19 and the responses of populations and their governments have varied from one country to another. This has had a knock-on effect in dentistry, with variations in the instructions and guidance given by academia and those who regulate the profession.

Here in the UK, the situation has been made even more complicated by the four governments of England, Scotland, Northern Ireland and Wales issuing different instructions and guidelines to their respective dental populations, leading to wholesale confusion and frustration for both professionals and the patients they serve.

“All things must pass” is a phrase I have reminded my clients of during the lockdown weeks and as they now return to work. Patients, team members and clinicians are having to learn a new dance, Dentistry 2.0, and that takes time. Perhaps the most useful advice I find myself offering is to use the mantra of a marathon runner—“pace not race”—recommending that dental teams ease themselves into the new routines that have been imposed upon them.

An interesting and inspiring observation has been the level of trust and loyalty that has been demonstrated by many patients. They have waited for lockdown to end, have sometimes maintained dental plan payments throughout and now recognise that the catch-up may take some time as patients are triaged according to urgency and importance.

Patients have also displayed high levels of trust in the ability of their dentist to take appropriate measures to ensure their safety and that of the team. It may be unfamiliar for them to see their regular nurse, hygienist or dentist covered in personal protective equipment (PPE), but they know that it is you under there, doing your best.

I have observed that dental team members have sometimes presented more of a challenge when invited back to work. Perhaps because they are healthcare-trained, there have been requests for reassurance that standard operating procedures and PPE will be adequate to ensure their safety.

Also, many have had to deal with domestic issues that have complicated their decision to return to work. Personal health, childcare and vulnerable relatives count among the most common of the issues raised. It has been important for any dental practice owner to maintain a regular and personal dialogue with salaried team members and selfemployed clinicians to provide either reassurance or offer compassionate leave.

This month, most of my English clients are making their way back. In the other UK nations (at the time of writing) the debate rages and pressure is building. In Europe, many, if not most, are back and operating with different levels of compliance. Who could have foreseen that dentistry would differ so much, depending on where you are standing?

However confusing this may seem, we all still seek the same ultimate objectives:

  1. a safe environment for our patients and team;
  2. the opportunity to provide appropriate care, whether that be pain relief, functional repair, preventative maintenance, specialist services or elective treatments;
  3. businesses that are solvent and profitable so that trade creditors, lenders, landlords, teams and self-employed subcontractors can be paid in a fair and timely fashion and, equally, that owners can make a decent living and grow prosperous businesses;
  4. businesses that play a responsible role in their community, respect the environment and value their people.

These core values remain unchanged, and yet it is important to remind ourselves of them after what has been many months of distraction and crisis management.

“COVID-19 is undoubtedly the greatest challenge to humanity that I have witnessed in my lifetime, and I am confident that we can and will prevail”

Almost all of us are beginning the slow journey back to normality. I recently shared with my UK clients some guiding principles that I hope will assist in this process:

  1. This is what we are good at.
    Humans are designed to adapt and survive. Consider, if you will, the 250,000 years over which Homo sapiens has evolved and the unimaginable hardships that humans have endured on that journey. I do not wish to make light of any individual’s personal or professional challenges, but I do want to remind you that we are wired to win. COVID-19 is undoubtedly the greatest challenge to humanity that I have witnessed in my lifetime, and I am confident that we can and will prevail.
  2. Stay calm.
    When all about you are losing it, leadership is about calmly taking control and demonstrating the way forward. Every dental team member has a leadership role, whether it is calming team members or patients, answering the phone, offering virtual consultations or meeting patients face to face (at a safe distance or in PPE). Emotion is contagious and your calm demeanour can help all of those around you.
  3. Be kind.
    That may sound cheesy to you, but I have witnessed many random acts of kindness during the pandemic, and people remember the way you show up in times like this.
  4. Learn a new routine.
    During the first weeks of lockdown, what we all had in common was that our existing routines were stolen from us by circumstance. We are creatures of habit, and even though we may have complained about the commute to work, the office hours or other aspects of our pre-COVID-19 life, the fact is that lockdown threw us all into chaos. Some reinvented new lockdown routines quickly; others floundered. Whichever group you found yourself in, return to work is now yet another new landscape, and you will have to develop your new routines quickly and settle in to them.
  1. Communicate.
    The winners in lockdown were those who communicated regularly with patients, team members and clinicians via video calls, newsletters and messages. Just because you are back to work, do not stop! It is essential that you listen to the feedback on how your dental business is perceived by all concerned; essential that your communities have the opportunity to tell you how they feel; essential that you tell everyone what you are thinking and what is going on.
  1. Do not be afraid of giving and receiving feedback.
    As we all learn the new dance steps, mistakes will be made—and that is OK. That is how we grow. So be open to feedback and be ready to give feedback when you see things that are not right. At the moment, your patients and your team are some of the best consultants you could ask for.
  2. Do not be afraid to ask for help.
    When the COVID-19 dental history book of 2020 is written, I like to think that one of the benefits of this horrible situation will have been the growth in unity of the dental profession, both nationally and globally. Have you ever seen so many free webinars? I hope that continues over the years ahead and that dentists do not disappear back into their former silos. Asking for help is a sign of personal strength and confidence. Membership of trade associations and other representative bodies has grown. My wish is that this momentum continues into postgraduate education and beyond.
  3. Be patient.
    Dentistry will not be back to how it was before, perhaps ever. However, that indomitable spirit of enterprise that identifies humans will, in my opinion, drive even more experimentation, invention and innovation over the years ahead. I believe that we will see a sudden acceleration in digital innovation, in virtual consulting and in the arrival of new procedures, materials and techniques in every aspect of dentistry and patient care.
  4. Take time to think.
    Please do not jump into a new hamster wheel to replace the one you were running in before COVID-19. This is a once-in-a-lifetime opportunity to start again, knowing what you know now. If you were starting your business again, what would you do differently? Well do it!
  5. Seek balance.
    Back to that once-in-a-lifetime moment—I have had many of my clients use this time to create lists of aspects of their personal and professional lives that they like and dislike. I have asked them to seriously consider eliminating the tolerations—the people, things and situations that get in the way of their happiness. You can.

“Dentistry will not be back to how it was before, perhaps ever”

Over the months ahead, there is a great deal to consider:

  • financial modelling and forecasting;
  • marketing for new patients;
  • the new patient journey;
  • clinical and non-clinical operational systems;
  • your team—their structure, roles and responsibilities;
  • your overall game plan.

Each of these is on my task list to consider, decide and execute new versions for my clients that apply to the postlockdown time and (we hope) post-COVID-19 landscape.

I am working with a community of over 120 UK practices, and we are taking that journey together, sharing our experiences and collaborating on solutions. Dentistry can no longer be a fragmented collection of small business owners. As I heard on a webinar a few days ago: “We may not all be in the same boat but we are in the same storm”. It is only by staying together that we can enjoy strength in numbers.

Editorial note: A list of references is available from the publisher. This article was published in digital―international magazine of digital dentistry Vol. 1, Issue 2/2020.

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