Oral Health Group

Dentistry is Back! RE-flect and RE-learn to RE-build

July 31, 2020
by Lisa Philp RDH, Chief Visionary Officer and founder of TGNA

Dentistry is finally back after a historical and unprecedented shutdown due to the COVID-19 pandemic. Transitions Group, whose mission was to remain open as an essential service to support dentistry through this pandemic, lived it for 100 days and nights building a live COVID-19 survival guide. We are proud of the camaraderie and collaboration that was shown by the Canadian dental community.

Reflecting on what we have endured and accomplished along with what we will focus on, will fuel the motivation to re-build your dental practices back to pre-COVID performance. It will also help to make sure a shut down for dentistry never happens again!


We reflect on how we lived through many days and weeks of unpredictability and fast-paced change, from the initial closing of the practice, laying-off team members, loss of wages, delay of patient care, applying for government help, minimal cash flow and the relentless effort to find PPE to name a few.

The proactive and dedicated dental professional has spent hours on Zoom meetings, virtual training webinars and town halls. They remained relentless in their search for PPE while staying connected to their team and modifying their facility. They worked throughout the entire shutdown to make the required changes happen in their practices with constructing closed-off rooms, implementing air exchange units and installing plexiglass. They also built their own or utilized the Transitions Practice COVID-19 playbook for liability, team safety and training tool.

The COVID-19 pandemic impacted the dental profession with demanding things to learn and relearn to be prepared for the impact of reopening.

Relearn – Team Training. The ownership documented guided playbook along with the IPAC manual needed to be reviewed with each team member in preparation for them to re-enter the practice.

We learned and relearned about PPE and its global shortage and the importance of repurposing N95 masks. The Clinical team practised the donning and doffing processes. The team trained on staggered lunches and breaks to maintain social distancing in the workplace. We also needed to learn about air exchange and operatory management for AGP Aerosol Generated procedures and reorganize the daily start-up and shut-down.

Learn – COVID-19 signs and symbols to post in the practice. There must be hand hygiene visuals placed in bathrooms and above each sink, as well as donning and doffing posters for team reinforcement. There are signs on the front door to stop entry with a phone number to text or call and arrows for directions and social distancing reminders in reception room and hallways.

Relearn – Patient Communication. How to explain the virus and dentistry’s management of it, new and enhanced letters, emails and text to let patients know we are safe.

Relearn – How NOT to be complacent. The existing Infection Control (IPAC) standards were in place before the pandemic and governed by public health standards. It is critical to take this seriously as we are more prone to on-site public health audits related to COVID-19. Their standards include sterilizer temperature and time tracking, logging of every bag or cassette in and out of sterilization, logging of indicators and clean-to-dirty reprocessing. They will want to see that every piece of equipment has instructions and all products are not expired and have SDS data. Keep in mind, public health can shut you down on the spot with no questions and force you to send patients a letter and this is a practice ending worse case. Be sure your IPAC is all up to par.

Photo: Transitions Group

Learn – COVID-19 virus screening. The screening is important for your team, patients and visitors. The screening includes six questions for symptoms of COVID-19 and travel along with a temperature reading. All screenings must be documented in case they are requested by public health to produce for contact tracing. If the dental office is under suspicion of the virus spreading, there will be an on-site audit in the practice to assess and evaluate your infection control.

Relearn – Scheduling. We must undertstand the importance of engineering the schedule in advance to block for AGP procedures, operatories and provider. The days of on-the-fly walk-in patients off the street is no longer possible. We must manage flow and stagger patient appointments.

Learn and relearn – The Contactless Patient Experience. This is a shift for the dental industry who has prided themselves on personal one-on-one connections, welcoming walk-ins, barrier-free communication, close contact greetings, treatment presentations and in-person checkouts. The cycle of care for the contactless patient experience must be taught and learned by all members in the practice. (See tgnapracticemanagmet.com COVID survival guide for e-learning course on COVID cycle of care.)

The changes in the contactless flow begin with the confirmation process that will take more time while the admin team outlines the preparation for the appointment and the virtual parking lot for the patient to inform the practice they have arrived.

The COVID-19 patient screening process is causing a lot more administrative work, as all patients must receive their screening the day before and to bring or send it back signed.

Anyone entering the practice such as lab drop off, couriers and guests must complete the COVID-19 screening questions and temperature reading prior to entering.

Touchless check-out can be done by auto pay with pay apps (like PayPal). If they have to use the POS machine, it can be disinfected after use.

Note: There is an app available called XCARE that will automate and make all COVID-19 screenings and temperature recordings paperless and stored in one place. There is a digital signature, date stamp and no more paper or multiple emails to remind the patient to complete the screening.

As things settle down and we have all educated ourselves with the new normal, we can begin to rebuild.

About the Author

Lisa Philp RDH, is the Chief Visionary Officer and founder of TGNA: Transitions Group North America; a full-service coaching company for dentistry. Her career began in clinical hygiene, however she quickly transitioned into a world class coach; creating a periodontal disease management program, in which she coached thousands of dental professionals. Lisa is an industry leader, author, consultant, coach and speaker. Through Lisa’s leadership, TGNA has developed into one of dentistry’s premier full-service practice development companies.

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