As the uncertainty of COVID-19 seems to have entrenched itself into all our lives, it is timely to take a look at strategies which will help reduce the anxiety caused by this continuing unpredictability.

In speaking with several GDPs over the past number of months, the effect and impact on patient attendance is beginning to manifest itself in a number of ways. The original fear/apprehension in attending has all but dissipated. Patients seem very willing to attend – even for the most minor procedures. This is very heartening – as it underlines the key trust we, as a profession, have worked hard to create and maintain. Most patients have some awareness of the levels of cross-infection control, hygiene and good practice that we operate. As each practice continues to improve its protocols (temperature checks/text messaging/patient distancing in waiting room etc), then the attending patients gain more confidence that correct measures and procedures are in place.

The main effect however, is not the added cost or time in providing these measures – though of course the cost of the added PPE – along with the consequent increase in clinical waste disposal – are significant. While these financial costs are appreciable, rather it is the loss of time that is the most impactful issue. The physical time taken to see a patient for a “regular” appointment has increased dramatically. The increased preparation before patient arrival – and the increased time for cross-infection control afterwards are eating into the operative time usually available for dental procedures.

As we all try to grapple with this new “way of working” – it is clear that certain methodologies can prove useful for maximising on the clinical time given to patients – all of which are conveniently and appropriately complimentary to the best practice information currently available for the NPHET, HSE and WHO.

1. Maximise time – Prioritise procedures that are required, and undertake as many of these (within reason) as possible per visit. This may seem like common sense – but if you put this into practice it will focus your team to deliver – and reduce the frequency (number of visits) per patient. 

2. Streamline PPE etc – By anchoring your strategy to the first point (Maximise time) – you will therefore maximise too on the use of PPE. Simply put – if a patient requires two or three restorations in the same quadrant, logic dictates that undertaking all three in the one treatment appointment – will (a) reduce PPE costs (b) increase treatment yield – more treatment in fewer visits and (c) further reduce risk of COVID transmission by reducing the number of visits

3. Confirmation of appointments – Now more than ever, with so much at stake, it is crucial that all dental appointments are verified in advance. This is particularly important as the “walk in” custom of old has all but vanished from this “new world”.

4. Patient retention – Relationship building:
To borrow an idea for the business world, it is self-evident – particularly in more established practices, that there is an existing relationship of attendance and treatment with your patient base. How many of us in the dental surgery have said: “Let’s keep an eye on that lower molar… it might need more attention in time to come.. perhaps at your next check-up?” With that in mind, and the continued uncertainty around another lockdown (regional or national) – perhaps that time is now? Remember your patients will be grateful for the care and attention you have shown – along with the conscientiousness that you are professionally delivering in their management. 

5. Referral – With many specialists working through the backlog caused by the first shutdown (March 2020), many are just now beginning to see availability/capacity back in their books. It might be timely (with good clinical indicators) to consider referral for that root treatment, orthodontic assessment of wisdom tooth? It may prove challenging in the months to come to ensure timely referral, so if there is a clinical history and indication, then appropriate referral now would seem the most prudent course of action.

6. Self-care – As the uncertainty seems set to continue – with (at time of writing) the schools reopening etc, it would appear that rolling lockdowns or even another national lockdown may be on the cards. Given the anxiety in the previous months, it is vital that each member of the team and staff have a strategy or mechanism in place to ensure they look after themselves both physically and mentally. We serve neither our patients nor ourselves if we are not in best form ourselves.

When this virus is properly controlled or eliminated, then healthcare delivery will revert to a more traditional model. When that time comes, those that have adapted and looked after themselves will be best poised to maximise on the happy return of normality.