After a three-month suspension where dentists in Ontario had to close their clinics due to the pandemic, they’ve finally been given the green light as of June 1^st to reopen their offices and service the backlog of patients again – but not without a few gaping caveats.

Due to the amount of people that come in and out of an office, and the close proximity to fluids, patients are naturally hesitant to go to the dentist’s office with what they might be exposed to. Dentists are taking extra precautions What was once a simple teeth cleaning procedure will be the furthest thing from what it used to be.

These calculated openings are in their early stages, and with so many questions and regulation still to take shape — the COVID pandemic will leave its imprint on the world of dentistry and every artery that touches it.

Dental clinics are at “high risk” of spreading COVID-19

The reason why dental offices are under such a magnifying glass are because of the biologic risk of COVID-19 when performing dental procedures. When dentists use handpieces under irrigation, there’s a close exposure to saliva, blood, and aerosol/droplet production which can contaminate the environment and instruments, dental apparatuses, and surfaces if not handled carefully.

Without careful planning and appropriate guidance, dental clinics are at a “high risk” of spreading COVID-19, if there is negligent planning and a lack of safety procedures, according to The Royal College of Dental Surgeons of Ontario.

One thing is for sure – dental offices will certainly not look the same

Dentistry, massage and physiotherapy are among the top industries that will be targeted with new regulations from their respective governing bodies with regards to reopening, as they are greatly called upon to step up their collective sanitizing standards to prepare for this next level of normal.

While each one will see considerable changes individually, for the sake of focusing on dental, here’s a snapshot of just a few of the adjustments that have already been implemented.

• Patients can expect to be pre-screened for appointments, both on the phone and upon arrival at the office,
• There won’t be any more shared spaces,
• Each room will have to be sealed off, and dentists won’t be able to float in and out like they used to,
• Washrooms are closed,
• Waiting rooms are restricted,
• Ventilation systems will need to be properly maintained,
• The addition of new medical filters to purify the air,
• Dentists will have to retrofit their offices with glass partitions to prevent the spread of droplets
• Consistent cleansing to maintain a sanitary environment.

Cleaning will be extensive, and dentists are taking every single precaution they can to ensure the protection of their patients and staff so they feel safe and comfortable while getting the dental attention they need.

Clinics are faced with higher fees, and lower revenue

The Royal College of Dental Surgeons of Ontario issued a long list of recommendations for reopening. While Ontario’s guidelines are pretty strict to reopen their clinics, and vary from province to province, one of the major suggestions that stood out were to keep rooms vacant for anywhere from eight minutes to nearly three-and-a-half hours between patients.

Spacing these appointments out to will allow for enough physical distancing between patients and time for staff to disinfect offices between appointments – but it also results in less flexibility for scheduling appointments and keeps waiting rooms empty.

If a clinic is seeing fewer patients than before the pandemic, and can only see one patient in that 3-hour window, it will naturally have a damaging impact to the cash flow. And managing feelings of apprehension and caution many patients are experiencing – it makes for a tough road to navigate when it comes to building a sustainable return to work strategy.

What exactly are the premiums going towards offsetting? 

The field of dentistry is one that will be under heavy scrutiny and policy throughout this post-COVID world.

With costs going up across the board, dental offices and other practitioners may apply COVID-19 surcharges for PPE with line items showing up on an invoice. And while it raises the debate for many folks questioning why they have to pay more at the dentist than at something else like a restaurant or nail salon, it comes with good reason.

Health and safety comes at a cost, and someone is going to have to foot the bill for everything from masks, face shields, gowns, compensating employees with higher wages and air purifiers to help keep their offices free of contamination. Most insurers will not be covering PPE, so dentists will have to absorb any additional overhead that comes up with PPE, or initial upfront costs for HVAC enhancements, and any ongoing costs for sterilization and sanitation. The list is significantly magnified compared to their retail counterparts – and with good reason.

There’s no clear-cut way for insurance companies to navigate this

In order to mitigate the costs of the extra expenses, there will be caps and limitations on claims and infection control fees, with COVID line items likely to be put into effect. So when claims skyrocket, who will be left to eat the charges? There will have to be careful measures to guard against fraud and overcharging, with a number of fees likely not to be covered by an insurer. One thing is for certain, the costs going forward will be increasing, and claims will likely be paid out slower than usual. Dental fee guides will be significantly higher to compensate for all of this. Dental recall will be changing from every 6 months to see your dentist to likely every 9 months or a year.

And while other spaces such as physiotherapy are looking at new ways they can conduct their services online, the question if dentists can effectively triage emergency dental claims and provide virtual platforms will be a new frontier they will have to explore. One thing is for certain – dentistry won’t be like it used to be.