Is the amount of money dentists make misleading?

[Viola]

Just curious how are dental offices affected by this pandemic?

[Lactic Folly]

COVID-19 Updates

The College has recommended that all non-emergency dental services should be postponed to help prevent the spread of COVID-19.

https://www.rcdso.org/en-ca/home

[cleanup]

On 3/31/2020 at 11:54 AM, Viola said:

Just curious how are dental offices affected by this pandemic?

We are doing emergency treatment only. That means orofacial trauma, uncontrollable bleeding, swelling/signs of abscess (this is a contentious one), pain not controllable by OTC meds (also contentious).

The issue is the latter two; those are very grey areas. Most patients don't know what swelling is, and most people have a very low pain threshold. 90% of dental issues are non-emergent. The entire goal right now is to limit person-to-person contact and community spread as much as possible, and the logistics involved with seeing patients physically, and possibly performing operative dentistry, not to mention producing aerosols, is unreal.

I did have to do some surgery the last few weeks and doing that in full surgical garb with a fitted N95 mask, loupes, a face-shield attached to the loupes, surgical gown, intra-oral isolation (an isolite/isodry) and a closed room is absolutely brutal. I felt so claustrophobic and uncomfortable.

I personally know someone who has ended up in the ICU after seeing a COVID19+ patient. So I'm ramping up my telemedicine/teledentistry hugely, because I think the threshold for what is truly a dental emergency is quite high. With the advent of technology we can manage a lot of things over the phone and pharmacologically, unless someone gets smashed in the face with a baseball bat.

There are rumours that after this is all over the RCDSO will again be changing mandates and basically requiring all aerosol procedures to be performed with an N95, high-volume evacuation, gowns, closed rooms, etc. Even beyond the PPE and IPAC protocols set forth by dental schools right now. I do believe that this will change the landscape of dentistry moving forward, much like how HIV/AIDS did in the '80s. That was obviously a necessary thing; I'm less comfortable with the idea of some of the rumours going around right now. Some N95 masks I can tolerate, some I can't. I don't know that I could tolerate all that plus a face shield plus gown for every single operative procedure I do, especially given that in dentistry we are required to leave the operatory multiple times to do hygiene checks, etc. the logistics of how an office runs (and how fast paced it is) would change drastically I think.

Dental offices are bleeding money. As are all businesses. I know plenty of folks are afraid that they'll have a business to come back to given how long this is going to go on, and given how high risk dentistry is (due to proximity and aerosol production), the pandemic could affect us even more greatly than it affects some other industries. 

Last two weeks of March this was the case. RCDSO is re-visiting their position tomorrow on the 6th. Based off of what has happened in the States (with many dental boards shutting down elective dentistry until May/June in some), April is a wash. May is likely as well. It's unclear what will happen over the summer.

I will say that I am very happy to not be a practice owner right now. The pandemic has certainly made me begin to re-evaluate a lot of things in my life. I would hope that most people use this opportunity to count their blessings, practice gratitude, introspect and come out of this stronger, better, clearer, more intentional. Stay safe everyone.

[VivaColombia]

3 hours ago, cleanup said:

We are doing emergency treatment only. That means orofacial trauma, uncontrollable bleeding, swelling/signs of abscess (this is a contentious one), pain not controllable by OTC meds (also contentious).

The issue is the latter two; those are very grey areas. Most patients don't know what swelling is, and most people have a very low pain threshold. 90% of dental issues are non-emergent. The entire goal right now is to limit person-to-person contact and community spread as much as possible, and the logistics involved with seeing patients physically, and possibly performing operative dentistry, not to mention producing aerosols, is unreal.

I did have to do some surgery the last few weeks and doing that in full surgical garb with a fitted N95 mask, loupes, a face-shield attached to the loupes, surgical gown, intra-oral isolation (an isolite/isodry) and a closed room is absolutely brutal. I felt so claustrophobic and uncomfortable.

I personally know someone who has ended up in the ICU after seeing a COVID19+ patient. So I'm ramping up my telemedicine/teledentistry hugely, because I think the threshold for what is truly a dental emergency is quite high. With the advent of technology we can manage a lot of things over the phone and pharmacologically, unless someone gets smashed in the face with a baseball bat.

There are rumours that after this is all over the RCDSO will again be changing mandates and basically requiring all aerosol procedures to be performed with an N95, high-volume evacuation, gowns, closed rooms, etc. Even beyond the PPE and IPAC protocols set forth by dental schools right now. I do believe that this will change the landscape of dentistry moving forward, much like how HIV/AIDS did in the '80s. That was obviously a necessary thing; I'm less comfortable with the idea of some of the rumours going around right now. Some N95 masks I can tolerate, some I can't. I don't know that I could tolerate all that plus a face shield plus gown for every single operative procedure I do, especially given that in dentistry we are required to leave the operatory multiple times to do hygiene checks, etc. the logistics of how an office runs (and how fast paced it is) would change drastically I think.

Dental offices are bleeding money. As are all businesses. I know plenty of folks are afraid that they'll have a business to come back to given how long this is going to go on, and given how high risk dentistry is (due to proximity and aerosol production), the pandemic could affect us even more greatly than it affects some other industries. 

Last two weeks of March this was the case. RCDSO is re-visiting their position tomorrow on the 6th. Based off of what has happened in the States (with many dental boards shutting down elective dentistry until May/June in some), April is a wash. May is likely as well. It's unclear what will happen over the summer.

I will say that I am very happy to not be a practice owner right now. The pandemic has certainly made me begin to re-evaluate a lot of things in my life. I would hope that most people use this opportunity to count their blessings, practice gratitude, introspect and come out of this stronger, better, clearer, more intentional. Stay safe everyone.

At this moment, the best case scenario is relaxing the lockdown conditions in July. Then slowly, reopening businesses as the month goes on. Only if people follow social distancing and prevent community spread. If not, we're potentially looking at this dragging out to Sept-October. The government has given small businesses some financial relief including 40,000 interest free LOC, wage subsidy at 75% for employees for the first 58k, CERB of $2000/month but I'm not sure whether that is enough for dentists. If your owning a practice, you get payment and interest deferrals but that money still gains interest and needs to be paid back, potentially lengthening the loan period. If this does drag out till Sept, dental owners, especially the new ones who bought their practice in the last year face hardship for years after covid disappears. And the public and government won't care because they think dentists make too much money.

Also, for the PPE, if they do require N95 going forward, how will they source it? Their already is a shortage in supply and hospitals would need it first, wouldn't this just increase the price and overhead of dental practices and decrease efficiency if they can't leave the room for hygiene check ups in the future?

[Starburst]

On 3/5/2020 at 7:59 PM, FutureDMD-QC said:

What are those 4 states if I may ask?

Also, do you need to fly Canadian patients? I have relatives who live in the US so they could help me find people who can qualify as patients.

You need to screen patients using radiographs to find these specific lesions. So unless you have relatives who are dentists, you're out of luck.

Correction: It was 3 states (Colorado Washington and Minnesota)