COVID-19 Outbreak and Dentistry: Guidelines and Recommendations for the Provision of Dental Healthcare Services

After lockdown beginning from the third week of March 2020, face-to-face dentistry is gradually resuming with dental healthcare personnel feeling encouraged to safely provide treatment to the patients amid stringent infection control strategies. Having alerted to the associated infection threat, dentists will be better responding to the challenges of infection control in their clinics. Infection control strategies will follow the rapidly evolving guidelines of the local and international regulatory bodies that are relevant to this pandemic. Despite this, a concern exists as both the dental team members and the patients do not want to be the vectors for this deadly infection; and hence, the need for guidance. This article aims to inform dental healthcare professionals of the guidelines and recommendations to follow when receiving and treating patients in reopened practices. It appears that the novel coronavirus disease 2019 (COVID-19) outbreak has significantly and adversely impacted dentistry. The impacts seem to have long-term effect on the pattern of dental care; and a need for significant changes in the way dentists will provide dental care from now onwards. A wider use of tele-dentistry consultation platforms will obviously reduce the need for patients 2019; visits to dentists and dental hospitals. Key Words: COVID-19, Dentistry, Guidelines, Standards, Healthcare services.

Practice Location Characteristics of Non-Traditional Dental Practices

Current and future dental school graduates are increasingly likely to choose a non-traditional dental practice-a group practice managed by a dental service organization or a corporate practice with employed dentists-for their initial practice experience. In addition, the growth of non-traditional practices, which are located primarily in major urban areas, could accelerate the movement of dentists to those areas and contribute to geographic disparities in the distribution of dental services. To help the profession understand the implications of these developments, the aim of this study was to compare the location characteristics of non-traditional practices and traditional dental practices. After identifying non-traditional practices across the United States, the authors located those practices and traditional dental practices geographically by zip code. Non-traditional dental practices were found to represent about 3.1% of all dental practices, but they had a greater impact on the marketplace with almost twice the average number of staff and annual revenue. Virtually all non-traditional dental practices were located in zip codes that also had a traditional dental practice. Zip codes with non-traditional practices had significant differences from zip codes with only a traditional dental practice: the populations in areas with non-traditional practices had higher income levels and higher education and were slightly younger and proportionally more Hispanic; those practices also had a much higher likelihood of being located in a major metropolitan area. Dental educators and leaders need to understand the impact of these trends in the practice environment in order to both prepare graduates for practice and make decisions about planning for the workforce of the future.

Dental Quality Measurement--A Practitioner Perspective

This article reviews the HealthPartners Dental Group's experience with clinical quality measurement and provides information on the administrative infrastructure that supports measurement within the group. Some examples of the role measurement plays in operations and clinical practice are also reviewed.

Digital intraoral radiographic quality assurance and control in private practice

At present, the American Dental Association and the American Academy of Oral Maxillofacial Radiology have guidelines for the dental environment that include quality assurance and control of film-based radiography. Approximately 19%-30% of US dental offices currently use some form of digital intraoral radiography, and growth is expected to continue. It is anticipated that new tools and guidelines will be needed to aid in the development of quality assurance (QA) and control of digital intraoral radiographic images. Working with a representative sample of private practice dental offices, this study examined and evaluated the entire digital intraoral radiographic system used in each operatory. The X-ray machine was tested for equipment performance and accuracy, and the computer monitor calibration was evaluated and adjusted as needed. The results confirm the continued need for updated QA procedures in the dental office that include digital X-ray imaging. By implementing these changes and practices, dentists should be able to improve the diagnostic quality of radiographs while reducing the radiation exposure of the patient.

The importance of control elements in dental office management

In the current economic situation statistical indicators suggest a decline in global and national dental services market under increased competition. Hence, a cost-effective and strengthening market position. Thus it is recommended the office management to focus on retention and follow active patients and to create a system of quality control maneuvers. In order to achieve these objectives we must monitor certain elements of medical control, economic, management and promotion.

[Discussing and evaluating professional behaviour. 1. Academic Centre for Oral Health Groningen]

Professionalism is considered as a core competency for dentists. As a result of changes in the healthcare sector, it is becoming increasingly important for dentists to be more transparent to the community in their delivery of care. The ability'to provide justification' thus becomes an important skill. To train dentists to become professionals who can account for their actions, we developed an educational programme in Groningen which trains students in the following professional skills: 1. make explicit; 2. concretize; 3. analyze; 4. diagnose; 5. generalize; and 6. formulate learning points and experiment with them. This educational programme is given, under the supervision of a coach (generally a practicing dentist), during the entire curriculum, in small groups. Professionalism is integrated with other course programmes (work placement, working in the clinic), because professionalism is a competency which is only expressed by practicing other competencies. The professionalism of the student is also assessed.

The role of coaching in the business of dentistry

Coaching is a subject dentistry appears to have let slip by, yet as this article outlines, it has so much to offer in many different aspects of dentistry, but particularly in fulfilling the Standards for dental professionals determined by the General Dental Council (GDC). Evidence suggests that coaching has produced tremendous benefits to business, and dentistry is a business.

The use of an evidence-based portfolio in the management of change in dental practice

In this paper the author gives his opinion about the problems of getting practices to change systems in order to institute clinical governance. There are many reasons why practices need to change and for this change to be monitored. This paper explains the need for change and the use of the evidence-based portfolio, which is produced by candidates for the Membership of the Faculty of General Dental Practice (UK) [MFGDP(UK)] examination. It can also be produced by individuals who are not taking the MFGDP(UK) examination in conjunction with the Faculty of General Dental Practice (UK)'s key skills programme. It provides a mechanism for demonstrating change and for assessing the quality of care provided by a general dental practice. The author concludes that the evidence-based portfolio will enable a practitioner to apply clinical governance in a practical way.

The responsibilities and rights of dental professionals 3. Professional rights

Professional status, professional autonomy, clinical freedom, self-regulation and the right to serve patients and the community seem to be the main rights of dentists. Although they simply may be seen as privileges that are related to being a dentist, these rights cannot be considered independent from dentists' roles and responsibilities. They are, in fact, valuable tools that serve dentists to meet their broad responsibilities that arise from the 'social contract' between the profession and the public.

Dental records: a Belgium study

The aim of this study was to deduce the quality of the average dental record kept by Belgian dentists and to evaluate its potential use for forensic dental casework. The evaluated material originated from 598 Dutch speaking and 124 French speaking Belgian dentists who completed a questionnaire and returned it by mail or through the internet. The age of the participating dentists ranged from 22 to 72 years of age. The results of the inquiry were statistically analysed taking parameters such as language, gender, age, university and ZIP code into account. In general there was a tendency for the young dentists from the age category 22 to 34 years of age, especially those living in larger cities, to perform better on several of the questions asked such as completion of the dental record, storage of x-rays, working with digital x-rays and a digital dental record.

Consistency

Consistency is a reflection of having the right model, the right systems and the right implementation. As Vince Lombardi, the legendary coach of the Green Bay Packers, once said, "You don't do things right once in a while. You do them right all the time." To provide the ultimate level of patient care, reduce stress for the dentist and staff members and ensure high practice profitability, consistency is key.