WHEN YOUR OFFICE REOPENS

The COVID-19 pandemic has affected AAO members in numerous ways. We remain confident that you will be returning to your practices in the near future but in the meanwhile, you are presented with a series of challenges. Among those challenges are the decisions about:

1. When to reopen
2. Personal protective equipment (PPE)
3. Developing a scripting and scheduling plan
4. Operational guidance
5. Infection control
6. Virtual consultations
7. Updated Informed Consent forms
8. Patient intake forms
9. Patient communications for reopening
10. Helpful information from our consumer blog
11. More helpful links from the AAO

When to reopen

Before deciding to reopen your office, check with any federal, state, and local regulations, as well as applicable dental boards. For your reference, the ADA has developed and is maintaining a database of State Mandates and Recommendations.

Interim Orthodontic PPE Summary Based on Current CDC and OSHA Guidelines

In response to the current COVID-19 pandemic, the AAO has formed an AAO COVID-19 Task Force. The COVID-19 Task Force, comprised of a diverse and experienced group of individuals, includes orthodontists, orthodontic educators, members of the AAO Legal Department, and experts in the areas of infection control, infectious diseases, and office design. The Task Force is reviewing all pertinent literature in regards to a variety of topics, including aerosolization in practice and PPE recommendations from the CDC, OSHA, and ADA. While final recommendations from the Task Force are forthcoming, some interim suggestions are indicated as orthodontic offices start to reopen.

AAO is not a legislative body and does not produce regulations that require adherence. These can only come from the regulatory bodies in the United States and Canada. However, the AAO does have a duty to inform, educate and protect members of the public, clinicians and staff during the delivery of orthodontic care.

View Interim Summary

These suggestions are based on current CDC and OSHA guidelines and may be helpful as practices start to reopen. The professional judgment of the orthodontist should be used to determine how to best apply these in practice.

Additional Resources:

Interim Mask and Face Shield Guidelines

Understanding Mask Types

Donning PPE: Put on N95 Respirator

Doffing PPE: Remove the N95 Respirator

Purchasing PPE: Get an Inside Track on Sources

The AAO has been communicating with our industry suppliers in order to identify those best-positioned and willing to fulfill large orders from AAO members in a cost-efficient and time-efficient manner. PPE availability includes masks, face shields, gowns and gloves. Some suppliers also offer office supplies such as thermometers and sneeze guards.

N95 face masks are regulated by the National Institute for Occupational Safety and Health (NIOSH) and the Centers for Disease Control and Prevention (CDC). Concerns have been raised about counterfeit versions of N95 masks entering the market. The CDC has outlined signs that a product may be counterfeit in its guide, “Counterfeit Respirators / Misrepresentation of NIOSH-Approval.” 

In addition, recommend expanding the article to read:

View Information from PPE Suppliers and Updates on KN95 Mask Authorization 

(Exclusive to members; log-in is required.)

Scripting

Prior to scheduling the patient’s first visit back in your office, it is recommended that you develop scripting that suit both the orthodontist and the team, to best communicate your new scheduling plan. Scripting goals should revolve around helping the patient realize that they remain important to you and your team.

Scheduling Process

Consider keeping all patients first post-quarantine appointments as short as possible so that all patients may be seen in the office within a reasonable amount of time. Patients that had been previously scheduled with lengthy visits, such as debond appointments, should be advised that, prior to rescheduling their long visit, a cursory brief evaluation is necessary and in their best interest.

Seeing all of your patients without too long of a delay will allow them to recognize that they are important to you and will be cared for in a timely manner.

Planning for Recovery: Operational Guidance from Mary Beth Kirkpatrick

Among the experts who have offered in-depth recommendations for AAO members is Mary Beth Kirkpatrick, managing partner of Impact360 Consulting and founder and president of Gaidge, a cloud-based business analytics dashboard for orthodontists.

Ms. Kirkpatrick’s webinar from 4/23, “Doctors, Start Your Engine: A Roadmap for Re-Opening,” has been archived and is available at no cost to AAO members. Click on the title to access the webinar (exclusive to members, so log-in is required). Please note CE is not available.

Taking the perspective that the current situation, while extremely challenging for orthodontic practices, also will bring opportunities, the webinar takes a deep dive into every aspect of re-opening planning. Topics addressed include:

• Overall re-opening planning
  View the handout, “Prepare Final Plans for a Strong Recovery”
• Physical planning for the COVID-19 office: Reception area furniture arrangements to reduce risk, removal of as many sources of infection as possible, reception desk sneeze guards, and social distancing floor decals may all be helpful;
• Clinic area changes: Separate locations for aerosol-generating procedures, partitions between treatment chairs;
• Staff preparation: Training, assigning roles, scripting and rehearsing;
• Infection control basics;
• Planning patient entry and triage processes;
• Communicating with returning patients about what to expect.

View Ms. Kirkpatrick’s Responses to Questions from Live Webinar Participants

What to Do if An Employee Tests Positive for COVID-19: CEDR HR Offers Guidance

CEDR HR Solutions has produced a video about employees testing positive for COVID-19, featuring company founder Paul Edwards.

The video reviews current CDC guidance and offers risk assessment recommendations.  To support the risk assessment process, CEDR HR encourages employers to bookmark the following websites:

• Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19
• Criteria for Return to Work for Healthcare Personnel with Suspected or Confirmed COVID-19 

In addition, CEDR HR compiled step-by-step recommendations on what to do if there is a potential exposure in your office:
Handling Ongoing Concerns About Employees Contracting the Coronavirus.

 
Track Your Team’s Health with the AAO Daily Employees Screening Form 

The AAO has developed a fillable PDF, “COVID-19 Daily Employees Screening Form” for member use in tracking temperatures and symptoms being experienced by team members.  
 
After using all of the rows in the chart: 
▪ Simply save the form if you wish to maintain a long-term record; then,  
▪ Save under a different filename and use the CLEAR FORM button at the bottom to clear all fields and re-use the form. 
 
A six-page portfolio version of the form is also available for those who prefer to keep records in one large document. 
 
AND, COMING SOON:  Two patient temperature/symptom tracking forms, each offering a different approach for varying preferences: 
▪  One PDF will provide a fillable chart to enter each patient’s information upon arrival on a specific day; 
▪  The second form will be patient-specific and include fields to enter the patient’s information at each appointment. 
 
Watch your in-box for more information.

Frontload Your Practice’s Recovery with Proactive Recall Management 

Ms. Kirkpatrick also addresses marketing the re-opened office. To build new revenue from starts, she recommends that orthodontists initially focus on those who have been in monitoring/recall status, so as to quickly ramp up new starts following re-opening.

Handouts include Proactive Recall Management guides covering five of the major orthodontic software companies. These guides outline each step for identifying a practice’s monitoring/recall patients in the respective systems. Click below to access this information for:

• Cloud9
• Dolphin Management Systems
• Ortho2 Edge
• OrthoTrac
• topsOrtho

Find Answers to Many of Your Infection Control Questions 

Click on the title to access the free webinar from 4/21, “Coronavirus: Getting Back to Work after Closure ,” by Jackie Dorst, RDH, BS. In this free webinar Ms. Dorst, an infection control and OSHA expert, provided a comprehensive COVID-19 Infection Control plan for patient and orthodontic team safety for reopening orthodontic practices. (Non-CE webinar)

Access Handouts from This Webinar

The Virtual Consultation Option: Is It Right for Your Practice 

Prior to re-opening and even after your office has re-opened, virtual consultations may offer an efficient opportunity for initial interaction with prospective patients. A Trapezio webinar included in our article on this topic provides a comprehensive how-to guide.

View “Onboarding New Patients with Virtual Consultations”

Updated Informed Consent Forms

The AAO has updated the informed consent form adding a new section covering transmission of communicable diseases. This form represents sample informed consent provisions offered as a service to AAO members. It is not intended to serve as legal advice, and each state may require unique provisions. You are encouraged to have this form reviewed and approved by counsel in your state prior to using it. Any such items should be included by you in the space provided. The AAO accepts no liability for any modifications you may make to this form. LEARN MORE >

Two Intake Form Options Available for Check-in Documentation

Screening patients for fever and other symptoms as they check in for appointments may be easier with a choice of two patient intake forms formatted as fillable PDFs. Depending on your preferences, either form may work well for documentation in your practice:
 

1. The Daily Patients Screening Log:  Track information on each patient who checks in for an appointment on a specific date.  
   
   After completing daily input or using all of the rows in the chart:  
   • Simply save the form if you wish to maintain a long-term record to observe trends in your practice over time; then,   
   • Save again under a different filename and use the CLEAR FORM button at the bottom to clear all fields and re-use the form. 
2. The Individual Patient Log:  Track each patient’s check-in health status from one appointment to the next with an individual patient log that may be kept in his or her chart.   

Patient Communications for Reopening Your Practice

You have been busy planning for re-opening, acquiring PPE and preparing your team to return to work.  While individual timetables vary by state and practice, you may be ready to let patients know about your reopening plans.

To help ensure that all important information is communicated, our guide provides recommended points to cover and sample letters shared for AAO members by Mary Beth Kirkpatrick. Also included are suggestions for reinforcing information via social media between the reopening soon and welcome back communications.

View the Guide to Patient Communications for Reopening

Helpful Information from Our Consumer Blog 

We will soon provide templates for patient communications announcing re-opening. In the meantime, to help patients understand the changes they may find upon returning to your office, you may want to share the following on your social media:

“My Orthodontist’s Office Has Re-Opened: Is it Safe to Go?”

More Helpful Links from the AAO COVID-19 Resource Center

Financial resources

Along with your regular financial advisors, these sources may be helpful for addressing financial issues related to re-opening:

• 90-day cash flow planning tool from Cain Watters
• Updates from the most recent funding of PPP loans

HR resources

Bringing your team back to work will require some basic steps. See the following resources for recommendations.

• CEDR HR rehiring checklist
• Form letter for offers of reemployment for your employees.

Two Intake Form Options Available for Check-in Documentation 

Screening patients for fever and other symptoms as they check in for appointments may be easier with a choice of two patient intake forms formatted as fillable PDFs. Depending on your preferences, either form may work well for documentation in your practice: 
 

1. The Daily Patients Screening Log:  Track information on each patient who checks in for an appointment on a specific date.   
    
   After completing daily input or using all of the rows in the chart:  
   • Simply save the form if you wish to maintain a long-term record to observe trends in your practice over time; then,   
   • Save again under a different filename and use the CLEAR FORM button at the bottom to clear all fields and re-use the form. 
2. The Individual Patient Log:  Track each patient’s check-in health status from one appointment to the next with an individual patient log that may be kept in his or her chart.   

Patient Communications for Reopening Your Practice

You have been busy planning for re-opening, acquiring PPE and preparing your team to return to work.  While individual timetables vary by state and practice, you may be ready to let patients know about your reopening plans.

To help ensure that all important information is communicated, our guide provides recommended points to cover and sample letters shared for AAO members by Mary Beth Kirkpatrick. Also included are suggestions for reinforcing information via social media between the reopening soon and welcome back communications.

View the Guide to Patient Communications for Reopening

Helpful Information from Our Consumer Blog 

We will soon provide templates for patient communications announcing re-opening. In the meantime, to help patients understand the changes they may find upon returning to your office, you may want to share the following on your social media:

“My Orthodontist’s Office Has Re-Opened: Is it Safe to Go?”

More Helpful Links from the AAO COVID-19 Resource Center

Financial resources

Along with your regular financial advisors, these sources may be helpful for addressing financial issues related to re-opening:

• 90-day cash flow planning tool from Cain Watters
• Updates from the most recent funding of PPP loans

HR resources

Bringing your team back to work will require some basic steps. See the following resources for recommendations.

• CEDR HR rehiring checklist
• Form letter for offers of reemployment for your employees.

ONLINE LEARNING RESOURCES

AAO members can access live and recorded education anytime, anyplace, and on any device. Our recorded lecture archives give you access to over 500 doctor and team clinical lectures, as well as the complimentary Business of Orthodontics series

The recorded lectures library covers a wide range of clinical and practice management topics. Presentations are viewable on your computer or mobile device, or through the AAO mobile app.  

• Access clinical content   
• Access business content    

CE credit varies by lecture and requires completion of a test or evaluation after viewing.   

To register your entire orthodontic team for online lecture access and our Orthodontic Staff Club Facebook group, click here to access the OSC application. Each OSC member will receive an individual login.  

Recognition  

The American Association of Orthodontists is an ADA CERP Recognized Provider.  ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.  

American Association of Orthodontists designates for all CE activities, 0.25 credit hours will be awarded for each 15 minutes of activity time unless otherwise noted.  

Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at www.ada.org/cerp.  

WEBINARS: ALL THINGS COVID-19

Catch up on CE with webinars on all things COVID-19:

Coronavirus Issues for Orthodontic Practices

On March 24 an AAO featured speaker on sterilization, infection prevention, and OSHA safety, Jackie Dorst, RDH, BS presented “Today’s Coronavirus:  Management in the Ortho Practice.” This free event aired with a special introduction by AAO President, Dr. Gary Inman.

Resurrecting Your Practice after the Shutdown

Paul Edwards with CEDR HR Solutions presented “Resurrecting Your Practice after the Shutdown” on Monday, April 13th at 12:00pm CT. Edwards fielded Q&A from AAO members and covered how to handle Coronavirus as an employer with practical solutions for the impact that the outbreak may have on your business. *Non-CE webinar*

Using Virtual Appointments to Maintain Continuity of Patient Care During a Crisis and Set Yourself up for ‘Normalcy’ Upon Return

On April 9, Dr. Michelle Neal presented “Using Virtual Appointments to Maintain Continuity of Patient Care During a Crisis and Set Yourself up for ‘Normalcy’” Upon Return.” Dr. Neal answered questions on the topic of utilizing virtual appointments to remotely monitor patients in active treatment and identify potential emergencies.*Non-CE webinar*

CARES Act: What It Means for Small Businesses

On Monday, March 30, 2020, Steven Dickerson and James Van Orden from Cozen O’Connor Public Strategies presented a webinar for AAO members on what the CARES Act means to small businesses and their employees. AAO members can access this video below for an update on how to navigate small business issues during COVID-19 related closures and restrictions. *Non-CE webinar*

ADDITIONAL RESOURCES:

YOU, YOUR TEAM, YOUR PATIENTS:  IS ANYONE EXPERIENCING CORONAVIRUS-RELATED STRESS?

Emotional Check-Up:  Taking Care of Our Mental Health during COVID-19 

As we try to manage necessary tasks and support others, it is important to take time to process our own reactions and truly take care of ourselves emotionally as well as physically.  Here are some resources that can help: aaoinfo.org/emotional-check-up-taking-care-of-our-mental-health-during-covid-19/ 

The entire AAO team wishes you well and we will strive to help as best we can.