Office Closure Guidelines
The AAO supports the recommendation from White House Coronavirus Task Force member Dr. Deborah L. Birx to postpone any elective dentistry for the next two weeks – through the end of March. The AAO office will be working remotely in response to this announcement as well.
Elective vs. Non-Elective Procedures
Non-elective procedures, including those considered to be orthodontic emergencies, are defined as remedying one or more of the following:
- Significant oral pain (Keep in mind many patient “emergencies” can be managed by wax or sectioning an archwire with cuticle cutters/nail clippers.)
- Limited function
- Physically traumatic event yielding the above
Unless any of the above is true, loose brackets and bands, as well as lost or broken retainers/aligners, should be considered elective. Discretion should be used should a long period of time pass in such a state.
Congress passes Family First Coronavirus Response ActAAO Joins Dental Coalition in Advocating for Dental Practices
Yesterday, March 18, Congress passed H.R. 6201, the Families First Coronavirus Response Act, to provide relief to families and businesses that may be affected by the coronavirus outbreak. The AAO, in cooperation with other dental groups, is taking steps to see that AAO member practices are not unduly affected by the legislation.
The Families First Coronavirus Response Act provides paid benefits to employees affected by the coronavirus in two different ways, through 1) amendments to the Family and Medical Leave Act (FMLA) and 2) new emergency paid sick leave provisions.
Under the FMLA amendments, employees are entitled to take up to 12 weeks of job-protected leave to care for a child younger than 18 whose school is closed or whose childcare provider is unavailable. Notable for many AAO members’ practices, the amendment carves out an exception for businesses with 50 or less employees, which are shielded from liability for damages in a civil action for violating the new extended FMLA leave provision.
OFFICE CLOSURE GUIDELINES
The AAO supports the recommendation from White House Coronavirus Task Force member Dr. Birx to postpone any elective dentistry for the next two weeks – through the end of March.
You’re closing. Now what? Consider these steps:
- Notify your employees: Access HR-related information that the AAO has compiled, which includes a variety of recommendations regarding the coronavirus and team members.
- Develop a process and assign responsibilities for notifying patients and re-scheduling appointments.
- Notify your patients:
- Notify any other key suppliers, especially those that may have pending or regularly scheduled shipments
- Reschedule appointments.
- If patients will be called by your team for re-scheduling, clearly state such information in your closure announcement so you are leading the charge, and patients aren’t all trying to call and re-schedule at once.
- Mitigate the long-term financial impact on your practice and utilize AAO financial resources related to COVID-19.
- Stay in touch. Keep your patients and team members informed with virtual meetings and social media.
- Explore these 5 free virtual meeting tools & educate yourself on cyber security measures for orthodontic offices during this time.
- Share AAO blog “My Orthodontist’s Office is Closed. What Does That Mean for my Treatment?” with your patients.
- Consider other fun ideas, like sending handwritten notes or calling patients to check in.
- Monitor the AAO’s COVID-19 Resource Center for updated information daily and keep an eye on recommendations and news from health agencies.
- CDC information related to case counts by state (updated regularly);
- State and territorial health department websites;
- State and provincial dental boards
- American Dental Association compilation: State Governor and State Society Position Statements (3/18)
- Earn continuing education credit. Now is a great time to stay connected with the orthodontic community virtually. Explore our upcoming educational opportunities.
- Prepare for when you reopen. (see below)
Fostering Personal Connections with Patients during COVID-19 Office Closures
Maintaining strong relationships with your orthodontic patients even when you’re not seeing them at appointments may be helpful for their treatment compliance, motivation and mental health. Beyond treatment issues, you may wish to make your practice a source of support for the many challenges your patients and their families are now facing. Here are some ideas for phone contacts and social media content to help you get started. Read More >
WHEN YOUR OFFICE REOPENS: RECOMMENDED PROCEDURES
Consider the following procedures that have been implemented by some AAO members:
- Communicate explicitly with patients: Don’t assume that patients and parents know the substantial efforts put forth by your team to prevent the spread of infections – both routinely and with any added processes since the coronavirus emerged. Provide reassurance by including a brief overview of your sterilization and sanitation procedures.
- Many AAO members are using social media posts and emails to let patients and parents know that their offices are open as well as to outline any changes in procedures, if applicable (see below).
- Stagger the scheduling of patients so that it will be possible to keep them six feet apart. Adjacent dental chairs should be assessed for the six-foot minimum when seating patients as well. Ask patients to brush their teeth before coming to their appointments so as to minimize contamination via the toothbrushing station.
- Pre-screen patients for symptoms and exposure. This may best be done by contacting patients and parents the evening before their scheduled appointments, via phone or email, asking them the following questions and indicating that a response is required in order to secure their appointment time
- Have you recently participated in any large gatherings (of more than 50 attendees) or gatherings of people you didn’t know?
- Have you or a member of your household traveled outside the United States within the last 14 days?
- Have you or an immediate family member been sick or had a fever within the last 14 days? Patients answering “yes” to any of these questions should be re-scheduled. One exception may be elementary and high school students whose schools are not closed and who have attended classes.
- Consider adjusting the patient check-in process so as to keep your waiting room traffic to an absolute minimum. Approaches to consider:
- Patients check-in via text from their cars, or staff could visit their vehicles to check them in. Patients are then called into the office via text when the team is ready for them.
- Restrict who can enter your office. Regardless of the check-in system utilized, establish that adult patients and teens are to enter the office alone; only children are to be accompanied by one adult.
- Put away items that may be accessed in your waiting area and potentially contaminated, such as magazines, pens, coffee/tea stations or toys.
- Don’t overlook delivery personnel. Consider using signage directing delivery personnel to call and inform your office of their arrival; further consider that they leave shipments outside for you and your team to collect. Ask key shippers if any required signatures can be collected electronically.
- Consider temporarily limiting the procedures done in your office. A key concern is avoiding production of AEROSOLS, given the potential that asymptomatic patients may have unknowingly been exposed to the coronavirus:
- Postpone debonding procedures;
- Avoid the use of a handpiece.
If someone enters your office showing symptoms of coronavirus:
Ask the individual if they will let you know their test results and consider an immediate closure of your office pending test results. If results are positive, everyone who entered the office after the affected patient will need to be notified immediately.
FREE ONLINE LEARNING RESOURCES
The AAO is extending a free month of learning to all members with convenient, 24/7 access to over 500 hours of CE for you and your team. Because orthodontic staff is so important to your practice, we are also extending free access to AAO’s Orthodontic Staff Club (a $50 value).
While many offices may be closed, this may be a great time for orthodontists and their teams to earn valuable CE and participate in clinical and business learning events.
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.
To view doctor and business lectures, there is no need to register. Your member ID grants you access to the free content through the end of April.
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. Your staff registration in OSC will be processed at no charge with the membership period good through May 31. Each OSC member will receive an individual login.
This special offer for recorded lecture access and Orthodontic Staff Club registration runs through April 30, 2020 and is available to all AAO members.
It will be necessary to log out and log back in to view the price changes (i.e. $0 for recorded lectures through the end of April).
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.
WEBINAR: CARES ACT: WHAT IT MEANS FOR SMALL BUSINESSES
On March 30 at 6:00pm CT, Steven Dickerson and James Van Orden from Cozen O’Connor Public Strategies will present a webinar for AAO members on what the CARES Act means to small businesses and their employees. AAO members should register immediately for this timely update on how to navigate small business issues during COVID-19 related closures and restrictions.
Register here: https://zoom.us/webinar/register/WN_icvk0AyMSwiVLPdU1Pc-KQ
WEBINAR: CORONAVIRUS ISSUES FOR ORTHODONTIC PRACTICES
On March 17 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.
Ms. Dorst created an understanding of the following:
- The process of coronavirus infection
- Reducing the stigma
In addition, Ms. Dorst also reviewed:
- CDC guidelines for infection control and recommendations for orthodontists and staff, including personal protective equipment and supplies;
- Patient communications, including emails, social media, and signage;
- Implementation of Standard, Contact, and Airborne Precautions, including the use of eye protection for staff and orthodontists;
- Cyber security and scams that will occur during the coronavirus outbreak and taking a proactive approach to avoid risks.
YOU, YOUR TEAM, YOUR PATIENTS: IS ANYONE EXPERIENCING CORONAVIRUS-RELATED STRESS?
For help with coping with the coronavirus situation and helping team members and patients, here are some mental health resources.
The entire AAO team wishes you well and we will strive to help as best we can.
More COVID-19 related questions? Let us know
Please also recognize that we are here to serve you. If there are additional assets or guidance that would be useful for your practice,
please make us aware by sharing it with us at Coronavirus@aaortho.org.