To our family of patients at San Ramon Dental Excellence,
First and foremost, we hope you and yours have remained healthy and safe over the last 2 months. If you have been affected by COVID-19 through illness, isolation, or economic impact, please know that we are thinking of you and are here for you as we begin to resume normal dental care. Most importantly, please know that WE HAVE MISSED YOU! We are so excited to see you again. While this message is fairly lengthy, we feel that it is very important and we encourage you to read the entire letter.
As communities are phased into normal activity, this is a perfect time to provide our patients information about some important changes in the way we will operate to continue to provide you the best oral health care possible with an uncompromised dedication to patient and team member safety. We have been closely monitoring all of the emerging science related to the COVID-19 virus. What we know is that the usual sterilization and surface disinfection protocols that we have always had in place are 100% effective in killing the virus. The products and technologies we’ve always used to clean instruments and working surfaces are designed to kill pathogens that are far more difficult to destroy than COVID-19. That said, with the unique nature of certain dental procedures and instrumentation that produce aerosol, the challenge presented is to not only kill the virus that may land on surfaces (easy to do) but to capture any aerosol that may carry any pathogen (not just Covid-19).
Our mission is to provide the safest treatment environment possible for our patients. We will have measures in place to make our offices as safe as staying in your own home. We shall be strongly adhering to ADA, CDC and OSHA mandated frameworks.
Some procedural, technology and protocol highlights:
- Phased Opening and Treatment Expansion – Our tentative opening date is June 1st. We have chosen this because a critical volume of advanced PPE (personal protective gear) will not be available until that date. Meanwhile, we do have limited supplies of this gear to treat dental emergencies which we have done safely since the interruption of usual work schedules. Please call and follow the emergency prompts to connect with your doctor in the event that you need care prior to June.
Our early treatment options will include:
- More loosely defined emergency procedures
- Cleanings without the use of ultrasonic instruments
- Exams and diagnostic procedures
- Orthodontic procedures
- Delivery of crowns already fabricated but not cemented.
We anticipate the 2nd phase of practice operations (which will essentially include any and all treatment) to begin in late June/early July. By that date, we will have installed the latest technologies in aerosol control.
- New Technologies – Over the last few weeks, we have invested tens of thousands of dollars in new devices designed to eliminate the risk from aerosols that are created by certain instruments. For details about these technologies please click the link: https://sanramondentalexcellence.com/patient-safety-is-our-number-one-priority/ to visit our website dedicated patient safety page. As a short summary, these include installing:
- ISOLITE units in all of our treatment operatories including hygiene rooms (many of you have experienced this technology when you were getting restorative treatment). While designed to improve bonding outcomes and patient comfort while delivering fillings and crowns, this intraoral isolation unit clears away a lot of the water and patient saliva directly into the vacuum lines rendering far less available to reach the environment.
- ADS aerosol capture technology. This unit captures >99% of all aerosol into a vacuum tube that sits just outside of the mouth. What is captured travels through sophisticated filtration and an eventual UV sterilization base unit so that all pathogens are eliminated before anything recirculates. In other words, what’s not captured inside the mouth has no place to go but into this virus and bacteria killer.
- Countertop HEPA air purification units. You will see multiple units throughout the office which are always passively working in the background filtering and cleaning the ambient air. In other words, while we closely control potential pathogens during treatment, these filters are always cleaning passive areas like the waiting rooms and general square footage.
- UV sterilization technology. Consumables and durable goods (things as simple as pens and reusable barriers will not only be wiped with disinfecting wipes, but can also be placed in UV cleaners throughout the day.
- Heightened Pre-Appointment Screening – Everything listed above will make our office one of the safest environments possible. These highlighted technologies are essentially a highly effective parachute of insurance to protect all involved from a potential asymptomatic carrier. The other tactic to reduce transmission is to eliminate the possibility of sick or potentially infected patients from entering the office. Please be prepared to receive screening questions (whether automated through texts, email, or live phone calls). These will be similar to the questions most have undoubtedly already experienced asking about any illness, history or symptoms, exposure to others who may have been ill, travel… etc. Any patient who may not clear these questions appropriately will expect to have appointments rescheduled beyond guided clearance dates.
- Curbside Reception and Chaperones – Those patients who have appointments will be reminded via text to remain in their cars until their doctor or hygienist is ready for them. This will prevent patient overlap and reinforce our 6-foot distancing policy.
We strongly encourage that only patients are taken back to the treatment rooms. There will be exceptions with anxious, young children or adults that require assistance. In these instances, we will permit one adult chaperone.
- In-office Screening and Hygiene Measures – We will take touchless temperatures from all entering the office and dismiss anyone exhibiting a fever until recovered. We will incorporate hand washing or waterless sanitizing for all patients. All patients will also be asked to perform a 1.5% hydrogen peroxide rinse prior to care. This poses no risk to you as the patient but provides an added measure of intra-oral disinfection of your saliva and mucous membranes.
Finally, we will be seeing fewer patients per day in the office, eliminating overlapping hygiene appointment schedules and modifying waiting room traffic and arrival policies. Details will be provided upon scheduling and confirmation. These changes will support universal distancing strategies that are in play everywhere.
We hope this information resonates with you and reinforces our commitment to your health and safety. We know you are eager to get back to normalcy and a big part of that is the commitment to maintaining your own health. We appreciate all of your calls, texts and emails asking “when can I be seen again?” We love hearing from you and can’t wait to help you and your family members maintain and improve your oral health! In fact, one of the things that the COVID crisis has highlighted is the importance of overall systemic health. The stronger and healthier you are, the less vulnerable you may be to complications from any infection. There is a proven link between oral/periodontal health and general systemic health. Unhealthy teeth and gums can have correlations to cardiovascular health, diabetes and other systemic issues highlighted as risk factors for anyone that may contract the Covid-19 virus. The interruption to all dental procedures (besides absolute emergency care) was a necessary step over the last couple of months as a global strategy to combat the pandemic. The next equally important phase is to restore normal health and dental care services so that we all become healthier as a population.
For patients who had appointments canceled in March, April and May, please be on the lookout for communication from our front office and hygiene teams. They will be calling you in the next 2-3 weeks to rebuild your appointments into the summer schedule and to answer any other questions you may have.
Due to the huge escalation in PPE consumables costs, investment in new technology and a significant reduction in patient flow, we have incorporated a patient safety fee of $20.00 that will be collected prior to each appointment. Please understand that there is absolutely no profit built into this fee, it is only designed to offset the tremendous increase in overhead associated with the elevated costs per visit. As supply pipelines open up and costs of PPE materials subside, we would like nothing more than to reduce this fee as it is not in any way an aspect of our business model.
We will end by sharing a basic financial forecast about our practice in the spirit of transparency and openness. With the impact of almost 3 months of lost practice time and the prospect of operating at a significantly reduced capacity in future months, we expect a tremendous financial loss in 2020. We know we share this in common with many other businesses and individuals. As a group of doctors, we understand that we will have to cover these losses primarily out of our own pockets. Our biggest concern remains the safety of our patients while delivering the best oral health care possible. We understand that if we can commit to this goal with resolve, business viability and fiscal stability will hopefully return in 2021 and beyond.
Best wishes for health,
Dr.’s Hakim & Patel