10 steps back to practice after COVID-19 – virtual consultations

virtual consultationsWith a growth in popularity, Claire Berry explores whether virtual consultations are the new way forward for dental advice.

When the world was thrown into lockdown and dental centres were forced to close, it meant a sudden halt to general treatment and cancelling our patients. In some cases this meant cancelling in the midst of a treatment plan; there were patients between visits for RCT, Invisalign, crowns, bridge work and implants amongst many other things. All without us knowing when we might continue.

The thing most shocking was the number of patients contacting me over worries about missed periodontal treatment. Worried they would get bone loss or deterioration in their periodontal condition because they had gone over their three-month recall. Two thoughts crossed my mind:

  • I am proud that a large proportion of my patients understood the benefits a teamwork approach gave to the stability of their periodontal disease. And how this shows an understanding about the working of their disease (pat on the back for me)
  • Patients need an outlet to talk to me or another clinician properly. Like an appointment, where we could discuss what they could do to treat their own disease and provide reassurance.

I was thrilled when the BSDHT started running free virtual clinics and asked for my involvement. This provided the service to the public which I felt was needed. Unsurprisingly, it was a big success. This particular initiative was a collaboration between the BSDHT and Oral B. It was in an effort to bring vital preventative advice to the public, whilst they were unable to speak to their own dental care provider.

How it works

The platform we used initially was Zoom. Patients would contact the BSDHT to make an appointment with a clinician. From there they would sign a consent form indicating that they are aware we cannot make a diagnosis via a Zoom call. Advice given is always within the scope of practice of the clinician. It will always be our advice to see the appropriate clinician face to face as soon as possible; these clinics offer oral hygiene instruction to help the public deal with any issues relating to this while they couldn’t go to a dental practice for treatment or care.

The sessions were all 30 minutes long, with 15 minutes at the end to write notes about the conversation and advice given. These were sent to the patient afterwards, with notes about all the recommendations made by the clinician. In some circumstances, when it was advised that the patient should see a clinician as soon as lockdown was lifted and dentistry could resume, they were directed to their nearest practising hygienist using information from the BSDHT website (a hygienist location service is available on there so patients can find their nearest direct access hygienist for treatment).

Why it works

Virtual appointments are a great tool to connect patients with clinicians. It ensures they have the care and treatment that they need, made easily accessible to them. It allows us as professionals to ‘virtually’ connect with patients. We can provide advice about how to best maintain a healthy mouth. This in turn will help them to maintain a healthy body (as we know there are links to systemic health also). It is something that I think there is a place for, even when practices are open and functioning normally.

The motivated part of society generally knows where to go to get the advice they need. We see them at regular intervals in the dental practice. But there are people who avoid our place of work at all costs, maybe due to nervousness or a true phobia. These patients, often the ones who most need our help, we effectively leave to their own devices.

If we bridge that gap and give them a source of advice and care in an environment that they are comfortable in via virtual appointments, we may even manage their anxiety enough to get them into a dental practice. At worst we can give them advice that will help them try to sustain better oral health with what they can use at home.

How to make it work for you

Offering virtual appointments is good for your practice. It allows your patient base to contact you with issues you can alleviate without the need to physically attend the practice. At a time when we should all continue to remain socially distant, as few visits as necessary is a good thing.

Getting the right advice from your practice hygienist can help reduce inflammation and make periodontal treatment easier. It ensures the patient is using the appropriate tools for the job.

We can advise to a certain extent on how to use those tools and what products to buy in preparation. When patients do eventually come in to the practice, they can focus on technique and fine tuning. This can kick start a healthier routine before the appointment has taken place. We can also connect with patients a few weeks after treatment to encourage them to remain motivated. This is a vital part of ensuring behaviour change.

It gives the wider community, not just your own patient base, a clinical person to speak to. As a result you could even gain a new patient from it. It certainly doesn’t replace the need for you to see patients face to face, carry out their regular exams and it definitely doesn’t allow you to diagnose issues. What it can do though is reassure, prevent, keep up motivation and encouragement. It ensures good routines and connects the public with professionals in the interest of their health.

View the other 10 steps back to practice after COVID-19

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