Yesterday morning I woke up not expecting that the day would present itself with so many changes, yet it did, as we continued to witness the disruption that Covid-19 has had on our daily lives.  The last few days have been filled with much doubt and concern that it seems incredible that THIS is slowly becoming a way of life and it threatens to remain with us for quite some time.  Yesterday afternoon, we heard President Trump urge gatherings of less than 10 people, among lockdowns of specific hot zones.  Thankfully, Arizona is not one of those hot zones although we continue to move forward hand-in-hand with all of America.

For me, as a small business owner, doctor, and mother, it has been a time full of great responsibility to my employees, patients, and family.  The decisions I make at this time have to somehow meet the needs of all those placed in my care.  My decisions with regards to these come with much calm, peace, and prayer.  I’ve made my decisions with the advice of national experts, as well as with the advice and feedback of my employees and family.  As such, I would like to make you aware of how I will proceed with my practice moving forward amidst the daily changes, keeping in mind that things can change at any time.  I feel it important to share my plans with my employees, as well as with my patients, who trust me with their care.  Please know that I have the intention of making myself available to care for your needs throughout this entire global crisis. That means that our brick-and-mortar facility will remain open until it is mandated by the government to close its doors.  In addition, if such day should come, we will be available via phone, email, text message, social media and Teledentistry. 

Know that the decisions I am making are in an effort to contribute in a positive manner throughout all of this.  Remaining open allows for us to reduce the number of dental emergencies that hospitals and urgent cares see on a regular basis so that they can focus on more critical patients. All of this is happening during a time when a lack of protective medical equipment threatens to compromise the care that doctors are providing to patients.  In addition, it provides a sense of stability to my patients and staff which allows them to continue moving forward without fear.  I’ll touch a bit more on these things, but please know that we will be available to you no different than any of your other healthcare providers.  Personally, I have been very disappointed with the leadership that the American Dental Association has provided as it stands back without fruitful statements that can guide the dental profession.  In fact, it has been with information obtained from research abroad, journal publications and individuals in the front lines that I have modified some aspects of how we practice dentistry, making them stricter.  These modifications will be in place during and after the Covid-19 global pandemic in order to address the issues that we are facing with the Novel Coronavirus. How we see dentistry and medicine has changed as a result of this illness, no different than 9/11 changed many aspects of our lives, including travel and border security.  Thankfully, the changes are not overwhelming for us since dentistry is one of the professions who carries extensive OSHA regulations and a high demand for quality and safety.

As a result, there will be some visible changes in protocol while others will remain behind-the-scenes.  For your knowledge, below, I’ve listed existing protocol and new changes which will be upheld in response to this virus:

• Because the virus is expected to come in surges and will not likely be eliminated anytime soon, we will take your temperature and ask you questions with regards to recent social experiences and travel. 
• Because the virus is subject to oxidation, you will be provided with a 1% peroxide rinse to use for 30 seconds, prior to all dental appointments, in order to reduce bacterial and viral load prior to treatments.
• Because the virus can live on hard surfaces anywhere from 2 hrs. to 9 days, all front-office locations, including the reception and children’s playroom, will have all hard surfaces disinfected with hospital-grade disinfectants often and throughout the day, no different than in the back-office or treatment areas.
• No-touch waste baskets, tissues and antibacterial hand sanitizers will be readily available, as they always have been in waiting rooms, operatories and restrooms.
• Check-in tablets will have protective barriers to allow for better protection and easier disinfection.
• For the time being and in support of our President, there will never be more than 10 people in our office, at any given time, including staff and patients.  This is not a problem that we face in our office, since we have always been able to provide you with personalized care in a calm environment.  While these restrictions are in place, we ask that you please come alone, unless you need a translator who speaks a language other than English, Spanish or French.
• Strict disinfection, sterilization, maintenance and care protocols will continue in all treatment, sterilization and laboratory areas.
• Water lines will be flushed after every appointment. Shocking of water lines will be completed once a month. Distilled water in closed units will continue to be the norm.
• Autoclave testing is routinely completed, once a week through OSHA Review.
• We have always adhered to all OSHA PPE guidelines, but will now adhere to stricter uniform guidelines that have been suggested by doctors fighting in the front lines abroad, while confronting the virus. As soon as they are available, our back-office team will wear surgical caps, surgical gowns, and surgical shields, in addition to their daily scrubs, masks and eyewear.
• Surgical Masks will aid in better protection for the eyes, since Covid-19 is transmissible through the eyes. In milder cases, conjunctivitis was the only sign noted at the onset of symptoms.
• Surgical caps will be worn to protect hair from aerosolized blood, saliva and dental particulates.
• Surgical gowns will be worn to cover the entire body, in order to protect all standard PPE on the body from contamination which can be carried to other areas of the clinic setting.
• Aerosolization will be limited as much as possible, although it cannot be completely eliminated. Ultrasonic scalers will be used only as necessary and to the mutual comfort of the patient and care provider.

As time goes on, it is a realistic expectation that there may come a time when statewide lockdowns will be mandatory. In the event that the virus increases in numbers in our community so that it is impossible to keep our physical location open, we will lock our doors in cooperation with the rest of the nation.  Let me be clear that this in no way means that we will no longer be available to you.

Just as Telemedicine has made a presence, Teledentistry is here as well.  Some of you are familiar with Teledentistry through the somewhat controversial remote-guided orthodontics. In a similar manner, care and advice can be provided to our patients from your own home using the electronic devices you already own.  Although I cannot provide direct treatment as with a root canal, crown or filling, I can, however, provide you with emergency relief or comfort of anything that is concerning you.  Simply because Covid-19 has taken front-stage, it does not mean that toothaches, abscesses, fractures, and other maladies stop occurring.  You will still need to be “seen” and treated, and Teledentistry can fill that need especially during mandated lockdowns or periods of illness.  We are finalizing the details of this service and will send out an email providing information about it in the very near future.

In the meantime, I urge you to keep your appointments with us and do not be afraid to schedule. I know that everyone is highly concerned about transmission of the virus but we are doing everything we possibly can to keep it out of our office via thorough screenings. Now is the best time to catch up on a cleaning appointment or address that pain that’s been bothering you. To wait may only result in a greater issue or discomfort should our doors close down for an undefined amount of time.  For now, we are here and we will make time for you as you need us to.

Finally, You and I, have been blessed with a dental team who cares very much for all of us. Their loyalty to their profession, their patients, and me are one-of-a-kind.  I’d like to give a heartfelt thanks to Luz, Jeni, Kalin, and Vanessa for the sacrifices they make on a daily basis.  They’ve all been given the opportunity to stay home and practice social isolation with the rest of the country but have, individually and according to their own conscience, made a choice stay and care for you and those in need until the very end. They have been made aware of everything and are supportive of my decision to move forward as described.

Please feel free to call me with any concerns as we progress forward.  Please know that your safety, health and comfort will always be my top priority.  I hope that in the midst of much uncertainty, you feel some sense of continuity, stability and familiarity through us.  Please continue to follow us online.  We will always keep in touch there.

Warmest regards,
Dr. Sandra Reyes, DDS