Set aside clinics for vulnerable patients (those more likely to develop serious illness: older people, people with underlying medical problems, e.g. high blood pressure, heart problems, diabetes) at the beginning of the day

Marketing

At this critical time, it’s important not to reduce your marketing. In fact the very opposite. You need to communicate all your practice information, virtual consultations, reopening and infection control processes you are adopting.

Before you start re-investing in marketing to get patients back in your chair, it’s vital to have a plan to succeed. Follow the tips below to help you optimise your marketing strategy:

1. Identify your target audience and your objectives:

If you are targeting existing patients who have missed their recalls, you may consider running a marketing campaign that includes email and direct mail. If you are looking at targeting new patients, you might want to take a closer look at your data on where new patients are coming from before you start investing in paid advertising. Last but not least, you may want to specifically target existing patients with outstanding treatments. The Care Manager feature within EXACT has functionality to assist you with easily identifying and following up these opportunities.

2. Optimise your Google My Business (GMB) Profile. When people search for a dentist on Google, most likely they’ll see your GMB profile first, before your website:

Make sure the information section is completely filled out (including the services you offer and the region you serve) Upload more photos Set-up messaging: a new feature that allows people to message you from GMB Manage and respond to reviews

3. Update Your Social Media Pages & Website:

The next most likely place prospective patients may come across your business before they get to your website is on Facebook or Instagram. • Make sure your profile information is complete and accurate and that the information is consistent with your website.

Communicate any changes to your practice, such as business hours, new payment methods or heightened safety and hygiene protocols. Update your pages with current photos or use high quality images. Some free sites include Pixabay or Pexels. Monitor and respond to reviews in a timely manner. Ensure your pages have Online Booking so that patients can book on demand, even when your practice is closed.

4. List on new patient acquisition marketplaces:

Listing your practice on marketplaces, such as HealthEngine and MyHealth1st, that integrate with EXACT and OASIS software can help you get noticed and attract new patients, while helping you fill up your appointment book faster.

5. Conduct Oral Health surveys for new patients:

It’s important to ask new patients what are their concerns via a survey. This might identify opportunities to promote higher value treatments in the future, such as Invisalign, whitening or other dental issues. ForEXACT dental software users, these surveys can be completed electronically by a patient prior to an appointment at home with information saved directly into yourrEXACT software via our Patient Experience solution.

6. Confirm patient contact details:

It’s important to confirm email addresses and SMS mobile numbers of existing patients to ensure your communications, recalls and appointment reminders are actually being received. This will help ensure maximum effectiveness of your marketing campaigns and minimise FTAs and short-notice cancellations. EXACT, OASIS and Dentrix Ascend dental software all have the ability to automate your recalls and reminders.

Infection Control

Need to up skill or refresh on Infection Prevention?

Prime Practice Compliance team are offering a range of courses to help customers keep up to date during these times.

Live Online Training] Infection Prevention Part 1: Compliance 17 June 2020 | 10:00am (AEST) | 1.5 hours | $219.00

In this session, you will… • Understand the documentation required to ensure compliant infection prevention and control processes within your practice • Learn how to mitigate the risk of infection prevention breaches • Know who is accountable and how to develop strong policies for delegated tasks

Live Online Training] Infection Prevention Part 2: Standard Precautions 24 June 2020 | 10:00am (AEST) | 1.5 hours | $219.00

In this session, you will learn how to • Implement Standard Precautions to reduce the risk of spread for any infectious disease • Ensure team members are kept safe and know how to use PPE correctly • Understand risk assessment based on transmission-based precautions

Live Online Training] Infection Prevention Part 3: Sterilisation 24 June 2020 | 12:30pm (AEST) | 1.5 hours | $219.00

In this session, you will… • Learn how to manage instruments safely to reduce the risk of injury or infection • Understand Batch Control Identification to allow tracing of sterilisation processes • Know the importance of a validated process to maintain infection prevention and control standards Register for all three modules in our Infection Prevention Live Online Training Bundle for only $557 ex GST (save $100).

Aerosol generating procedures

SARS-CoV-2, the virus that causes COVID-19, is thought to be spread primarily through respiratory droplets. Airborne transmission from person-to-person over long distances is unlikely. However, the contribution of aerosols, or droplet nuclei, to close proximity transmission is currently uncertain. The virus has been shown to survive in aerosols for hours and on surfaces for days. However, it is unclear whether these particles actually are sufficient to cause an infection. There are also indications that patients may be able to spread the virus while pre-symptomatic or asymptomatic. See Dominic Hooley’s article on Aerosols And

Dentistry: The Science And Its Limitations

The practice of dentistry involves the use of rotary dental and surgical instruments such as handpieces or ultrasonic scalers and air-water syringes. These instruments create a visible spray that contains large particle droplets of water, saliva, blood, microorganisms, and other debris. This spatter travels only a short distance and settles out quickly, landing on the floor, nearby operatory surfaces, DHCP, or the patient. The spray also might contain certain aerosols. Surgical masks protect mucous membranes of the mouth and nose from droplet spatter, but they do not provide complete protection against inhalation of airborne infectious agents. Aerosol Generating Procedures (AGPs): • Use of high speed handpieces for routine restorative procedures • Use of Cavitron, Piezosonic or other mechanised scalers • Polishing teeth • High pressure triplex air syringe (NB Risk of aerosols could be reduced when using a triplex if only the irrigation function is used, followed by low pressure air • Flow from the triplex and all performed with directed high volume suction. Dry guards, cotton wool or gauze can also help with drying and moisture control • Opening teeth for drainage has now been added to this list.

Non-AGPs

• Examinations • Hand scaling with suction • Non-surgical extractions (NB If this became a surgical extraction, a slow speed reducing handpiece could be used for bone removal, with cooling provided using saline dispensed via a syringe along with high speed suction. If this is not a suitable option, temporisation or referral would need to be considered) • Removable denture stages • Removal of caries using hand excavation or slow speed handpiece if necessary If it’s possible for you to reserve one of your surgeries for AGPs this may be a good solution. There is currently no data available to assess the risk of SARS-CoV-2 transmission during dental practice or to determine whether DHCPs are adequately protected when providing dental treatment using standard precautions. The evidence review will continue to be updated in light of emerging evidence for this new pathogen. Of course there is the risk, not only of infection for the whole dental team, but also patient to patient infection. Consequently there will be an even greater emphasis on hygiene, PPE, decontamination and infection control.

The use of a pre-procedural mouth rinse along with the use of high volume suction apparatus significantly reduces the aerosol contamination and hence chances of cross-infection. It’s recommended by the ADA Managing Covid19 guidelines that prior to commencing treatment all patients should be asked to undertake a 20-30 second pre-procedural mouthrinse with either: • 1% hydrogen peroxide • 0.2% chlorhexidine rinse (alcohol free) • 0.2% povidone iodine • An essential oil mouth rinse (alcohol free).

Infection Control

Aerosol generating procedures - continued Ventilation will also be very important. You will probably need to open the windows when AGPs are used. There are several other practical measures which can be taken to reduce aerosol splatter and these include:

• Use intra-oral evacuation for treatments that involve an AGP (aerosol generating procedure). Click here to find out more about the Isolite system which has been proven in 3 clinical trials to reduce by 90% the aerosol and moisture created during dental procedures. • Use a high volume extraoral evacuator. Henry Schein have been researching and assessing the available technology.

Consider using electric contra angle handpieces rather than high speed turbines. It may be prudent not to polish until further advice has been issued. Consider buying some new scalers with silicone, ergonomic handles. Good posture and the possibility of incorporating reinforced scaling techniques to reduce repetitive strain, carpal tunnel and tendonitis may further help with long-term use of hand instruments. View Imogen Fox’s article on COVID-19 and periodontal managementwith a response from Professor Iain Chapple.

• They tend to produce a smoother and more precise cutting edge, due to the stable speed. • Smaller head diameter results in a better sight of the preparation area. • Patients tend to prefer electric handpieces because they are quieter and don’t produce the same vibratory sensation. • Most models are equipped with an LED light. • Ultrasonic scaling generates significant aerosol. Hand scaling is a minimally invasive approach to periodontal care which reduces patient discomfort from the sensitivity linked with root surface instrumentation. It also appears to give the same long-term results in terms of treatment outcomes.

• Rubber dams also offer protection and should be incorporated for use within all aerosol-generating procedures. For routine hygiene procedures, a split dam technique may be an option.

Advantages of electric handpieces include:

Ultrasonic scalers

Considered the greatest source of aerosol contamination; use of a highvolume evacuator will reduce the airborne contamination by more than 90% 25 to 30 kHz High aerosol content Air polishing Airborne contamination is nearly equal to that of ultrasonic scalers; available HVE suction devices will reduce airborne contamination by more than 90% High aerosol content Water syringe High volume flow of pressurised air and water is nearly equal to that of ultrasonic scalers; high volume evacuator will reduce contamination by nearly 99% Predominantly splatter Sonic scaler

Airborne contamination is somewhat less than ultrasonic scalers; use of a high volume evacuator will reduce the airborne contamination by more than 90% 6 to 8 kHz: air driven High aerosol content Tooth preparation with high-speed handpiece Minimal airborne contamination if a rubber dam is used 6 -7 kHz: air driven 3 kHz: electric 1:5 Combination of aerosol and splatter

Dental devices and procedures known to produce airborne contamination

90% of aerosols can be removed with proper high volume evacuation. Studies show that Isolite is more effective in reducing aerosols and spatter than using a rubber dam + HVE, or an HVE alone. Not only that, but because Isolite provides continuous isolation, retraction, and suction, you will not require an assistant to evacuate liquid and debris.

Sealant procedures can be done up to 25% faster Sealants are 95% intact at 12 months You can reduce chair time by 48% You can increase patient satisfaction by 69%.

Click here for more information

“With conscious sedation, it’s extremely important that we protect our airway. That’s one of the main reasons that I use the Isolite, not only because I am protecting that airway, but also it makes me be more efficient since I can be working on two quadrants at the same time.” Dr. Ana Vazquez “I’ve worked without an assistant, using an Isolite, not just for having it as an extra set of hands, but also for evacuating aerosols which is incredibly important at this time.” Dr. Laskin

Infection Control

PPE and masks

A surgical level 2 mask, eye protection, clothing protection and gloves are essential for all patient contact for non- COVID-positive patients. The Australian Dental Association released a useful document ADA Managing Covid19 Guide. In certain situations you will need additional PPE requirements based on the risk category of the patient.

An example is when treating a patient deemed to be moderate risk and applying droplet precautions the PPE requirements includes a disposable gown. It’s a good idea to make Covid19 PPE packs, so you’re best prepared for every patient risk category.

Fit testing

Perform hand hygiene before putting on PPE. The order for putting on PPE is apron or gown, surgical mask or respirator, eye protection and finally gloves. For removal, gloves are firstly removed, followed by the apron or gown, eye protection and finally mask or respirator. Hand hygiene should immediately follow removal of PPE.

Check out the Henry Schein range of PPE and infection control essentials here.

A face fit test should be carried out to ensure the respiratory protective equipment (RPE) can protect the wearer. To ensure you put on tight-fitting RPE correctly, use a mirror or ask a colleague. Fit-testers should follow government advice on social distancing, as they can make observations from this distance and deliver any instructions verbally. The user should then carry out a pre-use seal check or fit check. For information on fit testing training, click here 3M Fit Test or here for

Fit2Fit Test

Explore your PPE options and ensure that you have an adequate supply of surgical Level 2 fluid resistant masks and N95 respirators for when treating high risk patients (N95 respirators are currently in short supply and varied availability).

A VISUAL GUIDE TO SAFE PPE USE FOR DENTAL PRACTITIONERS

According to the CDC, high risk jobs are those with potential for exposure to known or suspected sources

of COVID-19. Workers in this category include dental professionals performing aerosol-generating procedures (eg. cough induction procedures, some dental procedures, exams or invasive specimen collection). It is important to wear PPE to protect yourself and others from COVID-19. Additional information on PPE use during clinical care can be found at https://www.cdc.gov/coronavirus/2019- ncov/hcp/dental-settings.html.

GENERAL CONTACT WITH PATIENTS AEROSOL GENERATING PROCEDURES OR HIGH RISK AREAS

Eye protection, goggles based on risk assessment

or higher-level respirator Level 2

Disposable/reusable cloth gowns

Disposable gloves

Eye protection, eye shield, goggles, or visor

or higher-level respirator Level 2

Long sleeved, luid resistant disposable/ reusable cloth gowns F

Disposable gloves

IMPORTANT TIPS TO REMEMBER: • PPE must be worn correctly before entering the patient area and remain in place for the duration of care. • Always extend the glove cuff over the gown cuff to fully cover the wrist and limit exposure. • If a respirator is not available, use a combination of a surgical mask and a full-face shield. • Infection control recommendations include the use of hair or shoes covers whenever available. • PPE should not be adjusted (ie. retying gowns, adjusting mask, etc.) during patient care. • Remove and discard all disposable PPE into a sealed trash receptacle. (Disposable respirators/masks, eye protection, gown, gloves, etc.). • Clean and disinfect reusable eye protection according to manufacturer’s instructions prior to re-use. • Reusable cloth gowns should be laundered after each use.

MEDICAL GLOVES MUST HAVE

• Standard AQL 2.5 or less (Lower AQL minimizes potential risk of contamination due to pinhole defects) • Conforms to ASTM F1671 and EN ISO 374-5 VIRUS (Barrier against viral penetration) • Conforms to EN 455 (Standard for medical exam gloves)

DONNING AND DOFFING GUIDE FOR DENTAL PRACTITIONERS

According to the CDC, high risk jobs are those with potential for exposure to known or suspected sources of

COVID-19. Workers in this category include dental professionals performing aerosol-generating procedures (eg.cough induction procedures, some dental procedures, exams or invasive specimen collection). It is important to wear PPE to protect yourself and others from COVID-19. Follow the doning and doffing steps below. Additional information on PPE use during clinical care can be found at https://www.cdc.gov/coronavirus/2019-ncov/hcp/ dental-settings.html.

For optimal protection and to avoid cross-contamination during the donning and doffing process, follow these steps:

DONNING

1. Perform hand hygiene

2. Protective Clothing: Don the gown first. When using a gown with back closure, a second operator should assist in securing the back.

3. Respirator: Proceed with respirator next. Tighten straps for secure, comfortable fit.

4. Eye Protection: Place goggles or face shield over the mask straps and ensure the elastic strap fits snugly on the head.

5. Perform hand hygiene before putting on gloves.

6. Gloves: Don gloves as the final step, be sure to extend the gloves over the gown cuff or clothing to cover the wrist and limit exposure.

DOFFING

1. Remove gloves being careful to prevent additional contamination of hands. Gloves can be removed using more than one technique with the primary goal of not touching the outside contaminated portion.

Discard in sealed trash receptacle. 2. Remove gown. Untie or unsnap all buttons (A) Reach up to the shoulders (B) Carefully pull gown down and away from the body (C) Rolling the gown down (D) Discard in sealed trash receptacle.

3. Exit examination room and perform hand hygiene.

4. Remove face shield or goggles by grabbing the strap, pulling upwards and away from head. Do not touch the front of face shield or goggles. Discard in a sealed trash receptacle or prepare for cleaning/reprocessing. 5. Remove and discard respirator without touching the front of the respirator. Remove the bottom strap by touching only the strap and bring it carefully over the head. Grasp the top strap and bring it carefully over the head, and then pull the respirator away from the face. Discard respirator in a sealed trash receptacle. 6. Perform hand hygiene after removing the respirator.

IMPORTANT TIPS TO REMEMBER

• PPE must be donned correctly before entering the patient area. • PPE must remain in place and be worn correctly for the duration of work. • PPE should not be adjusted (i.e.; retying gown, adjusting respirator/facemask) during patient care. • PPE must be removed slowly and deliberately in a sequence that prevents self-contamination. • Ensure safe waste management. Treat waste contaminated with blood, body fluids, secretions and excretions as medical waste, in accordance with local regulations.

HAND HYGIENE Before donning and after doffing PPE for care of any patient, proper hand hygiene should be performed.

Wash hands with soap and water for at least 20 seconds, or disinfect hands with an alcohol gel (>70%) in compliance with your organization’s recommended procedure.

Zero Suck-Back Technology

Reduce the risk of airborne contaminants entering the handpiece, treatment unit and ultimately, your next patient when you use a TwinPower handpiece by Morita.

Suck-Back happens when a turbine continues rotating by inertia after the drive air to the turbine has stopped. Morita’s Zero Suck-Back mechanism channels exhaust air into the Anti-Suck-Back Diffuser (ASBD).

The pressurised air in the ABSD is released to the outside when the turbine stops, effectively preventing depressurisation in the head and in doing so eliminating suck-back.

TwinPower is available to fit all major coupling brands.

Watch Video

Morita

Other

Infection Control (AGPs)

Why aren’t standard precautions sufficient for AGPs in Covid19?

The use of standard precautions (including hand hygiene, PPE, safe use and disposal of sharps, routine environmental cleaning, reprocessing of instruments and equipment, respiratory hygiene and cough etiquette, aseptic technique, and waste management) is the principal way we minimise the transmission of infections in any healthcare setting, including dental practice, and are applied to everyone, regardless of their perceived or confirmed infectious status. They ensure a basic level of infection prevention and control. Standard precautions are used when undertaking treatments or procedures where there is handling of blood, body fluids (e.g. saliva), non-intact skin, and mucous membranes. Transmission based precautions (contact, droplet or airborne) are used in addition to standard precautions when there is suspected or confirmed presence of infectious agents that are

not effectively contained by standard

precautions alone. The type of transmission based precaution required is dependent on the route of transmission of the infectious agent:

Contact precautions

• Are used when there is a risk of direct/indirect transmission of infectious agents e.g. highly contagious skin infections/infestations such as methicillin-resistant staphylococcus aureus (MRSA) and vancomycin resistant enterococcus (VRE) • Direct transmission occurs when infectious agents are transferred from one person to another, without a contaminated intermediate object or person. • Indirect transmission involves the transfer of an infectious agent through a contaminated intermediate object (fomite) or person.

Droplet precautions

• Are used when there is a risk of transmission through large respiratory droplets (>5 microns) or mucous membrane contact with respiratory secretions, generated by a patient who is coughing, sneezing, or talking. e.g. influenza, norovirus, pertussis, meningococcus. • Transmission via large droplets requires close contact as the droplets do not remain suspended in the air and generally only travel short distances. As the droplets do not travel over long distances, special air handling and ventilation are not required. • The droplets can contaminate horizontal surfaces close to the patient, and the hands of healthcare workers can become contaminated through contact with these surfaces.

Airborne precautions

• Are used when there is risk of transmission through small respiratory droplets (<5 microns) that remain infective over time and distance when suspended in air. e.g. measles, chickenpox, tuberculosis • Transmission via small droplets can result due to inhalation by susceptible individuals who have not had face-to-face contact with (or been in the same room as) the infected individual. “

“

The CDC concluded that when practicing dentistry in the absence of Airborne Precautions, the risk of SARSCoV-2 transmission during aerosol generating dental procedures cannot be eliminated, and provided the following recommendation:

• Avoid aerosol generating procedures whenever possible. Avoid the use of dental handpieces and the air-water syringe. Use of ultrasonic scalers is not recommended during this time. Prioritize minimally invasive/atraumatic restorative techniques (with hand instruments only). • If aerosol generating procedures are necessary for emergency care, use four-handed dentistry, high evacuation suction and dental dams to minimize droplet spatter and aerosols. This is not the first coronavirus pandemic this century. In 2003 we had Sudden Acute Respiratory Syndrome caused by SARSCoV1. A retrospective review [4], outlined measures to reduce the risk of cross infection with coronavirus in the dental setting, including the identification of patients with SARS through targeted screening questions, pre-procedural rinsing, hand hygiene, PPE, rubber dam isolation and recommended that “aerosol-generating procedures should be avoided as much as possible if rubber dam isolation is not feasible. Some of these procedures include ultrasonic scaling, root-surface debridement, and high- or lowspeed drilling with water spray.” These measures were adopted in both the ADA Managing COVID-19 Guidelines and ADA Dental Service Restrictions documents. A conclusion of this article was that while no dental healthcare worker was affected in either a nosocomial or dental setting, this was thought to be due to the use of universal infection control measures and/or the low degree of viral shedding in the prodromal phase of SARSCoV1. While both SARSCoV2 and SARSCoV1 demonstrate high viral loads in posterior oropharyngeal saliva samples, SARSCoV1 viral load was found to peak at 10 days after symptom onset. In comparison, SARS CoV2 has the highest viral load on presentation, suggesting that SARS-CoV-2 can be transmitted easily, even when symptoms are relatively mild. This finding could account for the fast spreading nature of this pandemic, with efficient person-to-person transmission noted in community and health-care settings. [5]

Fit testing • Tight-fitting respirators (such as disposable N95/

KN95 masks and reusable half masks) rely on having a good seal with the wearer’s face.

A face fit test should be carried out to ensure the respiratory protective equipment (RPE) can protect the wearer. To ensure you put on tight-fitting RPE correctly, use a mirror or ask a colleague. Fit-testers should follow government advice on social distancing, as they can make observations from this distance and deliver any instructions verbally. The user should then carry out a pre-use seal check or fit check. For information on fit testing training, click here or here

[1] https://nhmrc.govcms.gov.au/sites/default/files/documents/ infection-control-guidelines-feb2020.pdf [2] https://www.ada.org.au/Covid-19-Portal/Dental-Professionals [3] https://www.cdc.gov/coronavirus/2019-ncov/hcp/dentalsettings.html [4] https://www.osha.gov/Publications/OSHA3990.pdf [5] Samaranayake L, Peiris M Severe acute respiratory syndrome and dentistry. A retrospective review JADA 2004; 135: 1929-1302. [6] To KK-W, Tsang O T-K et al

Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARSCoV2: an observational cohort study The Lancet Infec Dis 2020; 20: 565-74

Infection Control (AGPs)

Cleaning has never been more important The Australian Government - Department of Health released some useful guidelines on routine environmental cleaning.

It’s recommended to apply two complete cycles of cleaning of all environmental surfaces using detergent and disinfectant (as per contact transmission-based guidelines). Environmental cleaning and disinfection principles for health and residential care facilities This information sheet should be read in conjunction with the ‘What you need to know’ and ‘Isolation guidance’ information sheets at www.health.gov.au/covid19-resources Cleaning is an essential part ofdisinfection. Organic matter can inactivate many disinfectants. Cleaning reduces the soil load, allowing the disinfectant to work. Removal of germs such as the virus that causes COVID-19 requires thorough cleaning followed by disinfection. The length of time that SARS-COV-2 (the cause of COVID-19) survives on inanimate surfaces will vary depending on factors such as the amount of contaminated body fluid e.g. respiratory droplets or soiling present and environmental temperature and humidity. Coronaviruses can survive on surfaces for many hours but are readilyinactivated by cleaning and disinfection.

When considering the cleaning and disinfecting of dental equipment please check with your dental chair manufacturer for appropriate and approved products. Whilst some surface disinfectants have fantastic virus killing agents the same disinfectants may not be approved to be used on medical devices such as dental chairs. It is good practice to routinely clean surfaces as follows: • Clean frequently touched surfaces with detergent solution (see diagram below). • Clean general surfaces and fittings when visibly soiled and immediately afterany spillage.

Routine environmental cleaning requirements can be divided into two groups 1 :

ROUTINE ENVIRONMENTAL CLEANING

FREQUENTLY TOUCHED SURFACES

Doorhandles, bedrails, tabletops, light switches

MINIMALLYTOUCHED SURFACE

Floors, ceilings, walls, blinds

Should be frequently, mechanically cleaned.

Detergent solution (as per manufacturer’s instructions) ordetergent/disinfectant wipes can be used (so long as mechanical cleaning is achieved). Detergent solution (as per manufacturer’s instructions) or detergent/disinfection wipes are adequate for cleaning general surfaces and non-patient care areas.

Damp mopping is preferable to dry mopping.

Walls and blinds should be cleaned when visibly dusty or soiled.

Window curtains should be regularly changed in addition to being cleaned when soiled.

Sinks and basins should be cleaned on a regularbasis.

Environmental cleaning and disinfecting principles for health and residential care facilities – Version 3 (13/05/2020) Coronavirus disease (COVID-19) 1 1 Adapted from Australian Guidelines for the Prevention and Control of Infection in Healthcare, Canberra: National Health and Medical Research Council (2019).

Other Factors

Your team • Consider testing your team for Covid-19 regularly.

Screen them at the beginning of their shift for fever and respiratory symptoms. Document shortness of breath, new or change in cough, and sore throat. If they are ill, have them put on a facemask and leave the workplace.

• Provide masks and hand gels for your team to use outside the practice and at home. • All team members should wear masks and goggles at all times in the practice. • Create a disinfection protocol. For example, before staff leave the clinic encourage them to remove their clothes and apply disinfectant solution to all exposed skin including the face and the neck. All used clothing should be bagged and immediately laundered. Upon arriving at home all staff members should shower for a thorough full body wash of at least 15 minutes before changing into fresh clothing. • The ADA is recommending (interim guidance) that

DHCPs may use extraoral dental radiographs such as panoramic radiographs or cone beam CT, as appropriate alternatives to intraoral dental radiographs during the outbreak of COVID-19, as the latter can stimulate saliva secretion and coughing. • Use resorbable sutures to eliminate the need for a follow up appointment. • Minimise your use of 3-in-1 syringe as this may create droplets due to forcible ejection of water/air.

• Stay on top of the new infection control products which are being launched to combat COVID-19 – for non-dental as well as dental equipment.

• Use wipe clean keyboards where possible.

• Consider a respiratory protection programme eg a medically certified air purifier unit, overhead uv-c decontamination or a negative pressure room in high risk settings, where patients with suspected or confirmed COVID-19 may be isolated.

• Think about the flow of movement within your clinic. There may be some recommendations for patients to enter one way and healthcare workers to enter another - at least for patients requiring isolation treatments (eg those with suspected COVID-19, discharged from hospital in the last 14 days or requiring an AGP). • Whole room sterilisation would be required between patients. You will also need a clean room where staff can get changed in and out of PPE. • Consider purchasing a flag system for your surgeries to indicate which of them are clean and which are waiting for a clean. • Use waiting room and operatory chairs that can be wiped down (no seams or cloth).

What’s lurking in your waterlines?

The last thing we want when returning to practice or increasing our aerosol generating procedures is another risk to public health with respiratory related diseases such as legionella!

With the decrease in chair use and aerosols procedures

now more than ever are dental chairs at risk of water

stagnation. What this means is potential of infecting patients and staff with possible respiratory related illness or things like Pontiac fever because the dental waterlines haven’t been treated and shocked properly prior to recommissioning.

The ADA released some guidance both to decommission and recommission your dental chairs and waterlines was a big part of that! If you missed this then we would recommend you test your lines prior to seeing patients again to ensure safety all around.

Dental Unit Waterlines should comply with the legal drinking water guidelines as set out by the National Health Medical Research Council in that the CFU should be less than 500CFU but as stated in the ADA Infection Control Guidelines:

When treating immunocompromised patients, it is recommended that water from dental unit waterlines contain less than 200 CFU/mL.

How do I test my water lines?

Henry Schein has HPC water sample tests available. They are simple and easy to use and will give you a reading in 7 days time – no need to send to a lab or complex interpretation

What do I do if I want to complete a shock treatment on my dental unit waterlines?

Shock treatments remove the build of biofilm formation so you can continue to treat patients safely knowing your lines aren’t contaminated. Henry Schein supplies appropriate TGA approved shock treatments from Biodegree called BRS Kit

After I’ve done my test and shock treatment, can I use something continuously to prevent biofilm from growing?

Yes Henry Schein has many options to suit every dental chairs configuration needs and requirements. To name a couple here are some options:

Chairs that are plumbed to mains water

The Dentapure Crosstex cartridge is an ideal solution for dental chairs that are plumbed. They also have small straws available for bottle set ups. Both products available through Henry Schein now, our service department can help install and get your water back to safe status sooner.

Chairs that have water bottles

There are many options for dental chairs with bottles, we suggest you find the solution that’s best for you but also effective. Whilst tablets seem to be an efficient method oftentimes these can become contaminated by handling and aren’t left for the correct time before use – so make sure you follow the directions entirely. It’s important to incorporate a procedure for how you disinfect your water bottles as well and how you dry them.

Ensure that any external water bottle attached to the dental chair is cleaned with detergent, and left to drain, and then replaced once fully dry. It is important to have no moisture as this would allow microbial growth.

Learn More About Our Commitment to Clean, Safe Dental Treatment Water

COULD THE WATER USED DURING MY DENTAL VISIT BE HARMFUL TO ME?

Have you ever thought about the water used during your dental procedures? During a dental treatment, water flows through a long length of extremely narrow tubing to reach many of the instruments used by your dentist or dental hygienist.

The narrow, wet environment inside this tubing is an ideal environment for waterborne bacteria and other potentially dangerous organisms to thrive. As water flows through, it carries these microorganisms, which can build up on the walls of the tubing over time.

If left untreated, these microorganisms can break off, causing a transfer of bacteria to patients.

AILMENTS CAUSED BY WATERBORNE BACTERIA

Instrument Management System

The topic of sterlisation is prominent in your back-to- practice plan. Hu-Friedy’s Instrument Management system is the secret weapon you need.

• Having the instruments in the cassette will help give the perception of comfort and organization. • Patients need to be 100% confident that going to the dentist is safe • Allows the clinician/staff an opportunity to explain how they’re helping to keep the patient safe and protected during this time. By incorporating our IMS™ (Instrument Management System) solution, you can complete your infection prevention story and use it to further illustrate your commitment to patient and practice safety, which then helps to drive volume and revenue. As you know, patient volume is critical to revenue, and patients need to feel safe in order for you to regain your patient flow. As practices begin to reopen, they are communicating the tangible and visible changes they have made to optimize safety and ease patient anxiety about coming back to the office. We have seen a lot of letters and videos from practices recently and noticed a heavy focus on highlighting things like PPE use, new patient in-out procedures, proper hand washing, and social distancing.

Hu-Friedy Rubber Dam Punch Ainsworth

16cm This classic punch is solidly built to for lasting longevity.

HF-RDP Hu-Friedy IMS ORDER HERE

Request a virtual consult today Click here

IF you look like this NOW…. Why does your tray STILL look like this?

KaVo MASTERtorque Series

Premium Air-Driven High-Speeds

• Direct Stop Technology stops the bur in 1 second • Shortest stopping time prevents retractive suction of aerosols and suction of particles into the ball bearings for more hygeine and longevity • Compact, ergonomic design – reduced head diamater on bur side • Low noise level of only 57 dB (A)

Watch Video

“ “ Shortest stopping time prevents retractive suction of aerosols and suction of particles into the ball bearings for more hygeine and longevity

Equipment

Technical Service

If you have temporarily decommissioned or left your equipment idle for the last few weeks, then it is more important than ever to take the appropriate measures to get your equipment back up and running quickly and manage the build-up of biofilm safely. Henry Schein has prepared a Guideline of Preventive Measures with instructions to enable you to properly recommission your equipment whilst managing the build-up of biofilm and avoiding other infection control risks. TheRecommissioning Guideline is available with detailed instructions of what to do with your treatment centre, autoclaves, plant room, ultrasonic baths, under bench & bench top disinfectors and lab equipment. Our service experts have prepared special packages to support you in maintaining a safe work environment and making sure that your dental equipment is fully functional. For more info, please call 1300 36 03 28 or email

equipment@henryschein.com.au.

Undertake any necessary preventative maintenance on your handpieces and make the most of our special offers (offers available until 30th June 2020) – please contact 1800 30 80 30 orclick hereand make your booking.

Equipment Hygiene Considerations

If you need a new treatment centre, or you would be interested in upgrading your current chair for continuous sanitisation, investigate those which have the best hygiene options as this will be increasingly important for you and your patients. Some chairs offer cost-effective fully automated cleaning and sterilisation solutions for dental unit water lines and vacuum systems, as opposed to a manual cleaning process that requires tablets and/or the measuring out of cleaning solutions. Enquire nowand get early access to our EOFY Specials.

The Morita Soaric provides the appropriate basis for efficient and safe hygiene in order to meet the increasing demands of hygiene regulations. The integrated suck back stop and the use of the multi-functional foot control for frequently used functions avoid cross contamination.

Planmeca’s ActiveAqua, waterline hygiene via electro-chemical activation.

KaVo DVGW purging systems with integrated waterline.

Scanners: Hygiene options include autoclavable and single use disposable sleeve options

Equipment Training

Have you purchased equipment in the past but not got round to mastering it? Now would be a great time to brush up on training – there’s lots of information and tutorials available online, so you could spend this time getting familiar with it. Many companies have developed online learning programmes for you to do just this egPlanmeca, SciCan, Durr DentalandKaVo. Alternatively, please contact your local equipment specialist to make a time for onsite refresher training with you and your staff. Please email equipment@ henryschein.com.au and book your appointment.

Going Digital

And if you are thinking of going digital or investing in an intra oral camera or scanner, research theoptions online. There are many videos and websites with information and ROI calculators including:3Shape and

iTero.

Planmeca’s ‘Time to Train’ website is a broad resource covering techniques in 3D and CAD CAM along with a back catalogue of webinars from clinical experts in their field. Visit:

https://www.planmeca.com/training/

Remember intra-oral scanners are less likely to spread infection for both dental and lab teams due to reduced touch points. As well as reducing the work and time involved and they will give you more control. Plus of course the usual benefits of increased accuracy, consistency of fit, less remakes, less chair time and increased patient engagement and treatment uptake alongside easy patient monitoring. For more info about scanners, click here.

Is Your Lab Digital, Will They Accept Traditional Impressions Going Forward?

• Consider purchasing a 3D printer. Not only can you use it for printing temporaries, splints, mouth guards, surgical guides etc, but you can also print your own PPE. • Ultimately, consider full chairside dentistry which not only offers swift turnaround and minimises infection risk, but speeds up treatment time, gives you maximum control and optimises your cashflow. Enquire nowand speak with one of our equipment specialists about our range of digital workflow solutions and EOFY pricing.

Financial Solutions

What better time than while you have been out of the practice to think about your equipment? What new equipment do you need? Now is the perfect time for you to update your dental practice so you can retain a competitive edge and continue to grow. With the recent increase in the Instant Asset Write Off Scheme, small and medium business owners can write off eligible assets up to $150,000 each if purchased & installed before June 30, 2020.

Click and find out more.

Henry Schein has also partnered with leading financial services companies to provide a number of financial solutions to help you recover, thrive and grow. Such as 12 months no interest or repayments, allowing you to get the benefits of integrating the latest technology now, with the peace of mind you have a holiday period on repayments. Please contact our team to find out more

Want To Find Out More – Book a showroom appointment

Our showrooms are still open and we have taken a number of steps to ensure your health and safety is our number 1 priority. Book your showroom appointment today and let our equipment team introduce you to the latest technologies. For bookings please email:

equipment@henryschein.com.au

As lockdown eases and dentists begin to resume their work, what will the new ‘normal’ look like for your dental practice? What’s changing? Here is a collection of things you should consider which will protect the health of you, your staff and your patients:

Staff changing room

• Provide an area for your team to don and doff their PPE • Airtight laundry basket with bag for easy and safe removal • Instructions for donning and doffing PPE clearly displayed on wall • Hand gel and PPE dispenser for the team • Disinfectant solution to apply before they leave the clinic • Tissue dispensers

Reception area

• Clear screen to protect receptionist • PPE for receptionist • Individual phone headsets for each staff member • All forms pre-filled in for fully contactless registration • Enable patients to self check-in to reduce human-tohuman contact • Contactless payments or provide branded pens for patients to keep • Wipe clean keyboards • Tissue dispensers

Front door • Screen patients before they come for their appointment.

Contact them and ensure they know what to expect when they arrive and to come alone where possible • Advise patients to wait in car or outside the practice until they are called • Electric doors for minimal contact, leave front door open (will also assist with ventilation ) or escort each patient into the practice • Poster in window to show how are you are addressing

COVID-19 to maximise patient confidence: • Specify that you are now a fully contactless practice • Display certificates for water treatments, COVID-19 decontamination treatments etc

Waiting room

• No magazines, drinking water units, toys etc • Chairs 2m apart and seamless wipe down material or cover them • Social distancing stickers on the floor

Surgery one (non-AGPS)

Surgery two (AGPS)

• Tissue dispensers • Shoe disinfection mat • Add patient toilet facilities out of service

Surgery one (non-AGP)

• Correct PPE • Infection control SOPs • Window open for ventilation • No air-conditioning • Chair with continuous sanitisation • Disposable covers on headrest • Rubber dam – use for appropriate procedures to reduce aerosol • High-volume evacuation such as Isolite/

Isovac to reduce aerosol • Chemo mechanical caries removal (reduced drilling) • Rubber dam • Single use items or disposable • Electric handpieces (generate less aerosol) • Special water line cleaning • Consider digital solutions to reduce infection transmission • Tissue dispensers

Surgery two (AGP)

• If possible, undertake all aerosol generating procedures in a single surgery • Window open for ventilation • Thorough cleaning process required in between patients including chairs, keyboards, curing lights, handpieces etc. • Door sign to show where the surgery requires decontamination or is ready for use • Tissue dispensers

Hygiene area for patients

• New PPE dispenser including shoe covers • Sink for patients to wash their hands with automatic tap and soap dispenser • Hand sanitising gel for patients • Table for patients to bag their belongings next to PPE dispenser • Contactless thermometer for temperature screening • COVID-19 test with instantaneous results (when available) • Preprocedural mouth rinse with 1% hydrogen peroxide or 0.2% chlorhexidine • Patient to don disposable masks and disposable gloves and advised not to touch anything • Tissue dispensers

Diary management and appointment planning

Think about your diary zoning plans and sessions. Which patients do you want to come first thing, last thing and in between? Will you be using two surgeries? Can you limit one surgery (even for part of each day) to Aerosol Generating Procedures (AGPs)?

Manage your appointment planning for reopening by calling and prioritising your patients. Don’t simply rebook patients that have missed appointments during lockdown because your days will be very different. You are likely to see far fewer patients and each will take a much longer time to include pre-screening and hygiene measures.

So leave a realistic amount of time for each appointment and also for deep cleaning the surgery in between. Your aim should be to retain your existing patients and to reopen in a structured way by prioritising existing patients in need of restorative work and using short notice lists to fill gaps with check-ups. If you end up with general appointments booked up when someone has an emergency, they may go somewhere else if they cannot be seen by you. So formulate your priority list as follows:

1. Existing patients who need urgent restorative work focusing on the most highly productive procedures first to start to rebuild your revenue stream. Don’t forget to train your team on this. 2. New patients. 3. Priority patients for check-ups. 4. Set aside clinics for vulnerable patients (those more likely to develop serious illness: older people, people with underlying medical problems, e.g. high blood pressure, heart problems, diabetes) at the beginning of the day. Stagger appointments to minimise the number of patients in the practice at the same time. • Block sessions for patients requiring AGPs and for patients requiring non AGPs. • Plan your AGP sessions at the end of the day. • Allow longer time for hygiene appointments with hand scaling. • Covid-19 positive patient emergency slots can be limited to the end of the day only or they may be referred to your local UDC. It’s likely that hot sites or urgent dental care centres will continue to operate and treat patients who need urgent treatment but have the symptoms of COVID-19. • Manage your time very carefully and make sure nobody runs over. When are you going to start implementing recalls? Your low risk patients could be moved onto annual checkups. If they’re on a patient plan, explain your decision and offer them a double appointment when they next come in so they still have the same amount of time allocated. Most patients should be happy with that if you’re explaining it well.

Complimentary Business Review

If you would like free expert advice about how to optimise your appointment book, you can book a complimentary business review with a Henry Schein One specialist. We can assist you with filling up your appointment book by: • attracting new patients, • optimising your patient recalls • Improving treatment acceptance and more…

Leadership and management

Never before will your leadership skills have been so thoroughly tested. You need to remain strong for your staff, lead by example and make sure that your whole leadership and management team does the same. You must be unified. You need to have a phased return to work plan. Knowledge of the plan should be limited to the management team until the way forward is clear and you are ready to communicate it more widely.

You will need an outstanding clinical leader (which might be yourself) to be present in the clinic every day that you’re seeing patients. They will need to be able to read the guidelines and decide what you are doing and why, then design your systems and your training plans. A clinical system, minute by minute of what the patient experience will look like, allowing time to talk to the patient and to deep clean the surgery in between. This is a very responsible role and this person also needs to be a good leader.

Also appoint a nurse lead to be available throughout the clinic. Their job will be to reassure, provide support and check systems.

Reassure your team that their safety is a priority and communicate regularly:

• Have online weekly update meetings at a regular set time. • Have 121 meetings with each member of the team every week when you can speak to them about how they feel, how it’s going and where they need help.

• 121s are needed for the leadership team.

• Have a huddle at the start and end of every session with the team involved.

Other leadership support

• Create a pleasant break out room where the team can maintain social distancing. • Have a changing area where the staff can don and doff PPE. • Create a positive team culture - minimise negative communication within the team by encouraging them to go to their manager or team leader with any concerns.

Leadership is about change and movement. Management is about order and consistency - and both are needed right now in equal proportions. “

“

Further reading and additional resources

Prime Practice specialises in training, implementation and support.

• Training consists of face-to-face workshops and online courses. • Implementation helps your practice run efficiently • Support means you are not alone! Your business coach is there to help.

Henry Schein and Prime Practice have partnered exclusively to bring you the ‘Four Pillars of Practice Recovery’ and the ‘Practice Accelerator Program’.

Looking after your business

Get free expert help:

Our goal is to help you run a profitable practice. You can get free expert advice on how to recover and thrive tailored to your needs by booking in a free business review.

During your business review we may discuss how to:

• Improve new patient acquisition • Reduce FTAs and short notice cancellations • Optimise patient recalls • Increase treatment acceptance

Ongoing business coaching:

Henry Schein One’s award-nominated 12-month Customer SuccessProgramis designed specifically to help practices accelerate their practice performance. Get expert coaching and personalised advice. EXACT customers who are not currently on the program can trial the Customer Success Program for free until 1 September 2020, as part of Henry Schein One’s EXACT bounce-back support package.

Analyse your practice performance:

If you use MyPractice Cloud, you’ll have access to performance dashboards to help you identify areas for improvement so you can make robust business decisions based on data. EXACT customers can trial MyPractice Cloud for free until 1 September 2020 as part of Henry Schein One’s EXACT bounce-back support package.

Bounce-back support package:

Between now and 1 September 2020, for Henry Schein One dental practices using EXACT or OASIS, we’re offering a bounce-back support package to help you recover and thrive.

Effectively implement change:

Watch our free 45-minute CPD on-demand webinar on how to effectively implement change in the dental practice in order to adapt to the new “normal”.

The 4 Pillars of Practice Recovery

Online Training - Duration: 4 hours | CPD Points: Up to 4 hours The business of dentistry is no longer just about exceptional clinical skills. Patient mindsets have changed in light of the recent pandemic and dental practices will have to adapt in order to thrive in today’s new normal. Henry Schein is proud to partner with Prime Practice to help provide all our customers with training and business solutions that will help accelerate their practice recovery and grow their business in the new era of dentistry. Get the business fundamentals that will help you run a successful practice and lead your team into the new dental landscape ahead. Presented by four of Prime Practice’s Subject Matter Experts, they will deep dive into the four pillars that will help with your practice’s recovery from the recent COVID-19-Shutdown.

The four pillars are: 1. Understanding your cash flow

Understanding the numbers of your practice is essential to successful recovery and taking control of your cashflow statement is the roadmap. Learn how to plan for recovery scenarios and the flow on effect into your personal budget. Cashflow forecasting will guide you to make timely, effective business decisions – essential in times of uncertainty.

2. Leading through Change and Uncertainty

We will take you through some practical tips on how to lead your team through change and uncertainty. What are the behaviours that highlight the most authentic leadership and how can you lead by being clear, direct and candid. You will also learn about the most sustainable motivators for team members and three core strategies to develop a team-managed practice.

3. Road map for marketing strategies

The patient experience you were once marketing is out the window. We will explore the tools you need to market effectively using what you already have. You’ll learn how to communicate with and leverage your existing patient base, and to focus on the marketing that will increase your new patient flow to get ahead of your competitors. Don’t miss this marketing breakdown to find out how your clinic can recover and thrive in the post COVID world.

4. Infection Prevention and Compliance - the new patient experience

Infection prevention is at the forefront of everyone’s minds, both staff and patients alike. We will ensure you have the necessary foundations in place for rebuilding your practice. Be confident in your compliance to reassure your team and your patients that you provide a team approach to their care and safety by following FOUR standard pillars of Infection Prevention and Control. Ticket Price $299 ex GST Exclusively for all Henry Schein Customers: Save 40% using promo code: HS4P40 Henry Schein360 members save 60%.

Email: schein360@henryschein.com.au for promo code. You can register here for the program

The Practice Accelerator Program

Do you want your practice to feel back to normal by October 2020? What would that look like to you? Perhaps it could be: • Staff have all returned to work and up to date on all the PPE requirements. • Your patients are confident in your infection prevention standards and treatment plans are being accepted. • You’ve set goals and understand your cashflow projections. • New patients are booking appointments. Do you think it is all even possible?

Get your practice ready to thrive again in 90 days with Prime’s Practice Accelerator Program.

The Practice Accelerator Program by Prime Practice will provide you with the resources, support and the training you need to kickstart your dental practice back to financial health over the next 90 days. You and your team will get equipped with everything you need to get your practice thriving once again with maximised patient flow and an enhanced patient experience. This 90-day program includes: • “4 Pillars of Practice Recovery” Online Training (for

Practice Owners and Practice Managers). • Prime Community Live Chat access (exclusively for

Prime Clients - clinicians and Practice Managers). • 2 customised online sessions per month for each practice; Online In-Practice Training for the team and a 1-on-1 Coaching session. • Access to all our Live Online Training. • Access to all available resources; Checklists,

Templates and Documents. • Access to our Prime Training Video Library.

You can find more information here on the Practice Accelerator Program.

Saving your business money

We understand there are many costs involved with running a dental business. Most of these costs are ongoing and relate to finance, banking, education, compliance, communication and insurance. There are countless deals in the market for these services, and as a rule of thumb, the bigger the business the better the deal available. We have aligned with companies you transact with every day and negotiated the best deal possible for our Henry Schein360 members. Once you become a member your business can save thousands each year, and a quick phone call or email is all you need to get started.

If it’s patient finance you need, we have partnered with Zip who offer a discount of up to 20% off their merchant fees. This allows patients to start treatment now and pay it off interest free, while you reduce your business expenses and increase traffic into the practice. It is common practice these days for patients to pay for treatment using a credit card. While it is convenient for the patient, your practice incurs the cost of the credit card fees (otherwise known as merchant fees). It is essential you pay the cheapest merchant fees possible. The team at HICAPS offer Henry Schein360 members up to 30% discount off their rates, and for most practices this is saving them thousands every year. The most important time of the year is approaching; Professional Indemnity Insurance renewals are due in June, however there is no need to wait until your policy anniversary. You can switch at any time. Experien are specialist insurance brokers in the dental industry and offer competitive cover through Australian Insurer CGU. More information about our Business Solutions can be found here. Until the end of 2020 when you join Henry Schein360 you’re automatically signed up to the Elite membership (conditions apply). This will offer your practice huge savings potential. The Elite level offers the highest tier discount, eligibility for a cash rebate and access to our famous Business Solutions. This is a massive offer which allow you to enjoy the benefits first, then fall in love with the program. If you’re interested in joining Henry Schein360, complete this form and we can have your Territory Manager contact you. The next page details all the Business Solutions and how your business can benefit. 

Average savings with Henry Schein360

Henry Schein360 Solution

Product Discounts (average 15%) Cash Rebate Patient Finance Credit Card Fees Free Freight Total Savings

Annual Savings $5,000 - $9,000 $1,700 - $2,500 $500 - $1,000 $1,500 - $2,000 $500 - $600 $9,200 - $15,100

HANDPIECE HOTLINE

1

Measure practice profitability and revenue. Explore key findings in the industry.

Earn up to 20% discount on merchant fees. 2

Reduce stock wastage & save your staff hundreds of hours each year. 3

Save up to 30% on transaction fees – this could save you thousands each year. 4

Save with in-practice audits & self-assessment audits. 5

Brand new websites for under $3,500. Easy to use and update whenever you need. 6

National insurance brokerage that specialises in the dental and medical sector. 7

Delivers innovative technology that improves every aspect of you dental practice management. 8

Save 15% off all service & repairs 9

Stand out from the rest with your amazing practice promo videos. 10

Protect your patients and your practice data. 11

Take another team member on us when you register for Primespeak. 12