Interview with CR, How Dentistry Has Changed in the Wake of a Global Pandemic, Hist 150 Honors Spring 2021, Conducted by Anna Reese Richardson, March 7, 2021.

Introduction to Interview

On March 13, 2021, President Donald Trump declared the virus, COVID-19, a national emergency and a country wide lockdown went into effect. On this day, the interviewee had to close his two dental practices in Virginia until May when he was able to reopen the businesses.  During the initial lockdown in March, the amount of individuals that were laid off or had lost their businesses, reached about 25 million people in the span of 2 months. A minute sum of these people included CR’s employees, however they were immediately offered their job back once the office was able to see patients again. In early 2021, the first vaccines became available to healthcare workers and individuals with health conditions that were in the red zone of contracting COVID-19. These included a two shot dose of either Moderna or Pfizer. Much controversy has been labeled surrounding the vaccinations because they were fast tracked by the FDA and have become highly politicized. CR talks about the importance of remaining educated and keeping his employees educated on the vaccines, as he and his entire family have been vaccinated with in the first 3 months of 2021. With hopes that the vaccine will end state mandated mask wearing and social distancing, this will remain in effect in dental offices. Personal protection has remained increasingly important as COVID-19 is spread through respiratory droplets, meaning the dentists and dental hygienists must wear not only a mask, but also a face shield that is sanitized after every patient. Now, a year after the initial lockdown, CR discusses his thoughts and feelings about COVID-19 and how he thinks it will impact the future of dentistry.

Biography: [mentioned in beginning of interview]

This interview discusses how a dentist has had to change to the “new normal” of life in a global pandemic and speculations for life after the pandemic in the medical field. This interview topic was chosen as dentistry is a necessity in the world and it is not a job that can be completed while socially distancing, 6 feet, and with all individuals wearing face masks. The interviewee also had a role in creating regulations in the state of Virginia about the reopening of offices, which gives a unique perspective to rules the general public has no say in otherwise.

[Any background noises are family members present in the room or outside noises as the windows and doors to the house were open]

AR: Today is March 7, 2021, and I’ll be interviewing CR. CR has been practicing Periodontology in Richmond, Virginia since 1998, and also works as a professor at Virginia Commonwealth University with graduate dental students. In addition to his Richmond office, CR also owns a second office in Midlothian, Virginia. He also is on the American Academy of Periodontology board as the President elect, along with many other active roles in various foundations focused on the advancement of studies. Say hello.

CR: Hi, this is CR.

AR: Alright, and then we can just go ahead and get right into it. What were your initial thoughts when you heard about the Coronavirus a year ago?

CR: Honestly, I compared it back to the SARS [Severe Acute Respiratory Syndrome] breakout in 2012. And I really didn’t think that much was going to come from it, I thought it would be well contained and we wouldn’t see a significant impact on the US economy.

AR: So saying that you didn’t really expect anything, how did the initial lockdown affect you mentally since everything was closed?

CR: Oh, it was pretty difficult. So our practice was closed, as well as all dental practices in Commonwealth of Virginia on March 16, [2020]. And it was it was challenging to get kind of your mind wrapped around that. Because in dental practice, when you are seeing patients, that’s when your business is working well When you’re not seeing patients, then your business is not working well. So we had to lay off all of our employees, because we had no financial income, and have them begin to draw unemployment from Virginia state coffers.

 

AR: Wow, that must of been tough. So you guys did eventually open back up. How did your employees feel about opening up? And did some of them choose to permanently leave their job?

 

CR: That’s a great question. So we were closed from March the 16th through May the seventh. And we had done a really good job during the shutdown, to make every effort to educate our employees on the SARS Covie-2, or what’s known as COVID-19. And make sure that they were aware of the transmission with the transmission rates were, what we had done to provide safety measures to make sure that, you know, not only they were safe, but also our parents, our patients that we were going to see could be safe. So we didn’t have any that didn’t want to come back to work. We did have a couple of younger employees that had young children, that their daycare stayed closed, and unfortunately, they were forced to quit so that they could take care of their kids and manage their their home life.

 

AR: So speaking of kids, you work with three other dentists and you guys all have children. Do you think that you’ve had to make more changes in your lifestyle, then somebody else who, say is, still working from home?

 

CR: Well, dentists are really good at managing [unclear]. [paused] So dentists are really good at managing disease pathogens. We work in an environment that has a high contamination susceptibility. So we were already very familiar with that from CDC [Center for Disease Control] and OSHA [Occupational Safety and Health Administration] guidelines on what we currently do, just everyday practice. So incorporating air filtration systems, barriers, adding more layers to our PPE [personal protective equipment] came pretty natural to us. So for us going back to work, it was a little bit scary. But it was a situation where we knew we had done the right thing to manage all of those fears, so to speak.

 

AR: So you had a role in creating the regulations of dentist’s office in Virginia, correct?

 

CR: I did.

 

AR: So what affected your decisions most and what did you think are the most important rules to in-state?

 

CR: So I was on the task force to get back to work for the Virginia Dental Association. And what we did was came up with a package, or a set of recommendations, where we followed CDC and OSHA guidelines as well as guidelines that were put out by the American Dental Association. And incorporated those into the Commonwealth of Virginia so that we could help people get back to practicing safely. It was important for not only dentists but their auxiliary staff, including assistants, administrative staff, as well as hygienists, to get back into the workplace so that we can start to care for our patients. It was pretty interesting to see how impactful that shutdown was on patients missing their dental care, and how stress and dental disease began to proliferate within those patients and had a significant impact on their overall oral health.

 

AR: So do you think that the changes you’ve made now to the office will continue to stay in effect, even after things, quote, unquote, return to normal?

 

CR: I do. It’s one of those things where, if you go back to the early 80s, when the HIV AIDS came into kind of more of a national focus. That changed the practice of dentistry, and there’s been things throughout the practice of Medicine and Dentistry that have changed the way that we work significantly. And I think this is just a new change. And actually, they’re all good changes. They’re safer, they’re safer for our employees, they’re safer for our patients, and it helps to mitigate disease transmission.

 

AR: So have you had any encounters with patients who have tested positive [for COVID-19]?

 

CR: No, our, what we do for our measures that we take before we allow patients in [the office] is we ask them if they’ve had any symptoms associated with COVID, when when the COVID issue first came out, we asked them if they had undertaken any travel outside of the US. And then we took temperatures of everyone, we still take temperatures of every patient that comes into the office. Now we’re talking about patients that have had one or both vaccines, depending on their place in line. And it’s becoming more and more safer, as the number of cases drop. But we’ve, to our knowledge, we never treated an active COVID patient.

 

AR: Okay, that’s reassuring. So in other countries, they have had a second shutdown, much like our first and there was talk for a while, a second one in America, how would that affect your office and employees?

 

CR: It would affect it pretty significantly, to be honest with you, again, it’s not one of those things where I can go and work from home, I need to be in the office in order for my business to run, and for patient care to continue. So being shut down means that I am not working at all that my staff is not working at all. And unfortunately, we have no way to keep a steady influx of income. And then we’ve become more reliant on the state and the federal government to provide and subsidize that income.

 

AR: So what are your thoughts, and what are your employees thoughts about the vaccine? And will you be requiring everyone in your office to receive it?

 

CR: It’s a great question. So my thoughts about the vaccine are that I think, it was very, very quick in getting out which is fantastic. I, looking at the success rates are the vaccine. And remember, the vaccine is not supposed to keep everyone from getting sick, it’s supposed to prevent death, it’s supposed to make sure that your symptoms associated with the possibility of getting COVID-19 mean that you have very mild symptoms, much like a common cold or a mild case of the flu. You get over it and you move on. It’s interesting that you asked the question about our employees, because in the Commonwealth of Virginia, you can tell everyone that they have to have it, but you can’t do anything about it if they don’t get it. So you can’t mandate it and and the effect that you can actually fire an employee for not getting the vaccine. And to be quite honest with you, we don’t want to fire anyone. We want to make sure everybody understands the evidence based approach and science involved in making the vaccine and how it is effective, how it is safe and really talk about some of those conspiracy theories that are out there. The majority of our staff have gotten the vaccine all of the doctors. There’s four doctors in our practice, and we’ve all received both doses of the vaccine. And fortunately, everyone’s doing well. And if you’re tracking the vaccinations across the US, the post-vaccination complications are immensely minute, And then it’s a really safe vaccine. Now, are we going to be needing booster shots down the road? We don’t know the answer to that, because there’s not been enough time. But my suspicion is that it will end up being like the flu shot over time.

 

AR: Okay, interesting. So, considering COVID is spread through respiratory droplets, and it’s kind of impossible for you not to interact with somebody in that way, have you felt more at danger contracting COVID-19 when you are in the office?

 

CR: Not really, we use face shields, we use level three N-95 mask. We’ve put air filtration systems in place that filtrate down to a 0.001 microns, which is smaller than the Coronavirus particle, we have a number of safety measures in place for prevention of patients that are coming in with COVID-19. Remember, COVID-19 it’s not something, it is something that you know, 98 to 99% of the population is going to be take two weeks off, get better from and then come back to their dental care. So it’s, it’s, you know, something that is going to make us if a patient calls and says, “I’ve just been diagnosed with COVID-19 or I was around a positive patient with COVID-19.” What we would simply do is just put their appointment out for two to three weeks unless they need emergency care, if they need emergency care, then we would manage it for them. But we haven’t been put in that in that position.

 

AR: Thank goodness for that. Thank you so much for letting me interview you. I know that this topic is talked about a lot and it gets a little difficult, so thank you.

 

CR: Definitely.

Interview transcribed by https://otter.ai

The transcript was approved on 3/28/2021 and no changes were asked to be made by the interviewee.

Research:

COVID-19, or coronavirus, is highly well known throughout the world which meant that a majority of research done for the interview was on regulations in the dental community. I began by looking into the broader requirements for dental offices to create a background of general knowledge that would let me interview CR in a prepared manner. I personally have experience working in dental offices when not at school which also allowed for him and I to connect in shared experiences about what has changed since the pandemic began a year ago. I started to focus more on the effects of COVID on dentistry specifically which showed just how much lockdowns are effecting people in this certain section of healthcare. After the interview was finished I also looked the SARS outbreak and how it was handled vs how COVID is being handled as it was mentioned in the interview.

Bibliography:

“CDC SARS Response Timeline | About | CDC”. Cdc.Gov, 2021, https://www.cdc.gov/about/history/sars/timeline.htm. Accessed 26 Mar 2021.

Cheeseman, Vicki. “COVID-19 And Its Effect On Dentistry: Predictions, Recommendations”. Dentistryiq, 2021, https://www.dentistryiq.com/dentistry/article/14189818/covid19-and-its-effect-on-dentistry-predictions-recommendations. Accessed 18 Feb 2021.

“Healthcare Workers”. Centers For Disease Control And Prevention, 2020, https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html. Accessed 18 Feb 2021.

Morath, Eric. “How Many U.S. Workers Have Lost Jobs During Coronavirus Pandemic? There Are Several Ways To Count”. WSJ, 2020, https://www.wsj.com/articles/how-many-u-s-workers-have-lost-jobs-during-coronavirus-pandemic-there-are-several-ways-to-count-11591176601. Accessed 1 May 2021.

Staff, AJMC. “A Timeline Of COVID-19 Developments In 2020”. AJMC, 2021, https://www.ajmc.com/view/a-timeline-of-covid19-developments-in-2020. Accessed 1 May 2021.

Interview was recorded in person using Voice Memo app on the iPhone and transcribed from audio to text using Otter-Ai. After the transcription, I edited the interview for any minor spelling or grammatical errors present for easier reading. While it is recommended that the transcription is moved to a different program for editing, I found it easier to edit on the website so see how it would look when published. Also, wording that is unchanged in the interview and repeated words or grammatical errors present in the transcription were left intentionally by the interviewer.