Derek Mahony, a specialist orthodontist based in Sydney, Australia, discusses how COVID-19 has shaken up dentistry Down Under.
How was dentistry affected at the start of the pandemic?
We did have to close our doors at the beginning. It was projected to be three months, but it only ended up being six weeks because the case numbers were improving. During those six weeks we could only see emergency cases, where we were minimising aerosol. After this time things had gone back to normal.
However during those six weeks there were a couple of things we found in the dental community. Firstly, a lot more people were at home on Zoom, meaning they were looking at their faces more than they probably would have ever done in the past. This simply generated huge interest in cosmetic dentistry.
Secondly, people had a higher disposable income. Obviously they’re not travelling. When we came back – and this is shown in the surveys that a lot of the dental groups in Australia carried out – the productivity across the board has boomed.
This applies to not just myself as a specialist but also in general dentistry. They’re all trying to work out what has led to this. I think in many ways it is due to the good fortune of returning to practice so quickly.
From our perspective, in the six weeks we were locked down we spent time improving our game in telehealth. We have a fairly big practice – six locations with around 5,000 new orthodontic cases a year. Each of my associates reached out to every patient during the lockdown period, personally, via Zoom or the telephone.
Some of the software we used was really helpful in assisting us track tooth movement. It allowed us to see where that patient was in treatment and predict their next step with a virtual call. The patients were eternally grateful for that opportunity.
Did you ever have to implement a fallow period?
No. We didn’t get to that stage. They were talking about it, particularly the maxillofacial surgeons. In orthodontics, the only time you need to use aerosol is when you’re removing braces. But there’s new handpieces that have been developed post-COVID that actually do the same job without aerosol. They have a micromotor and they don’t produce the spray.
We also changed our waterlines into Ozone, which is very, very good at killing contaminants etc.
You mentioned teledentistry. Do you think the pandemic has accelerated its use?
Absolutely. It’s the survival of the fittest. I’m an international lecturer, but I wasn’t that great on Zoom before the pandemic because I’ve never had to use it. In the same way, a lot of dentists have never had to use telehealth even though it’s been sitting there for ages.
The government rolled out a national broadband network (NBN) that allows remote areas in Australia to have consults with specialists. You can look at X-rays in real time. All that was already there because of the distances in Australia but it probably wasn’t utilised enough as there wasn’t the demand until COVID hit.
We actively marketed to a lot of our patients that if they wanted a consult during this period, we were very happy to do it via telehealth. We actually did a lot of consultations that got us ready for coming back. This really brought a boom for us – a plateau during the six weeks but a spike as soon as live appointments became available.
I think education of the patient and keeping in touch with the patient is so important, but also having systems in play that allow you to discuss many aspects in dentistry that you probably never had time to discuss when you had a full book, whether this is preventive dentistry, or cosmetic dentistry, for example.
You’ve spoken about the benefits of using artificial intelligence within dentistry. Why do you think there’s value in AI? What does this add?
Even before COVID, AI just makes everything you do more accurate. Patients can see that. If you take your car for a tune up, nowadays you expect the mechanic to hook it up to a computer and check its performance. Dental patients expect this now too. Patients are obviously a lot more educated because of Google. I think dentistry and CAD/CAM go hand in hand.
Every time you go to a dental show all you see is more and more computer software programmes. The big one for us is Invisalign – they were the market leaders in bringing AI to tooth movement. It’s well branded that everyone knows you can now check to make sure the aligner is doing what it’s supposed to do, by checking where the tooth should be at this stage of treatment.
I know in Australia that since everyone can go back to work, our stats are showing 50% of people are still staying at home because they’re realising they’re just as productive. The disruption in Australia is the realisation that people can do a lot from home.
As a result, the expectation is that now they don’t have to book a day off work to go to the dentist. Instead, they can be offered a chat, to determine if they need to come in.
For example with our aligner cases, rather than book them in for a standard check up, we can see what’s going on on a weekly basis with the software and a photo. If I need to get them in, then I will. Other times I can wait ten weeks.
Patients love it. In Sydney, much like London, what looks like a short commute on a map can actually be a 45-minute journey just to get to the practice for a five-minute appointment.
Being able to say to a patient that I do need to see them, but only every three months and we catch up in between, is much better. Patients want to know that somebody is looking after them. Sometimes we are actually shipping the aligners directly to the patient.
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