Dear ZenFamily, Hope everyone is staying safe and having a productive week so far! Last week here at Zen we had a webinar on Friday 5/15 on "Understanding N95/KN95 Masks and 3 Ply Surgical Masks, Compliance For Dental Practices Including research/diagrams/test/in office test log forms". Mary Govoni joined Tiger to answer questions on what products to start ordering asap, understanding the different masks types, compliance for dental offices, current market counterfeits and much more. Please find the full webinar here: https://www.youtube.com/watch?v=JdSx0fNEEvM https://open.spotify.com/episode/6ro2XbV7touiThhJc3gV05?si=XKhnHRiITMW4SIpzA5N2rg Notes and Links discussed during the webinar: *Disclaimer: all information below is only suggested and not presented as scientific research nor acts as a guideline for dental practices. This is only expression of the research we've done for our members in the attempt to consolidate different ideas in one resource. Below information is assembled by Zen Team only and not related to opinions/recommendations of guest speakers on the webinar. General Info on Mask and Identifying Counterfeit: ADA Tips to Avoid Counterfeit: https://success.ada.org/~/media/CPS/Files/COVID/ADA_TipsToAvoidCounterfeitMasks.pdf?utm_source=adaorg&utm_medium=adanews&utm_content=cv-counterfeitmask&utm_campaign=covid-19 ADA Guide on Understanding different masks: https://success.ada.org/~/media/CPS/Files/COVID/ADA_COVID19_UnderstandingMasks.pdf?utm_source=adaorg&utm_medium=adanews ADA 1 CE Course on Respiratory Protection in the Era of COVID-19 (great resource): https://success.ada.org/en/practice-management/patients/digital-events/ada-and-osap-respiratory-protection-in-the-era-of-covid-19-webinar?utm_source=adaorg&utm_medium=adanews American Association of Occupational Health Nurses Online Course: Respiratory Protection Program Training and Resources (Free Certification) - Recommended to have at least 1 team member to be Certified: http://aaohn.org/p/cm/ld/fid=1138 Level 1/2/3 3 Ply Surgical Masks: Study on effectiveness of N95 vs Surgical Masks: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868605/ Level 3 Masks are recommended for use in Dental Practices: https://healthcentricadvisors.org/wp-content/uploads/2017/04/3_MaskEnomics_Poster_2012.pdf Research from Dental Advisors from 2014 (Trying to find something more recent, if you know of a resource, please add in comments). Face Masks, What to wear and when: https://www.dentaladvisor.com/pdf-download/?pdf_url=wp-content/uploads/2015/02/face-masks-what-to-wear-and-when.pdf Choose the right mask from Cardinal Health. Visual diagram of Understanding ASTM level of Protection: https://www.cardinalhealth.com/content/dam/corp/web/documents/whitepaper/Face%20Mask%20Selection%20Guide.pdf N95 Respirators Resources: ADA Tip Sheet on identifying counterfeit N95 masks (as of May 7, 2020): https://www.ada.org/en/publications/ada-news/2020-archive/may/ada-tip-sheet-includes-cdc-guidance-on-identifying-counterfeit-n95-masks Fit Test Kit and Instructional Video (Product Available on Zen Resource Page): https://www.allegrosafety.com/product/saccharin-fit-test-kit/ How to Perform a User Seal Check with an N95 Respirator (different from Fit Test):https://youtu.be/pGXiUyAoEd8 OSHA Compliance requirement (documented on ZenResource Page as of May 7, 2020): Every Employee Must Complete - Respirator Medical Evaluation Questionnaire: https://www.osha.gov/Publications/OSHA3789info.pdf Every Employee must complete Fit Test prior to using a Respirator. ReCertification is required 1/year. Safety Fit Test Record: https://www.allegrosafety.com/wp-content/uploads/2019/10/Respirator-Fit-Test-Record.pdf List of Respirator Trusted-Source Information (From CDC Website): https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/respsource3healthcare.html#e NIOSH - Approved N95 Particulate Filtering Facepiece Respirators (Full List of Approved manufacturers): https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/N95list1.html Surgical N95 Respirators Approved Manufacture List (Short): https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/respsource3surgicaln95.html KN95 Masks Resources: NIOSH International Assessment Results - Not NIOSH approved: https://www.cdc.gov/niosh/npptl/respirators/testing/NonNIOSHresults.html List of Approved Manufacturers (FDA Approved as of May 7, 2020): www.cdc.gov/niosh/npptl/topics/respirators/disp_part/respsource3surgicaln95.html Steps to spot counterfeit products (these steps make assumption that documents provided are true in nature and have not been reprinted with logos of FDA/NIOSH and any other organizations): The manufacturer from who the product is manufactured should have an FDA certificate on file with their name and the approved product The manufacturer must be on the approved Chinese exporter list There should be a testing report on file that they can send to show you they are a legitimate product The distributor could or should have FDA Registration to be able to import these products. Always ask for FDA registration of the vendor who is exporting products. FDA Database of Registration & Device Listing: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRL/rl.cfm Reusable Gowns/Laundry Service and Washer/Dryer Installation: Cost of reusable gowns is between $20-$30/gown. We will work on getting a source for a group order for the reusable gowns. Cost of Pick Up and laundry service. First of all I would highly recommend to talk to your local Laundry Service provider and discuss how to work together. Prices that we found online are ranging from $.95 to $3 per pound, including pick up/drop off/folding. The other option is Washer and dryer Hookup: The cost of installation: https://www.thumbtack.com/p/washer-dryer-hookup-cost Portable washer/dryer: https://www.wayfair.com/GE-Appliances--Spacemaker%C2%AE-3.6-cu.-ft.-Portable-Dryer-DSKP333ECWW-L7322-K~GEAP1077.html?refid=GX350646125182-GEAP1077&device=c&ptid=753249148770&network=g&targetid=pla-753249148770&channel=GooglePLA&ireid=66097775&fdid=1817&gclid=EAIaIQobChMIr5rFq-O26QIVR5yzCh0z7ghOEAQYBCABEgJ67fD_BwE Here are the details on the webinar coming up for the week of 5/18: On Friday, 5/22, at 1pm CST, we invited Dr. Gina Dorfman, a dentist and fellow CEO of Yapi Dental and Julie Varney, CDA, RDA, COA, FAADOM, CDSO, CDSH, Mentor of Dental Assistants Rock to share their experiences, tips and advice on reopening your practice. Dr. Dorfman's practice reopened on Monday, 5/18 and she will share with us how her office went through the reopening process and what their quarantine experience was like. Julie is in New York and her office has not reopened yet. They've done a lot to train their staff on new updates, performed a systems check and stocked up on PPEs. Dr. Dorfman will also talk about some protocols! Be ready to ask Julie and Dr. Dorfman lots of questions and feel free to share your reopening experience with fellow Zen offices! https://livewebinar.com/892-097-831 We hope everyone is enjoying the live events! Stronger together!
Dear ZenFamily, Happy Monday and happy August to all! As we jump into another busy week, we’d like to share a recap of live events and webinars for last week (the week of July 27) as well as some exciting live events that we have planned for the week of August 3. So here goes! On Wednesday, July 29, by many requests from the ZenFamily, we invited Mary Govoni to the live webinar to discuss the new OSHA/CDC guidelines, requirements, and simply what's working and what our teams need to know about infection control. Tiger asked Mary about the current shortage of Nitrile Gloves and Surface disinfectants (wipes). What are the options if we can't buy any more? How do we get through the tough times? Please take a look at the full webinar here: https://youtu.be/Gr2K_HEyymU And here is the podcast: https://share.transistor.fm/s/b8be1436 To find more information on Mary Govoni & Associates, please visit: On Friday, 7/31 at 11 am CST, Tiger hosted our traditional "15 min Friday Supply Availability Update" for Zen Offices! Please join us Every Friday at 11am Central for a live update on what is going on on the market and availability of dental supplies. All you have to do is login to your Zen account, app.ZenSupplies.com For the week of August 3, we have planned the following events: 1. On Wednesday, August 5 at 11 am CST, we invited John Hatfield and Amanda Newhouse to a live event to share with us what the process of opening up a dental assistant academy entails. John from Dental Assistants Worldwide will cover in depth the challenges and exciting aspects of starting the Cornerstone Dental Assistant Academy. We plan to ask John and Amanda the following: -What made him want to start a dental assisting academy? -What will be different in their school as compared to other dental assisting schools? -Why is a dental assisting academy needed? -Will Cornerstone Dental Assistant Academy provide remote learning options? -What are the challenges with the school not being remote/being remote? -How will the curriculum change post covid? -How will the curriculum influence sedation, implants, sleep apnea procedures? How to prepare for the new trends in dentistry? The benefit of the LIVE Webinar is that we will be able to answer YOUR questions during this time. So please join us at 11 am CST on Wednesday 8/5 at 11 am CST! All you have to do is login to your Zen account, or follow this link: https://app.livewebinar.com/699-206-742 2. And per our Friday tradition, on Friday, August 7 at 11 am CST Tiger will host a 15 minute Supply Availability Update. The ZenTeam is spending countless hours every week doing due diligence, learning about different products and product shortages, and sourcing new vendors. In addition, the landscape of the supply chain is constantly changing and so are the prices of PPE products. Therefore, I would like to host a 15 min live event EVERY Friday at 11 am Central with a special guest to go over what we learn during the week. We will share EVERYTHING-good, bad and what to prepare for. And this Friday, we invited Dr. Matthew Kathan from Timber Dental to share his invention with us! Simply login to your ZenSupplies account and join us there for all live events! Thank you to all for participating in our live events and we look forward to seeing everyone during this week’s webinars!
Many are concerned with what’s next? When do we get back to normal? What is the new normal? While all of these things are important, I truly believe that the new normal is the renaissance of entrepreneurship in the dental space. Every person who is in the operatory or the front desk has an IDEA! Most importantly EVERY idea is worth putting in action. Every idea is worth exploring and giving it a try. So my question is how do we encourage and propel entrepreneurship forward at the time of uncertainty? Just a simple observation, tough times are the best time to start a business! When I meet with doctors, hygienists, and my favorite dental assistants I encourage them to bring small, seemingly simple/ uninspiring ideas, to some sort of fruition. You gotta get it out and let the world see it. Yes, most ideas will be labeled as “stupid” but if you have what it takes you will go back and think through and come up with a new version. There has been a strong push to start service type business or consulting, to help dental practices with different aspects of collections, operations, OSHA, Compliance, HR, etc. We also see a new wave of dental assisting schools opening across the country, and I want to give a shout out to my friend John Hatfield and his business partner Amanda for opening a new type of dental assisting school, with an added emphasis on budgeting, how to order supplies and compliance. The type of entrepreneurship I would like to encourage and support is around Product Innovation. It would be so great to encourage product type entrepreneurship. Imagine we create a world where dental professionals are encouraged to bring new, innovative ideas to life. I’ve been asking people to develop a new type of wipes that are eco-friendly, use natural ingredients, and use recycled materials. Anyone, please? So what do we need to do as an industry to help bolster entrepreneurship within the dental field? In my personal opinion few things need to be done or developed: Ecosystem for inventors to be able to quickly list a product (or products) provide a Shopify like experience and access to the audience of shoppers who can see new products and give it a try. The ecosystem needs to truly support inventors from the bottom up. So if there is no sales at all or just a small volume, there shouldn’t be any fees associated with listing and selling products. We need to give it a push just enough for inventors to see that there is a demand. The ecosystem that provides access to end users/ buyers. If there is a demand we need to provide inventors access to people who try the product and can provide feedback, either through review, or even online conversion - could be chat or Google Meet. Support Inventors with product distribution without any legal jargon or hard rules, or exclusive contracts. Or better yet provide a software solution for efficient drop ship (something similar to ShipStation). Providing support. It’s easy for some of us to create and invent and push forward, however after meeting so many people I realize there are a lot of people with great ideas and potentially with life-changing inventions that simply don’t believe in themselves. I also don’t believe in fake encouragement, however, the market is the market. If the product is good, people will buy it! There is really no downside in giving it a try. Podcast Support. It’s clear that the attention is shifting from forums to Facebook Groups and Podcasts. I believe each podcast should have a spot to allow Inventors to present products at no cost. It shouldn’t be a 2-3 minute commercial. More of a story, details, and why this product is important. This Friday I’ll be interviewing one of my good friends Dr. Matt Kathan, owner of Timber Dental, a Portland-based small DSO with 5 locations. During COVID, Dr. Matt invented a product and he will share with us what he learned. I’m really excited to discuss how we can help and support dental inventors across the US. [embedyt] https://www.youtube.com/watch?v=rCWWEbnc-Yc[/embedyt] Tiger Safarov
Dental practices have faced numerous challenges this year, due to the COVID-19 pandemic and those challenges continue. As the number of cases of COVID-19 continues to increase, dental practices are facing additional hardships. Supplies of PPE, especially respirators, continue to be difficult to find. Dentistry now faces shortages of disinfectant wipes and gloves. And as the community spread of COVID-19 increases, patients and dental team members are becoming infected in record numbers, causing confusion about what to do in case of exposure. Yet another challenge that looms on the horizon is increased surveillance of dental practices by regulatory authorities, such as OSHA and state dental boards. Managing these challenges requires dental teams to continue to access information updates from public health agencies, training when updates occur, and written documentation of efforts to provide the safest environment for both patients and dental teams. There have been numerous OSHA inspections in dental practices resulting from complaints from employees. In addition, some state OSHA agencies have been conducting unannounced inspection for compliance with COVID-19 guidelines for employee safety. In the case of a practice in MA, OSHA issued numerous citations and fines of $9500.00. Information about this inspection is available through these links: Inspection Detail | Occupational Safety and Health Administration (osha.gov), and Georgetown Dentist Fined $9,500 For Violating Coronavirus Safety Guidelines – CBS Boston (cbslocal.com). The good news is that vaccines should be available within the next few months. It is important to note, however, that the introduction of the COVID-19 vaccines will not immediately end the pandemic. Most public health experts agree that COVID-19 will continue to spread and require us to continue to follow our guidance from the CDC for at least the next year. We must continue to be vigilant in screening patients and employees, wearing appropriate PPE, practicing universal source control, updating infection prevention training and documenting all of the protocols that we follow to protect both patients and dental team members. While it is unlikely that dental practices will be ordered to close again, as in the beginning of the pandemic, we cannot let pandemic fatigue to cause us to let our guard down. Instead it is an opportunity to fine tune our protocols to be prepared for whatever may come our way. Let us look at these protocols and what is required. Both OSHA and the CDC state that when aerosol-generating procedures are performed, the respiratory protection level is N95 or higher. Guidance for Dental Settings | CDC and COVID-19 - Control and Prevention | Denstistry Workers and Employers | Occupational Safety and Health Administration (osha.gov). When N95 masks were very difficult to find in the beginning of the pandemic, the FDA allowed the use of Chinese-approved KN95 respirators to be used during the pandemic through its Emergency Use Authorization (EUA) provisions. In addition, when even the KN95 respirators were difficult to obtain, the CDC guidance stated that an ASTM Level 3 surgical mask and a full face shield could be work, but not for treating a patient that known or suspected to be COVID-19 positive. Although N95 respirators are still not in great supply, they are available now through both dental and medical distributers. Respirator manufacturers have increased production and shifted production to the U.S. to assist in getting these much- needed devices to health care professionals. In addition, the FDA EUA allows health care workers to reuse these disposable (one-time use) devices to help supplies to last longer. It is risky to assume that just because respirators were difficult or impossible to obtain several months ago, that may not be the case now. If your practice is inspected by OSHA, an inspector will ask to see documentation of your attempts to obtain appropriate PPE. Keeping a log of these efforts will protect your practice against citations and fines. There have been news reports of severe shortages of gloves. This could be a game changer. Unlike respirators during the EUA, gloves cannot be reused. Practices may have to switch from their preferred type or brand of gloves temporarily, even using latex gloves in some cases. Latex gloves have not been used routinely for some time because of the prevalence of sensitivity and allergies on the part of patients and dental professionals. If you must use latex gloves, be sure to screen both patients and employees for these sensitivities and make sure that your Epi-Pens are accessible and up to date in case there is an emergency. Many dental distributers are providing different brands of disinfectant wipes than what most practices are familiar with. Make sure that the product is EPA registered, and has a label claim as a tuberculocidal disinfectant. Although many manufacturers are promoting their EPA-registered claims against SARS-CoV2, the CDC Guidelines for Infection Control in Health-Care Settings states when there is the presence of blood, an intermediate level, tuberculocidal disinfectant must be used. RR5217 Dental Front.pmd (cdc.gov). The EPA stated early in the pandemic that products on the EPA List N should be used, but recently clarified that if a product does not appear on this list, but has a label claim for a microorganism more difficult to kill than SARS-CoV-2, it was acceptable to use. List N Advanced Search Page: Disinfectants for Coronavirus (COVID-19) | Pesticide Registration | US EPA. It is possible that your favorite brand of disinfectant is available in a liquid formula that can be applied with a spray bottle, however, it is important to remember that we switched from spraying disinfectants to using wipes to decrease chemical exposure (and potential for respiratory problems) for dental team members. The solution can be sprayed onto an applicator (gauze or paper towel) and applied to surfaces. The CDC Guidelines for Sterilization and Disinfection in Health Care Settings Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 (cdc.gov) state that solution should not be placed in containers where gauze or other applicators is soaked. The fibers in the gauze will inactivate the solution. Wipes are different in composition and do not cause this to happen. Several companies, including SciCan, sell dry wipes (StatWipes) that you can add your preferred disinfectant to. In addition to an OSHA-required Exposure Control (infection control) Plan, dental practices must also have a COVID-19 Preparedness and Response Plan. This must be in writing and is a key document scrutinized in an OSHA inspection. Key elements of this plan include a Hazard Assessment and Exposure Determination, and protocols to follow if an employee is exposed to COVID-19 at work. Guidance for the Preparedness and Response plan is available from OSHA in these documents: https://www.osha.gov/Publications/OSHA4045.pdf and Guidance on Preparing Workplaces for COVID-19 (osha.gov). CDC guidance on exposure to COVID-19 and returning to work is available in these documents: Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19 | CDC, Return-to-Work Criteria for Healthcare Workers | CDC. When dental team members wear respirators, a written respiratory protection plan is also required, which includes information on the required medical evaluations and fit testing of the devices. Again, OSHA has provided guidance on developing a plan in these links and documents: https://www.osha.gov/Publications/OSHA3990.pdf, OSHA 3384 SMALL ENTITY FOR RESPIRATORY PROTECTION STANDARD REV 9.28.11:Layout 1. Medical evaluations and fit testing must be documented. Although it has been reported that OSHA has suspended all fit-testing requirements, it has only suspended the annual fit-testing of respirators. These tests must be completed initially (when first wearing respirators) and any time that the type or brand of respirator is changed. Since this could be often, due to supply shortages, I recommend that dental practices conduct their own fit-tests. A member of the team can be trained to administer the fit-test and test kits can be purchased through most dental distributors. Some test kits come with an instructional video, but online training is available and there is no certification required. A free, online program for fit-testing is available through the American Association of Occupational Health Nurses at: AAOHN : Online Learning. Dentistry will be forever changed by this pandemic – mostly in positive ways. We have a better understanding of disease transmission and how to control the spread of infectious diseases. We have more scientific knowledge about the hazards of exposure to aerosols in dentistry and the importance of air quality in our dental health care settings. Our patients have a greater appreciation for all the safety protocols we follow to keep them safe. The negative impact is most certainly from the costs associated with PPE and other equipment and supplies. But we are dedicated to the delivery of quality oral health care in the safest manner possible. We will survive this challenge and quite possibly be more resilient because of it and be better prepared if another pandemic occurs in the future. If your practice would like some assistance in developing your OSHA and COVID-19 documentation, please contact me at mary@marygovoni.com, or visit my website at www.marygovoni.com. Mary Govoni, MBA, CDA, RDH Mary Govoni & Associates
This is a repost from Becker's Healthcare, written by Gabrielle Masson on March 30, 2020. President Donald Trumppasseda $2 trillion emergency spending bill March 27 to combat the economic effect of COVID-19. Below are provisions of the legislation relevant to dentists, as explained by Chad Gehani, DDS,American Dental Associationpresident. Provisions the ADA believes are most critical for dental teams: 1.Economic Injury Disaster Loans. The emergency grant will be awarded on a first-come, first-served basis to those who apply for loan advances of $10,000 or less. Applicants won't have to repay the money even if denied the loan. 2.Loan forgiveness for certain small business loans. Eligible employers may have a portion of federal small business loans forgiven for certain payroll, sick leave, family leave and other expenses occurring between Feb. 15 and June 6. 3.Additional Small Business Administration loan payments. The Small Business Administration will pay the principal, interest and associated fees owed on 7(a) loans, 504 loans and microloans for a six-month period. 4.Retirement account withdrawals. A dentist can withdraw up to $100,000 in 2020 from retirement funds without paying a tax penalty if the dentist, their spouse or dependent tests positive for COVID-19, or experience adverse financial effects as a result of being quarantined, furloughed, laid off, or having reduced work hours. 5.Student loan interest deferral. Federal student loan borrowers will not be required to make a payment and no interest would accumulate on federal loans through Sept. 30. 6.Deferred Social Security tax. Employers and self-employed individuals will be able to defer payment of their employer share of the Social Security tax until Dec. 31. 7. Federal tax rebates. A one-time federal income tax rebate of $1,200 would be available for individual tax filers making less than $75,000. 8.Unemployment benefits. Emergency unemployment compensation benefits will be dramatically increased. Original Article Click HERE