NORWAY — Oxford Hills Dental Care reopened its doors on May 20. The solo practice of Maurice Convey, DDM, it also employs two dental hygienists, two dental assistants and an office manager. Convey had to lay off his entire staff back on March 16. His five employees were able to collect unemployment during the stay home directive but as the practice owner he did not qualify for those benefits.

Confusion surrounded dental clinics as Maine announced its rural reopening plan on Apr. 28, which included healthcare provided by Maine-licensed providers. On Apr. 29 the state revised the allowance to not include dental care. Following pushback from the Maine Dental Association and several of its members, Governor Janet Mills reversed course again and said that practices could reopen for regular dental procedures, following guidelines set by the MDA and the American Dental Association.

Connecticut, Rhode Island, New Hampshire and even COVID-19 hotspot Massachusetts had already announced plans and dates for reopening. Vermont will allow practices to reopen on Friday, May 29.

“When the governor made the announcement for Stage 1, which would begin on May 1, maybe that was not a realistic date for all,” said Convey the day after his staff began receiving patients for routine care. “We scrambled to prepare for that, mostly to make sure the proper personal protective equipment was on hand. It seemed the reopening was a last minute decision as well as the reversal announcement. But some dentists were ready for patients by May 1.”

Convey’s staff is wading through a backlog of cancelled appointments stretching back more than two months while adjusting imminent bookings.  Extra time needs to be included to clean and sanitize between patients and allow for foot traffic restrictions, as the number of people who can enter and exit the office is limited. The two hygienists at Oxford Hills Dental are normally booked six to eight months out at a time. That means the office had scheduled appointments through November of this year and is now trying to wedge in nine weeks of patients for dental care around reduced hours to provide it. Convey said he may hire someone part-time so they can catch up, but he is also seeing that some patients are still nervous about coming in and that may help ease the immediate bottleneck.

During March and April Convey continued to be available for dental emergencies. Before COVID-19 he said that he might receive two or three emergency requests a day but the definition of an emergency has changed.

“In normal times, a chipped tooth would warrant an emergency call,” he said. “Currently, that is a low-grade situation. For a pain or infection emergency, before I might treat five in the course of a week. But by April, I was taking four or five calls for help in a day.”

Convey stayed on call and handled each emergency as it came in. As his staff was laid off he had to treat each patient by himself. His current patient schedule for the next few weeks is about average, but as routine care ramps up he expects procedures to follow suit.

Oxford Hills Dental Care’s office was in proper condition to receive patients, as Convey had to maintain sensitization in support of emergency care. But acquiring enough PPE was a little trickier and a lot more expensive than it has been for dentists in the past. Convey needed to purchase caps, new gowns and more shields. He had to have a new air filtration system installed in his office at a cost of $6,500.

“We have to have more gown coverage now,” Convey said. “We use masks anyway, but ours were Level 1-to-2 rated, lower than the N95 mask we must use now. Early in the year it cost about $13 for a box of 50 masks. I just paid $250 for 50 N95 masks.”

Convey and other local dentists got together during the closure time and inventoried what they had for PPE. He reached out to the purchasing agent at Stephens Memorial Hospital and offered to make it available if they ran low on PPE. Fortunately, the hospital had adequate supplies and never had to look for outside assistance.

He and his colleagues continued to check in with one another as they moved towards reopening, sharing information on what they were doing for safety, about PPE supplies and coordinating to ensure they were handling the process consistently for the community.

As with other public-facing businesses opening in May, everyone in the office – staff and patients – are required to wear facial coverings. Similarly, every person entering has to have their temperature taken. Before coming to the office, each patient is screened over the phone and the process is repeated in person once they arrive. Once the patient is in the dental chair he is allowed to remove his facial covering to receive treatment.

Even if Maine’s reopening goes well and continues, dental care over the next year promises to be a high demand service.

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