An Update from Tabitha

March 17, 2020

As we all adjust to the impact of the coronavirus (COVID-19), we wanted to let you know some of the things we’re doing to help protect our clients. As well as pass on guidelines from the ADA in coordination with the CDC for disease prevention. Please note the ODA has issued a RECOMMENDATION as well https://www.okda.org/covid- 19/ as of late this evening.

Certainly, for those in the higher risk groups (some of my senior doctors) we understand closing your office for the next 7-21 days. Be certain to review the pending tax legislation below in regards to paying team during this time. To clients who recently purchased your practice and may be panicked I hope this will provide you some guidance. We will be here to support you and your team so let us know if you have any questions. For the many offices remaining open be advised the CDC recommends the guidelines below which are basic sanitization principles for normal use but with the recent events is nice to have a refresher and to be certain you are letting your patients know of the precautions you are taking to keep them safe. Post attached Safety Announcement AFTER customizing to your office.

Precautions should be made to ensure the highest chance of patient and team safety, these guidelines are coming from the ADA in conjunction with the CDC.
* Clean and heat sterilize handpieces and other intraoral instruments that can be removed from the air lines and waterlines of dental units.

* For handpieces that do not attach to air lines and waterlines, use FDA-cleared devices and follow the validated manufacturer’s instructions for reprocessing these devices.
* If a dental handpiece cannot be heat sterilized and does not have FDA clearance with validated instructions for reprocessing, do not use that device.

* Ask patients about any recent travel and signs and symptoms of infection when they update their medical histories.
* Taking temperature readings as part of their routine assessment of patients before performing dental procedures.

* Making sure the personal protective equipment they use is appropriate for the procedures being performed.
* Using a rubber dam when appropriate to decrease possible exposure to infectious agents.
* Using high-speed evacuation for dental procedures producing an aerosol.
* Autoclaving handpieces after each patient.
* Having patients rinse with a 1% hydrogen peroxide solution before each appointment. * Cleaning and disinfecting public areas frequently, including door handles, chairs and bathrooms.
*Coronaviruses are enveloped viruses, meaning they are one of the easiest types of viruses to kill with the appropriate disinfectant product. The Environmental Protection Agency has developed a list of registered surface disinfect products for use against SARS-CoV-2, the coronavirus that causes COVID-19.

Verbals -When speaking with patients regarding their appointments it is important for them to know you and your team are taking this very serious and you are doing everything you can to not only protect them but also your yourself and your
families. Keep in mind the patients at highest risk are your older patients over the age of 55, those with a compromised immune system and small children. Some of your elderly patients will elect to not leave their house, others may want to know that they will not have to wait in the waiting room or can wait in their car until you are ready for

them. Let your patients know you are happy to accommodate them. You may want to block your schedule for higher risk patients and allow for slightly longer appointment times to avoid multiple people coming and going at the same time and to give your team ample time to turn over the room and properly wipe everything down. Be certain to keep instruments bagged until your patient enters the room so they know they are getting sterilized instruments.

Schedules – ultimately due to the constant breaking news updates you should expect changes in the schedule. Listen to patients concerns and be sympathetic about their concerns WHILE educating them on the precautions you are taking in your office and reassuring them that their health is of the utmost importance. Of course the calls will range from everyone is crazy to even be worried to mass hysteria. Take a deep breath before answering the phone and remember your tone and confidence on the calls make a huge difference!! What we know for absolute certain is so much starts in the

mouth. So if your patient is healthy and not having any symptoms then we want to keep them that way. For patients who are scheduled for restorative work and are in pain you want to get them in and get them taken care of immediately. Those who may be scheduled over the next couple weeks for routine work need to be asked the following questions:

1. Have you traveled within the last 2 weeks? If yes, have you had any fever, cough or flu-like symptoms? If yes, reschedule their appointment for a minimum of 4 weeks. If no travel and no symptoms, confirm their appointment and reiterate what your office is doing to keep them healthy during their visit.

2. If you are speaking to a family with children – be certain to look at ALL family members charts for outstanding treatment and unscheduled hygiene. Parents don’t want to have to pull kiddos out of school, especially after having them home for an extended period. So help them take advantage of this time off and get all their appointments completed! Again, making certain that no one has a fever, cough or flu- like symptoms.

3. For larger families with more than 2 children we do strongly recommend splitting up these kiddos appointments – possibly 2 children on one day and 1 child a couple days later or the following week so that if someone in the house becomes ill you do not have an entire afternoon fall apart.

Pending Tax Legislation provided by Craddock Financial Office# 918-948-9142

As news changes daily regarding the COVID-19 (Corona) Virus, we are sure all of you have questions regarding tax relief legislation. We are monitoring pending legislation in Congress. The

bill that was passed by the House of Representatives last Friday has yet to be approved by the Senate. At this time nothing definitive has been offered by Congress or the IRS.

In the meantime, we urge you to check your state website for any information and changes in unemployment regulations due to the pandemic. Based on pandemic response requirements being considered by Congress, if you decide to close your office, we suggest you be prepared to continue paying your employees’ wages for the upcoming two weeks and possibly four weeks. At this point, this is a possible requirement being considered in the legislation and has not yet been mandated. Along with the mandated employee pay is also proposed tax credits to offset the employer costs so the government, based on what we have seen so far, intends to subsidize this pay but unfortunately after we have paid our employees.

Other things to consider at this time: 1) Evaluate your access to cash reserves and/or a business line of credit. 2) Reach out to your current banker or business lender to see if there are any special loan programs available to help you through this period of time. 3) Make sure you have a personal line of credit available as well for your own personal needs in case you cannot draw compensation from your business.

While we hope for the best, it is prudent to plan for the worst.

We will do our best to provide further guidance as more definitive relief is enacted by federal and state tax agencies.

Essential Oils

Many of you diffuse oils in your offices which I absolutely love! This is a critical time to educate your patients about what you are diffusing and how you are keeping yourself and your patients healthy in the process. If you have On Guard from DoTerra or Thieves made by Youngliving these are both very beneficial oil blends to diffuse in your practice right now. Your patients will immediately be able to smell the pleasant scents and the oils in these two blends are all Rock Stars for your immune system. DoTerra also has OnGuard mouthwash which is similar to peridex. This was developed by Wendy Briggs and DoTerra and does wonders when having patients rinse prior to an appt and following their appt to kill as much bacteria as possible. Due to people buying in large quantity they are limiting one per order so if you are out right now you can order here my.doterra.com/tabifernandez

Additional Resources:

Cain Watters – Manage Cashflow COVID19

https://www.cainwatters.com/digitalblogs/covid-19- update/?utm_source=notice&utm_medium=email&utm_content=cash-flow-blog

CEDR HR Solutions

Customized Employee Handbooks & HR Insourcing Support

Small Business Website link

https://www.sba.gov/disaster-assistance/coronavirus-covid- 19?utm_medium=email&utm_source=govdelivery

Seattle Study Club Webinar -Coronavirus and the Dental Professional March 19th 5:30pm PST

https://zoom.us/webinar/register/WN_VP07YmV5RjSvZC4Wm8MLuQ

Our offices will be available to assist you and since some offices are open part-time or have some team working remotely please know we can provide assistance remotely or screen share as needed. Be confident in your leadership and your team will follow!

Tabitha