Hygienists on the Frontline: How We Are Navigating COVID-19

Kelly Louthain and BeTrice Casada


There is no question that the COVID-19 pandemic has dramatically changed the dental industry. We are seeing the biggest shift in how we operate and care for patients in decades. Our personal protective equipment (PPE) looks different. Our workflow has changed. Our appointments include new patient risk assessments and procedures.

It’s only natural that dental hygienists would have some trepidation about returning to the frontlines of their practices. To be honest, we did. It’s no secret that hygienists face a higher risk of exposure to COVID-19 because of our close contact with patients and the generation of aerosols during treatment. In fact, US Department of Labor data indicates hygienists are at greater risk than dental assistants, dentists, and respiratory therapists.

So, how are we continuing to manage the increased risk on the frontlines and make our hygienists feel safe during these uncertain times? At North American Dental Group (NADG), I think there are three critical steps we took to help us better navigate this pandemic.

Giving Hygienists a Voice… and Listening

First, NADG gave hygienists a seat at the table and ensured we had a voice in creating the safety measures and guidelines that are now in place at all our affiliated practices. So often in our industry, hygienists do not get heard.

The relationship between the doctor and dental hygienists should be one in which they work together as partners. From the beginning of the COVID-19 outbreak, hygienists had a seat on NADG’s Dental Advisory Board, which is led by the organization’s dentist-led Professional Dental Alliance. We were able to express our concerns and discuss things that could impact our company and our care.

For example, when hygienists expressed concern about how they were going to be able to complete all the additional safety procedures and stay on schedule, we were comfortably assured that safety was the top priority. As a result, we extended appointment times so our hygienists could get comfortable with the new protocols.

Making Safety the Top Priority

Second, NADG has been very deliberate in creating safety protocols to keep our team members and patients safe. That thoughtfulness and attention to identifying best practices has tremendously helped ease any fear or anxiety our hygienists had.

When the COVID-19 pandemic first began, NADG developed and integrated an innovative “Essential-Treatment Only” model that helped team members and dentists in its practices make decisions about which procedures to postpone to a future date and which to maintain on schedule. Providing clear guidelines on essential and non-essential care empowered us to make educated, thoughtful decisions that are in the best interest of our patients.

NADG’s Dental Advisory Board developed advanced infection control procedures and protocols to help dental practices ensure the health and safety of their team members and patients. NADG also developed guides and tools to help dentists across the industry treat patients safely during the pandemic.

In addition, the organization also conducted briefings for other dental service organizations (DSO) and dental industry leaders in the United States and across the globe to share its perspective on how to operate responsibly in this unprecedented environment, including relevant regulatory/legislative information, employee relations strategies, patient engagement approaches, office operational plans, and more.

NADG-affiliated dental practices have also implemented additional safety procedures, including the use of company-issued N95 or KN95 masks for all staff, screening patients prior to their dental appointments, and sanitizing equipment and evaluation rooms after each patient visit.

All these added layers of precaution helped reassure us that we were returning to the safest environment possible.

Communication, Engagement, and Training

Third, NADG stayed connected to its dental practices and teams, even when their offices were closed. They regularly communicated with us and scheduled education and training opportunities to keep us engaged, learning, and energized.

We had weekly calls on Thursday that included state-of-the-union updates. Throughout the pandemic, NADG leaders have been very transparent about what was happening in the business. That was a great comfort to many of us because we had a clear picture of NADG’s vision for reopening our practices and we saw that they generally cared about every one of us.

To help make the most of our time away from our practices, NADG held webinars for CE credits and knowledge. During the time our practices were closed, we held 64 webinars and offered 72 continuing education credits. In all, nearly 5,400 team members attended.

There was never a moment during the weeks our practices were closed that team members did not have an accurate picture of the business. They also saw firsthand NADG’s commitment to protecting its employees and patients and minimizing the risk of exposure. As a result, when we finally did return to work, we knew the safety processes and procedures and had received extensive training, which made it easier to transition back to seeing patients.

With COVID-19 cases rising again in many states, we don’t know what will happen next with the pandemic. But what we do know is that hygienists at NADG-affiliated dental practices and beyond are here on the frontlines providing our patients with the essential dental care they need in the safest matter possible. And, we will continue to do so as the world navigates these uncertain times.

Ms. Louthain is director of clinical operations at North American Dental Group, a leading US DSO that supports 432 doctors at more than 230 dental practices in 15 states. 

Ms. Casada is regional director of clinical operations at NADG.

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