Rachael Norton is a dental nurse at Bow Lane Dental Group in the City of London. Here, she discusses the pandemic’s impact on smile makeovers and how patients are considering the bigger picture when it comes to their dental care

Video conferencing tools, such as Zoom, have largely become the ‘norm’ in our day-to-day working lives. Many businesses were forced to adapt and work remotely due the pandemic and, whilst video conferencing has offered a lifeline to many interactions around the globe, it has also brought with it a new phenomenon – the ‘Zoom boom’.

An increased use of video has created intense moments of self-reflection and a greater awareness of how we look to others. For some, it may have highlighted concerns about their appearance and their smile. Lockdowns reduced opportunities to go out to socialise and the money saved, because of restrictions on eating out, shopping and holidays, have offered the perfect opportunity for patients to invest in other areas, including a new smile.

Since practices re-opened in June last year following the first lockdown, I have noticed an increase in patients taking up more complex treatments and smile makeovers. It seems patients are no longer looking for a temporary or short-term option. They are now thinking of the bigger picture and considering their future smiles. This could be because they are worried about dental practices closing again if the COVID-19 outbreak worsens. Dental pain is no joke – and having no access to dental care is everyone’s worst nightmare. This has motivated a lot of our patients to get the ball rolling with their treatments and even come in more often for their routine check-ups and hygiene appointments to avoid dental emergencies.

Working from home

Due to patients working from home and not being in the city, they seem to prefer to get their treatment carried out in as few visits as possible. This means they don’t have to travel on public transport unnecessarily. It’s not uncommon now for us to have a patient booked in for a three-to-four-hour session, combining the appointments with the hygienist or a specialist. This means fewer patients coming in, which makes it easier for us to follow social distancing protocols.

I’ve had a few patients say to me that, during lockdown, they have had more time on their hands and have started looking in the mirror more than usual. They have noticed some imperfections in their smiles that they want to change. This has spurred them on to have a more cosmetic approach to their treatment, investing in smile makeovers to include veneers, composite bonding, orthodontics and whitening procedures. It’s more convenient than ever to have these treatments completed at Bow Lane Dental Group. We have all the specialists under one roof, including an implant dentist, and we offer procedures under sedation if requested.

We have a CEREC machine, which enables patients to have a crown prepared and fitted in a single appointment. We also have an on-site lab, which means we can make changes to the shape and colours of veneers and crowns while the patient waits. All our dental nurses are trained to make whitening trays and Essix retainers while the patient relaxes in our waiting room. Dental nurses are also qualified to take X-rays and clinical photos, so it really is a one-stop shop! Not only is it convenient for the patient, it also makes it fun for us working with all the specialists and following the patients through their entire treatment start to finish. It really does make the patient experience more enjoyable when a relationship has been built – not only with the dentist, but the dental nurses and the reception team as well. It also makes it easier for anxious patients to come in and know they will be looked after.

Uptake of orthodontics

At Bow Lane Dental, we try to make the treatment as simple as possible for our busy patients, offering the best care in a safe environment.

Since our patients currently have fewer client-facing opportunities within their jobs now, we have also noticed an increase in the uptake of orthodontics. Invisalign always proves popular. Invisalign can easily be taken out for Zoom meeting. Perhaps patients are becoming more aware of their smiles during Zoom calls. Or maybe because there is a lack of lunch meetings, client drinks and after work social occasions, it just makes it more convenient. Gone are the times of having to carry a toothbrush, floss, and aligner storage box to and from the office. Working from home now means you can simply walk into your own bathroom to clean your teeth and aligners.

If a patient takes up Invisalign treatment with orthodontist, Raman Aulakh, we can limit the appointments they need face to face so they can stay safe at home.

The first appointment is meeting the orthodontist for a consultation and a full set of records will be taken, including photos, X-rays and an iTero scan by our orthodontic therapist. This scan provides a simulation of how the smile could look following Invisalign.

A full treatment plan is then sent for the patient to review with costings, treatment time and all of their photographs.

A Zoom consultation is then optional for their next appointment where we are able to share screens to discuss their ClinCheck (3D simulation), which will outline exactly how many aligners they will be issued and which movements to expect with each aligner.

When the ClinCheck has been agreed by both our orthodontist and the patient, the patient will be required to come into the practice one week later to have the Invisalign aligner fitted. At this appointment, they will be given instructions and the dental monitoring system.

This system includes a mouth retractor, ScanBox and a downloadable app. The patient is able to scan their mouth on their smartphone using the app every week and it is uploaded directly to our orthodontist and therapist, so they are able to monitor progress. It means they can have weekly check-ins with the orthodontist and personalised tips and advice. This system cuts the amount of physical appointments needed in the practice by 50%, whilst keeping in close contact with them. Patients absolutely love this. It means they only need to come into the practice for their appointment every 8/10 weeks. Of course, if they wish to come in to see us, they can.

If a patient needed more aligners during their treatment, we can easily post them out to their homes. When our practice was closed during lockdown, this was a great way to continue patient treatments in a safe and easy way. I helped with keeping in contact with our patients and sending out aligners.

Number one priority

Since going back to work in June, we have had to adapt to many new protocols to fit in line with the government. The care and wellbeing of our patients and each other is still our number one priority. One of the protocols is to take patients temperature upon arrival at the practice, so we invested in an automatic temperature scanner at the entrance of reception. This machine scans the patient temperature and it even tells them to wear a mask. For social distancing reasons, we have also opened another waiting area on the second floor.

On the first day back in June, before we saw any patients, the whole team were scheduled to have their masks fit tested and staff training was provided over a Zoom call.

Sourcing the PPE from different suppliers has been my main challenge, due to the shortage of supply. I could only order a limited amount per day, which meant I had to call a few different suppliers. The increased level of PPE was certainly a challenge for all of the clinical team in the heat of the summer – being able to work with the window open definitely helped.

The last six months both at work and outside of work have been very different from what anyone at Bow Lane Dental has ever experienced. The whole team has managed very well and was able to adapt, be flexible and empathetic to patients and each other. It makes me realise how lucky I am to have this fantastic team around me.