DENTISTING DURING CORONAVIRUS Part 3: Interview with Dr. Betsy Carmack

In our third installment of this new series, we’ll be asking questions and getting first-person perspectives on what it’s like so far to practice amid the pandemic. Every region, every practice, every practitioner has unique stories so we’re chronicling them here to give you an up-close and personal look at challenges, solutions and inspiring moments across the country.

Dr. Betsy Carmack is one half of a husband-wife dental team along with Dr. Tyler Carmack. The dynamic duo from Bennington Dental Center (and three other office locations) in Vermont are also current members of Incisal Edge magazine’s 40 Under 40 spotlighting the best, most innovative, most interesting young dentists in America. She’s also a mother of three, champion bodybuilder, and former International Medical Missions Coordinator for Operation Smile.

Q: When did you reopen your practice?

A: Officially, we opened in June. We did see emergencies throughout the period, but we weren’t officially open until June 1.

Q: What has been the biggest challenge so far?

A: Educating ourselves on the new recommendations and protocols, figuring out how to implement them, and coming up with a new protocol manual was challenging for us. I wrote a whole new, 10-page manual that encompassed the new guidelines. Trying to ascertain and find supplies that were not counterfeit was extremely difficult. It took a lot of strategic networking to order things with the hope they would arrive on time. It almost felt like a game show. It took a lot of resources and reading and things are still changing. One week, a circumstance could be okay and then the next week things could change. It’s like ‘Survivor.’ Some situations would change and you have to adapt to the new situation.

Q: How have the changes in PPE affected your ability to practice?

A: It’s been a learning process and a learning curve with the new material. It’s like training for the army…you have to wear all the gear and the uniform and you start running the race. It’s very heavy and hard to breathe. You have a full headlamp, you have your loupes, you have your shield on top of that. We have air filtration units for each operatory as well so you’re shouting through the mask and the shield and the air filtration unit through the suction to the patients hoping they can hear you. We have started doing virtual consultations as an additive to patient communication. It’s more difficult now to have meaningful conversations when you can’t hear or understand or see the doctor. It can be challenging when you have all the PPE on to convey different options to patients.

Q: How has the experience been with patients? Has it been difficult to encourage patients to come into the office?

A: I have found that most patients are eager to come back to routine care. A lot of patients were hesitant to reach out earlier during Covid in fear that they were not in pain. It wasn’t a dental emergency, but it was still a bother to them. Things are going to ebb and flow, but the majority of patients are happy to be back. I don’t sense a huge fear factor. Being in rural Vermont, the caseload is extremely low, and the patient is very safe in terms of what we’ve put in place as protective for patients and staff.

Q: Have you encountered any challenges with staff members?

A: Honestly, I think there was an underlying anxiety everyone felt from what the news publicized. Going into any new challenge is going to be intimidating when you are not used to something, but our staff has really been fantastic. After the first week, they settled in very well. You get headaches, it’s hard to breathe, your personal comfort is not as high as it was prior to Covid but luckily, all of our staff really like what they do. They miss the patient and personal interaction and they’ve been excited to come back.

Q: Will dentistry ever return to what it was like pre-Covid? Should it? Or are the new precautions justified even in a world with a vaccine?

A: I don’t foresee this ending or the regulations changing in the near future. The standard of care in dentistry has always included advanced infection control regulations and if anything, COVID has given dentistry the opportunity to revisit those guidelines. We all joke “I feel safer at work than going to the grocery store” because we’re screening patients, we do temperature checks, we’re allowed to question them and we have full protective gear on. I think it might be the new normal. Dentists fall into this interesting category where we can’t make any other income. A lot of dentists have reached a certain point and they said, I’ve been building my practice my whole life and rather than lose my home and my whole life I would rather start working again. The risks for young dentists are much lower and we’re not going to lose our livelihoods over that.

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