Local dentists are eager to get back to work, but reopening brings even more uncertainty

“All of our income production has halted, all of our outgoing bills are still due."

Healing Hands Dentist Dylan Christian and Registered Dental Assistant Crystal Simmons preform an emergency procedure on patient, Carolyn Pippin on Wednesday, April 1, 2020. With the ongoing COVID-19 pandemic, the workers take extra precautions with protective eyewear, face shields, N-95 mask and extra gowns. Only emergency procedures are being preformed at the current time. Healing Hands in Bristol, Tenn., provides services for our working, uninsured people of the region.
Dentist Dylan Christian and registered dental assistant Crystal Simmons preform an emergency procedure on April 1 in Bristol, Tennessee. Since the shutdown in Massachusetts, 80 percent of practices have been doing only emergency procedures, while the rest have closed. –David Crigger/Bristol Herald Courier via AP

The coronavirus pandemic hasn’t been kind to many small businesses, and local dentists, who can’t perform their work from home or through a computer screen, have especially taken a hit.?

In Massachusetts, the American Dental Association’s Health Policy Institute reported that during the week of April 20, 80.3% of dental practices were closed and only saw emergency patients. Another 17.8% of practices were closed entirely.?

As cash flow-dependent businesses without any patients, the virus has left many dentists with outgoing bills and no income to pay them, let alone their staff, since March when they first closed their doors.

Janis Moriarty, president of the Massachusetts Dental Society and owner of her own Winchester-based practice, said most dental practices will need between $150,000 and $300,000 to reopen depending on the amount of time they’ve been shuttered.?

Advertisement

Hoping to address that financial need, Moriarty said the MDS Foundation created a Recovery Fund solely dedicated to fighting the impacts left by the pandemic.?

She said the foundation is still discussing what form the fund will take — whether it helps with programming, is distributed as a general grant, or just assists dentists in acquiring personal protective equipment.?

PPE, like gowns, N95 masks, and gloves, are everyone’s biggest concern. They’re also, she added, in short supply, and more expensive than ever.?

“The bottom line is we don’t know what we’re going to do with that fund yet, but I’m very happy that we have established it,” Moriarty said, noting that it currently has well over $500,000. “We expect that to grow. We’ve gotten some other donations from some other dental stakeholders and now our district dental societies are putting some money towards that as well.”

At her own dental office, she said her entire model of business has ground to a standstill.

Moriarty no longer performs elective work or holds routine appointments like teeth cleanings, and when she first closed in March, she had to cancel 350 appointments.?

“All of our income production has halted, all of our outgoing bills are still due,” Moriarty said. “I have a staff of 17 people; all of them are now on unemployment. That is a drastic change for most, so it’s been dire, that’s for sure.”

Advertisement

Besides the financial toll, she said she also misses her patients and employees.?

“It was alright for the first couple of weeks, but now we’re just like, ‘We really are dying to get back.’ And who would say they’re dying to go and do a root canal?” she asked, laughing. “[But] we’re dying to get back to it.”?

Big changes coming

Yet when things do reopen, no matter the date, Moriarty said dentists may operate at 50% of their normal capacity and the way they operate will drastically change.

“I don’t think that any of us are going to go back to the amount of patients and the crowded waiting rooms, and doctors being late and behind for their appointments because they’re so busy, because of the fact that we’re still going to need to be cautious of social distancing and exposure rates because of COVID,” she said. “I think it’s going to be a very very slow return to what’s going to be called the new normal.

“It’s not going to go back to normal for a long time,” she said. “It could certainly take us a year or more to regain everything that’s been lost.”

As businesses adapt to a post-pandemic environment, Moriarty said the number one concern will be safety. Among other things, dentists will have to leave a buffer time between patients to conduct deep cleanings of their equipment in ways they hadn’t before.?

“We have to presume that everybody has COVID even though everybody doesn’t have COVID,” she said. Practices will also have to limit the number of people in the office.

Advertisement

“It was not uncommon to have a mom bring one little kiddo after school for a cleaning or a filling and the other four siblings would be sitting in the waiting room doing their homework or playing with the toys,” Moriarty said. “First of all there’s going to be no toys in the waiting room — we have to pretty much remove anything that anyone can touch and really get down to the bare bones of the physical space.”

And the longer dental treatment goes undone, the more dental disease will build up.?

“People love to miss their every-six-months cleaning every once in a while,” she said, “but if you miss too many six-month cleanings, you’re gonna start to have some pretty serious gum issues.”

Preparing for a soft opening on May 18, Moriarty said she applied for the Paycheck Protection Program Loan and the Economic Injury Disaster Loan Emergency Advance, both of which she qualified for.?

While these small business loans and the MDS Foundation’s Recovery Fund will help, she said, “no one of those items is the golden egg,” since they each only give so much.

‘A big issue for everybody’

On March 20, Dr. Michael Mayr temporarily shuttered his small South End practice, Harmony, and applied for the PPP and EIDL loans too.?

Just months earlier Mayr and his business partner, Dr. Yuko Torigoe, had hopes of expanding their business, bringing on new technology and equipment to grow their treatment capacity, but those ventures are pushed out indefinitely, he said.

Now, they’re looking at a soft opening on May 18 and expect June 1 to be the start of a more robust schedule.

“We have a pretty optimistic outlook on things,” he said. “We think that once we open the doors back up, we get into a routine again, and then we kind of establish an environment that patients feel safe in, that we’ll slowly pick back up.”?

Mayr said he’s still just five years into his career, which keeps his hopes high, but leaves him drowning in debt from student loans.?

“It’s such a big issue for everybody,” he said, explaining how every generation of dentists is facing a different experience right now. “I am a little bit younger in my practice. I have a more optimistic outlook because I have time basically to recover from this, whereas some older folks who are closer to retirement, who may have been looking to sell their practice, they might take a bigger hit on this because this is going to affect the value of their practice.”

Dr. Austin Lee, an independent contractor with the Concord Woods Dental Group, said there are two tiers to how this pandemic impacts dentists — one affects those who own a practice, and the other, those who are employees.?

As an employee, he said there’s only so much he can control even though he still has bills and student loans to pay too.?

“If I were to be a business owner, I can have more control as to how I would space things and consider cash flow and how I can adapt to what’s to come in the future,” Lee said. “But being an associate, working for other people, I can only try to control what I can, as to how I can minimize my personal expenses.”

He said for all the businesses that had to close down, the PPP and EIDL loans won’t be enough to make up for everything dentists have lost.?

But like Mayr, Lee is hoping to remain positive.

“I think a lot of people are freaking out,” he said. “I’m in a lot of Facebook groups with a lot of dentists. Especially in Massachusetts, there’s a lot of people struggling and worrying and stressing … But we’ll definitely be better than before when we get out of this.”?


Get Boston.com's e-mail alerts:

Sign up and receive coronavirus news and breaking updates, from our newsroom to your inbox.

?

Jump To Comments