By January 2021, dentists were well aware of the effects of the COVID-19 pandemic. Most had endured months of being limited to emergency procedures. Many were forced to lay off staff and were starting to rebuild at the beginning of the year. Some decided the pandemic was too much and closed their doors permanently. 

The first COVID-19 vaccine received Food and Drug Administration Emergency Use Authorization in December 2020, and vaccinations began for frontline healthcare workers. The summer seemed hopeful as more Americans received the vaccine, and new cases dropped dramatically. But that hope gave way to more pandemic fatigue as the delta variant surged in the fall. Mask mandates and social distancing continue to be a part of everyday life as the year closes. 

Despite all the hardships the pandemic brought, dentistry persevered. As 2021 progressed, many dentists found themselves busier than ever filling the pent-up demand for oral healthcare. At the end of the year, most practices were struggling to maintain adequate staffing while continuing to ensure maximum patient safety levels. 

While all dentists faced the same hardships throughout 2021, each dealt with the challenges in different ways. AGD Impact reached out to three dentists at different stages of their careers and asked them to tell their stories. Gerard Scannell, DDS, graduated dental school in the middle of the pandemic and was tasked with starting his career in one of the profession’s most difficult times. Toni M. Roucka, RN, DDA, MA, FACD, was forced to transition an entire dental education curriculum to remote learning in a matter of weeks. And, as she approaches retirement, Joanne Dawley, DDS, FAGD, was reminded of her love of dentistry and her commitment to her patients and staff. 

All three dentists tell personal stories, but, hopefully, readers will be able to connect with elements of each. Reflecting on the past year can help all dentists select lessons from 2021 and prepare for a brighter 2022.

This Year Brought Trials, Tribulations, a Job Search and Love
By Gerard Scannell, DDS 

“2020 is finally over, and our lives can go back to normal,” I thought to myself at the beginning of the year. Boy, was I wrong. It was more of a wish than a belief, but I imagine I wasn’t the only one holding out hope. 

I started the first half of this year preparing to graduate dental school and truly begin my career as a dental professional. I was finishing my requirements, practicing for patient board exams, and starting to look for a job and home with my fiancée in my hometown a few hundred miles away from school. COVID-19 vaccinations were just rolling out. Social distancing and mask mandates were still being enforced at school. In the meantime, our graduation ceremony was being canceled and rescheduled multiple times. But, as the months went by, I passed my boards, graduated in person with my classmates and successfully got licensed. However, my fiancée and I still didn’t have jobs or a place to live. 

We walked into countless dental offices, meeting dentists face-to-face and handing out our résumés. Almost all the answers we received were a version of: “You seem like a great fit for our team, but, unfortunately, we are not in a position to add another dentist at this time.” I overestimated the number of dentists enthusiastically willing to hire a new graduate — let alone any associate — in a time filled with uncertainty, staffing issues and a lack of patient inflow. Of course, not every dentist was in this position, but many in mid-2021 still had to focus on supporting their current team more than growing it. 

However, every dentist I spoke to when I walked unannounced into their office was more than willing to keep their ears open for opportunities around town. I did not sense an ounce of defensiveness or competitiveness when they learned yet another dental professional was coming into their neck of the woods. Many dentists thinking of retiring in a few years before the pandemic possibly ended up making the decision to do so sooner. For me, an ideal situation would have been to find someone looking for an associate who would work for a few years and then take over the practice. I think those opportunities existed, and still do, but they seem fewer and farther between compared to before the pandemic. 

I ultimately accepted a job at a larger group practice, which, for all intents and purposes, can be considered a corporate model. I was and still am very grateful for the opportunity when there were no others. But, just like any other job, it brought its own challenges. Most were expected, such as learning a charting system, dental materials I wasn’t familiar with, and, of course, the countless differences between each type of insurance. 

However, one challenge I did not expect was shadowing and working with a dentist who made some concerning decisions. I’m not sure how knowingly they committed the actions, but two examples stand out. The first was performing endodontic therapy on a patient without using a rubber dam or any other form of isolation. I may still be fairly green, but there are a few hard-and-fast rules we were taught and stressed not to break in dental school, and proper isolation is certainly one of them. The second example also includes isolation — or lack thereof. I observed the same clinician place a composite restoration with no isolation and continue through the process after the adhesive and then resin both got contaminated with saliva. The challenge presented to me was when and to whom to report these actions. That dentist is no longer with the company; in addition, I have also since left the company. I was promised a few opportunities as a new hire that I later found out would not happen. On the same day I was given this bad news, I received a text from a dentist I spoke with seven months prior when I was searching for a job. At the time, he said he didn’t have any positions open but would keep me in mind. Fortunately, he did just that, and presented me with a terrific job offer on that dismal day. 

Two highlights of my year are especially notable. One was graduating dental school, which had been a goal of mine since 2002. Though I took the scenic route, my journey helped define the person and clinician I am today. The second is getting engaged to the most amazing woman I know, who is also a new dentist — and a better one than me. My personal and professional goals for this past year didn’t necessarily change much because I began the year with the mindset of knowing I’ll need to be flexible with almost every aspect of my life at this point in my career. I knew I couldn’t be picky starting my career during a time when we’re still in a pandemic. 

Starting this new year, I’m more hesitant to claim our lives will be back to how they were prior to the pandemic. I know I’ll continue to face challenges and learn from mistakes, but I look forward to them because I know they’ll make me better. Lastly, I do feel confident stating that we are in the best profession and are one of the most resilient groups of professionals, always striving to make a positive difference in this world.

Gerard Scannell, DDS, is a general dentist practicing in his hometown of St. Petersburg, Florida. He is the former AGD Impact Student Perspectives columnist.

The Sun Rises 
By Toni M. Roucka, RN, DDA, MA, FACD

At the height of the pandemic lockdown in April 2020, I started a daily routine of walking along the Lake Michigan shore near my home. Because of the nature of my work — I am a dental academic, not a practicing dentist — I was able to work from home. These walks took place before work, and, in fact, before sunrise. I came to look forward to witnessing the daily sunrise no matter what the weather was. In fact, if I had to miss my walk for any reason, it fuddled my day and made me resent the computer screen my eyes would be glued to for the next 10 hours. The sunrise, ever changing yet ever the same, was a comfort during a very difficult time. Something constant, reassuring and sacred. Therapy. 

I was not alone. I came to see the same people out and about at the same time with their own walking routes, stopping to admire the sun at its first peek over the horizon. I didn’t know any of them. I wondered if they were like me — pandemic walkers — or just daily walkers. I found comfort in seeing these neighbor strangers and connecting with them for brief moments each day with a socially distanced wave, smile or passing glance. Any human connection at that time felt like a gift. 

While these walks were a luxury, my experience with work during the lockdown was not the quiet shut-in lifestyle that many work-from-home warriors enjoyed. In fact, my experience was more akin to a door that unexpectedly flung wide open in the middle of a raging storm, forcing me to stop everything and deal with it. While these systems have now become second nature, online classes and meetings were previously a fierce unknown at my institution. The curriculum, for the last 120 years, had been purely traditional. For the more than 500 predoctoral students and postgraduate residents at the University of Illinois at Chicago College of Dentistry, their academic worlds were flipped upside down in an instant. 

As an academic dean, navigating the uncharted waters of online learning was an experience I can only describe as both terrifying and invigorating. Thankfully, I am part of a very dedicated administrative and faculty team that worked tirelessly to pivot all program curricula to fully online within two weeks. The burden of maintaining the quality of the educational programming while balancing safety and supporting college community morale was unquestionably a huge challenge for the team. At that time, the problem-solver within me thrived. 

While most patient care activities and all preclinical laboratory operations were suspended for approximately three months, a small core of dedicated faculty and students continued to treat urgent care patients in pain, adapting quickly to the new Centers for Disease Control and Prevention guidelines for personal protective equipment (PPE). In addition to treating urgent care patients of record, for these three months, the college served as a safety net for dental practices in the area that were unable to treat their own patients due to state mandates and PPE shortages, and it met their urgent care needs. Simultaneously, the college invested heavily in building-wide high-efficiency particulate air filtration and bipolar ionization technology in the general clinics to mitigate viral transmission. No expense was spared to ensure patient, student and college personnel safety. 

Gradually, in-person instruction and comprehensive patient care activities resumed with social distancing considerations and mask mandates. It seems as though I blinked, and suddenly here we are toward the end of 2021. A new normal has emerged. Clinic operations are back to pre-pandemic levels, and the college has settled into a hybrid learning model, maintaining some didactic content online while also offering traditional face-to-face instruction. Remote learning is a new tool in our academic toolbox and a positive side effect of this pandemic. However, the pandemic rages on, and new challenges emerge regularly, both at work and in my personal life. 

My daily sunrise walks ceased in July 2020 when I returned to work onsite. While I vowed I would adjust my schedule to maintain these solar therapy sessions no matter what, it did not happen. My long commute and reluctance to take public transportation during the pandemic finds me in the car more hours than I care to admit even now, more than a year later. I walk on the weekends when I wake but usually not before sunrise anymore — another casualty of the pandemic. Pandemic fatigue is now the plague within the plague, and I suffer from it like anyone else. When the vaccine became available late last year, I got it as soon as I was eligible. When I got my second shot, it was like a ray of hope beaming down on me, offering the promise of the proverbial light at the end of the tunnel. I could see my grandchildren and parents, go back to in-person church and dining out, and otherwise be “normal.” But, here we are, nearing the end of the year after having fought surge after surge. We still haven’t reached the light at the end of the tunnel. 

When the pandemic was new, it seemed we banded together to fight this problem head-on as a united world under siege. That was good, and we were mostly happy to do it. But, as time passes, our resilience seems to be waning, and it feels like the pandemic will never end. Almost two years of death, conflict and uncertainty is taking its toll. I am tired and ready to move on like everyone else. I believe that acknowledging pandemic fatigue is important. As with any problem, if you don’t see it, you cannot deal with it. 

I have thought long and hard about how to manage this new phase of the pandemic. I have never been good at dealing with uncertainty, so, for me, the best solution is to admit I’m worn out, take time to grieve the loss of time and sanity, and do what I can to help. Staying engaged with work and the challenges it poses; volunteering with my favorite charities; supporting students, family and myself; wearing my mask; and swallowing big doses of humility and tolerance are my antidotes. I don’t know how this is all going to end, but I can focus on the present moment and do my best to be the change I want to see in my world. After all, the sun always rises. 

Toni M. Roucka, RN, DDA, MA, FACD, is associate dean for academic affairs and an associate professor at the University of Illinois at Chicago College of Dentistry. 

Even When I Retire, I’ll Always Be a Dentist 
By Joanne Dawley, DDS, FAGD

Whenever I thought vaguely about retirement 20 years ago, I assumed I’d be retired by this age. Back then, I planned to retire in 2020. Now, 2022 is around the corner, and I’m still working — because my patients rely on me, because dentistry is so rewarding and because it’s part of my identity. 

In my 41 years of practicing dentistry, I have never doubted my love for the profession. I believe that only those dentists who feel this way truly thrive. Otherwise, the challenges of the profession can really weigh us down. I’ve felt this more acutely since the start of the pandemic, but, then again, working has never been without its typical challenges: fast-paced workdays, busy schedules, dental staff turnover and — lately — difficulty filling open positions with qualified, educated and experienced dental assistants and registered dental hygienists. 

But these were never reason enough to deter me from doing what I love. In fact, I’ve only vaguely previously considered retirement. I used to think the time would come eventually, but I’d always felt content to continue working. Looking back at life before March 2020, I felt comfortable. I was enjoying running a successful practice, providing patient care and fostering patient relationships that brought them back to the office. I had a flexible schedule, and I felt fulfilled personally, too. I enjoyed beloved hobbies such as traveling and visiting with friends. 

As you can likely relate, all of that really changed when COVID-19 came about. Suddenly, I felt a shift and strain on all aspects of life. Travel and casual time spent with friends ceased. Our practice, like everyone else’s, shut down temporarily in the spring of 2020. Since reopening, I’ve recognized more stress in the dental office than usual. The pace of business has only accelerated, and our workloads have swelled with tasks unique to the pandemic. 

Aspects of dentistry have always been ever-evolving, but, since COVID-19, keeping up with the steady stream of information and things to do has been more intense. I took advantage of Paycheck Protection Program loans and have had to learn about navigating the process, completing the applications and meeting the deadlines. And, like everybody, we’ve implemented numerous measures to combat COVID-19. For example, I practice in my own single building, so I had renovations done to improve ventilation, minimize aerosols and implement other safety measures based on Centers for Disease Control and Prevention guidelines. And now, I have the ongoing maintenance on the new equipment and systems to consider, which is important but represents another stressor. 

But, no matter what’s happening in our practices, the nation and the world, I know I must stay positive to ensure we stay the course. I know from four decades of experience that when times feel difficult, it’s critical to remember the following: 

Supporting staff is essential so they stay at our practices and in the profession. As a practice owner, I believe in supporting my dental staff. This includes giving raises whenever possible as well as ensuring they’re equipped to work professionally, knowledgably and skillfully. 

I especially recommend that my dental assistants earn and maintain certification through the Dental Assisting National Board (DANB), plus complete continuing education options such as those available online through the DALE Foundation, DANB’s affiliate. 

As a dentist, I benefit when my assistants are educated and certified because they can take on more complex duties. I’ve also seen firsthand that investing in assistants in this way increases their career satisfaction and loyalty to the dental practice. This last point is key since the dental assistant and hygienist shortage persists in many locations nationwide. In my experience, some job candidates don’t even arrive for a scheduled interview, and I’ve heard the same from colleagues. As you can imagine, it is imperative we strive to retain our employees. 

Our patients appreciate our extra efforts to keep them safe, comfortable and cared for. Treating patients and building relationships with them always has been the cornerstone of why I love dentistry. My patients really are like family. I’ve always felt grateful that they trust me with their oral health and return to my practice. This has never been truer than it is now, and I’ve also never felt more appreciated. Perhaps because most couldn’t access dental care last year, patients seem to better understand the importance of being able to safely visit the dental office. I do believe that most feel safe coming to us because they know we’re doing all we can to mitigate COVID-19. I consider this a great honor. 

I also recognize the responsibility I have as a dentist to address vaccination against COVID-19 with those patients who are open to discussing it. I recognize vaccination is a choice, but I strive to lead by example. I support vaccination — I have even volunteered to administer vaccines — and I offer my input when I can. 

Positivity moves us all forward in work and life. When I reflect on the past year or so, I see stress, but I also see some silver linings: continued patient care, team loyalty and practice growth. We seem to be headed in a positive direction, where we’ll be able to put COVID-19 in its right place in the universe. I’m not saying it’s going to go away, but at least we’re learning to live and deal with it. 

Looking ahead, I’m hopeful that all the positive changes will continue into 2022. But I also feel retirement is around the corner. While I haven’t set a date, for the first time, I’m seriously considering what’s next. I see myself educating or mentoring. I see continued volunteerism on boards, both dental and nondental. 

There are continued unknowns for us all, but I do know that even when I’m retired, I’ll always be a dentist. 

Joanne Dawley, DDS, FAGD, runs her own general dental practice in Southfield, Michigan. She is the immediate past president of the DALE Foundation Board of Trustees. To comment on this article, email impact@agd.org.