Dr. Maria Janet M. Pandan
President, Association of Philippine Orthodontists (APO)
Please describe how Covid19 has affected orthodontic practice in the Philippines.
From the onset of the Covid-19 pandemic in 2020, the Philippine National Capital Region (NCR) – which includes Metro Manila, was placed under enhanced community quarantine. Since then, the familiar and routine everyday life changed for all our residents. Establishments where people gather and work, were either shut down or mandated to have limited physical encounters.
Public places like schools, churches and offices including dental clinics were advised to close its doors. Face-to-face encounters with patients in the clinics were limited to emergency procedures. Any orthodontic procedures which involve aerosol-generating treatment had to be postponed. Some cases were delayed as patients were fearful of catching the Covid 19 virus whenever they visit a medical/dental facility. However, since the vaccination roll-out among the healthcare workers and the general population, many clinics have slowly reopened to receive patients.
How have the members of your society coped with the changes?
In March 2020, the Association of Philippine Orthodontists (APO) realised the challenges and restrictions brought about by the pandemic and the inevitable changes that these brought to orthodontic practice. The Society created the APO Orthodontic Emergencies Advisory page using our Facebook social media platform. This platform provided recommended guidelines in clinical practice for orthodontists and allowed our members to address queries regarding dental emergencies where face-to-face visits were not possible. New protocols were posted as the situation evolves to help our members manage orthodontic emergencies and to allow continuity of treatment albeit the limited clinical hours.
This led to a sudden increase in the use of teleconsulting and teledentistry which made it possible for us to continue to be in touch with patients from the safety of our homes. This reduced the need for face-to-face clinic visits and filtered the procedures that needed immediate attention. Additional protective measures to assure the safety of both the clinic staff and patients were also mandated for dental clinics. This included use of PPE, increased and improved air filtration system and strict disinfection protocol.
All incoming patients must submit a health declaration form prior to their visit. Temperatures of staff and patients are constantly monitored, and any Covid-like signs or symptoms means postponing the dental appointment. There is a lot of anxiety and hesitance to resume the clinics because of the unpredictability in the incidence of the infection. It became a repetitive cycle of a surge in cases followed by a decrease in cases.
What government support and guidelines have been implemented? How has your Society +/- Ministry of Health helped its members during this difficult period?
We were fortunate to have managed to work together with the Philippine Dental Association (PDA), the national organization of all dentists in the Philippines to provide additional support to our members. The PDA is in constant communication with its members to provide updates on safe clinical practice guidelines. Regular webinars were conducted to raise awareness on safe management protocols. Financial support was also made available for the PDA members who might have contracted Covid-19 infection.
As early as January 2020, the Philippine national health agency, the Department of Health (DOH) issued interim guidelines on the preparedness and response to the Novel Coronavirus. Proactive measures were initiated to “minimise and manage false rumors and misunderstanding” which can lead to further spread of the virus. This has been particularly difficult to control. The PDA continue to coordinate its effort with the DOH to disseminate current data and recommended protocols and guidelines including those from the international health agencies such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC).
How has Covid19 impacted the lives of Filipinos?
Since the start of the Covid19 vaccination program, more Filipinos are more confident to go outside the safety of their homes and slowly return to their previous routine. However, schools and churches remain closed, and most office works are still working from home. With guarded optimism, life is slowly returning back to ‘normal’ although social interactions are still limited and this have raised different issues such as mental health.
Moving forwards, how do you think orthodontic practice will change?
Early in 2020, before the imposed community lockdown, APO was still able to conduct social activities. This rapidly changed in March 2020 when all scientific meetings and conferences were held virtually. Dental clinics have slowly started to re-open and to welcome back patients. With the inevitable constant presence of the Covid-19 virus, many orthodontists have adapted to a ‘new norm’ to be able to continue to provide dental care. These changes include choosing treatment modalities that are more efficient with less likelihood of emergencies, shorter chair times and which will allow longer adjustment intervals.
Please write a message to all APOS members from APO.
For us health care professionals to be able to continue our service to our patients, we should remain vigilant, share information and work with other orthodontic societies and allied health care providers closely to keep abreast of new protocols in the orthodontic practice. This will ensure the safety of the clinic staff, our patients and our families. The future may seem unclear, but I am looking forward to the day when the APOS family can safely meet face to face in future conferences.