Life as an Endodontist in the Era of COVID-19

On Monday July 27, AAE Integrated Communications Specialist, Michael Dobrow, spoke with AAE Member Dr. Sheila Chandrahasa, DMD, to learn more about her experience as an endodontist during the COVID-19 pandemic. Dr. Chandrahasa owns and operates Radiance Endodontics in Venice, Florida – a state which has seen a surge in COVID-19 positive cases.

Thank you for the chance to connect! I can only imagine how busy you and your team must be or what it may be like on the ground – treating patients and running an endodontic practice. Before we dive in, can you tell me a little bit more about yourself – like where you were born, where you went to school and what drew you into dentistry – or specifically endodontics?

I was born in New York and grew up in southwest Florida. I completed dental school and my endodontic training at Nova Southeastern University in Fort Lauderdale. I worked for a corporation on the East Coast of Florida after graduating. My family is also from Florida, and after a couple of years on the East Coast, I moved back to be closer to them. While here, I bought a small practice and have had it for the last eight plus years… It’s been quite a journey.

Since I was in high school, I always knew I wanted to be a dentist! While in dental school, I became really fascinated with the level of detail and precision involved in endodontics, but I wasn’t quite sure it was the field I wanted to get into.  It wasn’t until I completed my General Practice Residency Program at the Miami VA Hospital that I knew I wanted to be an endodontist. There was something about the finite details, experiences of looking through a microscope and the fact that every tooth is different that really excited me. Also – for me – alleviating patient tooth pain, saving their natural teeth and seeing them smile again is truly a great feeling!

Can you tell me a little bit more about your practice and the role your staff plays?

I bought my practice from a well-respected, local endodontist who was winding down and getting ready to retire.  That said, it was quite a work in progress!  We really wanted to change the image in our community. About a year ago, I bought a different space. We moved the practice and really grew it to be the current image and experience it is today.

I am the sole practitioner, owner and have a great staff of four.  They’ve been with me for quite a while, and we have become like family. My team consists of two incredible dental assistants and two incredible front desk team members.  I really strived to build and manage a practice that shares common goals; and values everyone from patients, to staff, to the letter carrier who delivers our mail.

For me, it’s critically important to foster a healthy and respectful environment that encourages progress and respect for one another in our work and personal lives. I mentioned that my team has become like family to me… My dental assistant, Liezel, has been with me for seven plus years. In that time, I’ve seen her date (and marry her husband) and have 2 beautiful children.

It’s really rewarding to me to be a part of the growth and prosperity of each of my team members. One of my other team members, Kim, has such a great personality, but came to me with very little dental office management experience. There was something about her though that stuck out with me when I met her, and I just knew I needed to bring her on. Over the years, she really became a pro at office management and a valued member of my team.  I’ve seen her get married and have a baby… My practice has really become a family, and I really value that.

We also treat our patients like family. I believe patients see that chemistry, and they experience it when they come for a consultation or treatment.  It bears repeating – for me it’s important to make patients and staff feel at home.

I imagine COVID-19 has made it significantly harder to make a patient or staff feel at home. Can you tell me about how COVID has changed your day to day and the steps you take to protect yourself, staff and patients?

We’ve always made office cleanliness a priority, (even Pre-COVID) but how we do things certainly changed. We allow more time in between patients to properly sanitize the office and really go over surface areas. That has slowed down our schedule and certainly lessens our patient load or ability to treat more people. And, if we’re treating less patients, it can certainly impact finances…

My staff and I follow all the guidelines from the AAE, ADA, and CDC. We’ve changed our office configuration to promote more social distancing, changed how we manage patients and installed new UV lighting in the ventilation system and HEPA filters in the office.

Again, we’ve also increased the frequency in which we sanitize the office and equipment. We no longer permit guests of the patients in the office – unless the patient is a minor or may be elderly and needs a helping hand… We’ll greet patients outside; implemented greater patient pre-screening scrutiny and check their temperatures upon entry too and also require masks for entry.

Keeping up with the evolving protocols from CDC can be challenging, but we’re making our way through it. We’re working hard to let patients know that we’re here for them and encouraging people to be safe in general.

Can you tell me more about your PPE and how you obtained it?

When our state was in the process of shutting down, my team and I were prepared…We stayed open for dental emergencies and treated patients with severe pain or who were experiencing serious tooth infections and swelling.

I was really starting to follow some of the news stories and scholarly articles about COVID-19 in January and February. I ordered more PPE items like N95 masks for myself and my team. I’ve always been a prepper type of person in general. Broadly, early on, the guidance around what sort of PPE to use seemed to change which made it a bit difficult. Now that it’s more consistent, we continue to use N95s or KN95s with level 3 surgical masks, hair coverings, face-shields and gowns which really prevent anything from getting in there!

How have you increased awareness among that public that your practice is open and safely treating patients?

 I’m very fortunate to be a part of a close-knit community that has a great chamber of commerce. Pre-COVID, we won the Healthcare Business of the Year award from them, and we continue to network with the chamber— which has helped spread the word. We are actually up for the award again this year as well.

As endodontists, it can be disheartening at times that we don’t share the same name recognition or awareness general dentists or orthrodontists do. It’s really incumbent on us to be involved in our communities, have robust social media and work with our Association and state chapters or societies to help increase awareness about the specialty.

With that said, we’ve really leveraged our networking, increased check in calls with referrers and maintained a presence on social media. My office and I are really focused on informing patients that we’re here for them.

We’re also really focused on encouraging patients to see us for dental emergencies and not risking greater exposure to the virus or overburdened hospitals. I’m really committed to showing people that we’re not something to fear. I firmly believe it is critical for our specialty to be proactive and our biggest cheerleader. I actually started working on a small book pre-Covid about the important work endodontists do in hopes that it will bring greater public clarity for what we do and the practice. Educating the public on what we as endodontists do is a driving force for me.

Do you think the recent surge in cases in Florida will effect your practice? And, if so, how?

 Certainly. I think patient anxiety and uncertainty may make them more hesitant to seek care. On the other hand, if their pain is so debilitating, they may still seek out care. I try to assure patients and really understand their needs to help alleviate their concerns. I make sure to answer all their questions about what to expect and make them aware of all the steps my team and I are taking to ensure their safety. I’ll conduct a telehealth consultant appointment with them first. Sometimes, these sorts of consults help me determine the patients’ needs. We did use this virtual consultation when we were on lockdown in March to help evaluate who really needed to come in and be seen.

Earlier you talked about your practice a bit, can you tell me how you balance your work and personal life?

It’s been rough. I’m not going to sugar coat it. I’m a single mom. My daughter’s school switched to a virtual model which made it even harder to juggle everything. We’re making it work though. I have some help with taking care of her and school work, but it is tough…

I can’t imagine what it must be like for a kid to not be able to interact with their friends at school or afterward with an in-person play date. Even her piano lessons are virtual now. It’s been a learning curve for me and at times stressful managing a business too. I try to make the most of the time I have with her and family.

At the same time, I truly believe that God doesn’t give us anything that we can’t overcome or handle. Things are certainly scary and at times unknown, but I think they will improve. We will get through it. I also think we’ll be stronger because of it. I think people may be more unified, and we may all look at life a little differently — when this is all over.

You also mentioned finances earlier. Have you utilized any COVID-19 relief packages that the states or Congress passed?

I used the PPP loan which helped me keep all my staff. I am thankful that the government provided that opportunity. As a medical provider, we don’t usually seem to get that sort of help. The process was online, and I think getting my mortgage may have been much more complicated.  It was straightforward, but it was also a bit of a waiting game. I applied in March and hadn’t heard anything for about two months, the bank had depleted their first round of funding so it became a waiting game to see if a second round of funding would help us. Then, I learned we were approved in May. The waiting was certainly a difficult part of that journey.

What do you think the AAE’s role is in this and how can it assist its members?

I was super thrilled to learn about AAE President Dr. Alan Gluskin’s radio news tour about dental emergencies during COVID-19. The Association can be a mighty voice for its members and the specialty. So, I’d say: please keep it up! Keep educating the public on the importance of seeing an endodontist. The more the AAE can do to increase awareness about endodontists, the better for our field. I also think the latest Worth Saving and Save Your Tooth Month Campaigns help greatly, and we need to keep it up!

Is there anything you’d like to share or tips for AAE members or patients?

To all members: We are going to get through this. No matter where we’re at crisis wise, big city, small town etc., we’re in this together. And, we need to get out there, tell the world who we are, what we do and really advocate for the specialty. We should all be proud of the work we do. To patients: Endodontists are here to help you! Root canal procedures are not scary anymore. It’s a safe procedure done by specialists who are taking extra care in these unpreceded times.