The Times, They are a Changin’

“The times, they are a changin’,” are renowned lyrics from the celebrated singer-songwriter Bob Dylan. The times, they are a changin’: what’s it mean, or at least, what did it mean then, and what does it mean now? When Dylan wrote the song, it was meant as a call to action, for all of the United States, during the civil rights movement. The song summed up the anti-establishment feelings of people who would later be known as “hippies”. It’s message was simple: you better start swimming, or you’ll sink like a stone…the battle outside ragin’.

And the times, they changed. And they have continued to change, each and every day, each and every year. Just think of it - from the civil rights movement to the Me Too movement, we have all seen incredible changes in the world around us. And we ain’t done yet as we all recognize so much change is left before us.

However, dentistry has been paused in relation to infection control. We had a monumental shift during the 1980’s with the HIV/AIDS crisis that brought ‘universal precautions’ to the dental office. Face masks, gloves, eye protection – can you even imagine the idea of putting your fingers in someone’s mouth (other than your own) without having gloves on your hands? The term wet fingered dentist was coined simply because dentists fingers were covered with, well, you can imagine. For 30-35 years we have been following, essentially, the same protocols that were established in the late 1980’s. Think about that for a minute: with all of the changes in medicine, and in the science of dentistry, ‘universal precautions’ have been virtually constant.

The same recommendations exist– mask, gloves, protective eyewear, plastic barriers where necessary, anti-bacterial/anti-viral wipes where needed. For 30 + years I have followed pretty much the same protocol that I learned in dental school. However folks, the times, they are a changin’.

Here’s your two options:
1) embrace the changes that are coming and accept the ‘new norm’ or
2) ignore and/or fight the new changes that are coming, and be forced into accepting the new regulations.

It will be, at times, both frustrating, as we are given conflicting direction, and expensive, as we invest in new technology, updated products, and additional materials. Either way, the manner in which we practiced dentistry in February of 2020 is gone, likely never to return. I cannot promise you that my view on this ‘new world order’ is here to stay, but I can honestly state, it’s about time. It’s about time that we stopped ignoring the pathogens expelled into the air from our patients’ mouths into our own little stratosphere that we call our operatory or treatment room. Maybe this terrible pandemic is a little kick in the ‘tuchus (Yiddish for the ‘booty’) to up our game. We need to create safer and healthier work environments for ourselves and our valued team members. We need to better serve and protect our patients who trust us with more than improving their smile or their bite: they trust us protect their health.

A thought passed through my mind this past week: it never occurred to me that I had taken for granted that our team members, most of whom have been trained on the job, have never been taught the proper technique for putting on and taking off a mask. I honestly never thought it mattered. You just put on the mask, and when you are finished with the patient, you remove it. Maybe it is that simple. But maybe, after treating the patient with a hidden, silent infection, we carelessly remove the mask, touching the fabric where countless pathogens are chillin’.

Then, without even considering or realizing it, we rub our eyes. Does it matter then? I don’t know. But I do know that whatever the CDC, OSHA, the ADA and any other governing board has in store for us when it comes to new protocol, I, for one, will embrace the change. I will be upset, and I will be frustrated knowing that it is going to be costly, both in terms of money and time. I will be at times outraged at what I will consider ‘an over-reaction’ and inconsistency by the powers-that-be. But in the end, I will remain grateful to be part of the greatest profession around, and look forward to protecting those who have put their trust in me, to provide the safest work environment that I can.

Many of us, myself included, are worried at some level about what the future holds for us personally, and for the field of dentistry. Know that you are not alone if you are harboring some fears. But, we will prevail as we did in the 1980s and before. We will be a better version of ourselves, not because we necessarily wanted to, but because the world said that it needs us to be. I leave you with this stanza from Dylan:

Come mothers and fathers
Throughout the land
And don’t criticize
What you can’t understand
Your sons and your daughters
Are beyond your command
Your old road is rapidly agin’
Please get out of the new one if you can’t lend your hand
For the times they are a-changin’

Yours for better, and safer, dentistry,

Dennis Hartlieb, DDS, AAACD

DOT Founder

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