July 4, 2020
Hope you are having a great 4th of July weekend and you are staying safe!
Over the time we have been open for all dental procedures, we have had several patients who have come for their routine cleanings with dental issues that require extra time to diagnose or treat. Unless it’s an obvious issue, a pre-existing condition we have discussed, or a minor concern, please let my front office staff know BEFORE your scheduled appointment, especially if you would like us to address the dental issue at your cleaning visit. Otherwise with reduced staff hours (not in my control), it is especially difficult to work these issues into our day and it may require us to schedule another visit.
Please make sure you are signed up for Email reminders with Solutions Reach, our practice communication software. We are noticing that those patients who are signed up for only text messages are not receiving our COVID-19 questionnaire before each appointment, our newsletters, or other important updates. Because texting has character limits and other restrictions, we can only provide a link to the newsletter or questionnaire with little explanation. Therefore, patients are not clicking on these links.
I do have the general information on my website blog (http://www.irvinedds.com/blog-post.html) and on Facebook https://www.facebook.com/irvinedentistkeithtangdds for texters who don’t want to click the links. This is information that is necessary as we continue to make changes to keep you safe and for my office to run smoothly.
Changes to our office recommended by the CDC and the ADA include
- Park and Call when you are in the parking lot. To allow for social distancing, we ask that only the patient with a scheduled appointment (and one parent for children) come into the office after we let you know that we are ready to seat you.
- Covid-19 questionnaire- as part of our screening protocol, we are required to ask you these questions and take your temperature to check that you are healthy. If you have signed up for email, you will be able to submit this questionnaire with a few clicks from the email. Again if you have opted in for text only, you will receive a link to Dropbox and you will have to download Adobe Acrobat, import the pdf to Acrobat, answer the questions, save it and either email or text it back to us one day before your visit.
- Yes for texter without email, this requires multiple steps!I have tried a couple of outside services at additional cost, but they still required several steps and patients have to sign up for an account with the new vendor.For your convenience, we will be adding the Covid questionnaire as a download button on my website, Irvinedds.com home page
- .During your routine cleaning visits, we will not use an ultrasonic scaler or polish your teeth to reduce aerosols in our office. If you require the above because of heavy calculus or stain, it is still available with an infection control fee of $15 for the increased disposables we have to use.
Dr. Keith Tang & Staff
June 15, 2020
Please note for upcoming appointments – in order to prevent the spread of COVID-19, we're asking patients to wait in their cars or outside of the office rather than in the waiting room. Please call the number below once you have parked.
We are open for business with modified hours Monday, Tuesday, Thursday, and Friday (closed on Wednesdays) during the months of June and July. Thank you for those who have come in for a dental visit and expressed positive comments with the changes we have made in keeping you safe in our office.
As one of those changes, we are sending out COVID-19 questionnaires 2-3 days before your scheduled visits. Please answer the questions on the questionnaire and return it on the day before your scheduled appointment.
- If you are opted-in for Emails, we can batch email the questionnaire from Solution Reach which allows you to click “Take the Survey,” answer the questions, and submit them by clicking the button at the bottom of the survey.
- If you are opted-in for Texts only, it has been more problematic to deliver the questionnaire and newsletters to you due to character limits and other texting regulations. While we have tried a couple of new vendors, all methods still require a few steps. Currently we are texting a link to the questionnaire on Dropbox which requires you to first download Adobe Acrobat, click the link on Dropbox, and import the questionnaire in to Acrobat before answering the questions. Then after saving your responses, the questionnaire can be emailed back to us at [email protected]. It would greatly simplify this process if you would subscribe to emails (and text) from Solution Reach (our office communication system).
- If you have not opted in for emails or text or have not returned the questionnaire to our office, we are having you fill out a questionnaire in the office at the time of your check in.
Note that I have converted most of our forms to Adobe Acrobat which can be individually emailed to you for a paperless experience if you prefer. Having Acrobat on your phone will also enable you to store a digital signature and provide informed consents for many of our dental procedures.
If you would like an appointment for treatment or a cleaning, please call us. We apologize if you have been waiting for a phone call from us and have not received one yet. With limited front office staff hours, it is difficult to call everyone who we were not able to see while the office was only open to dental emergencies during the last couple of months.
Thank you for letting us continue to care for you and keep our community healthy at the same time!
Dr. Keith S. Tang & Staff
June 3, 2020
We have modified our hours based on staff availability. Our hours are
Thank you for your understanding as we continue to adapt to a COVID-19 world!
Dr. Keith S. Tang
We are experimenting with a few options for online forms so patients have the option of not having to touch paper, pens, or clipboards in my office. Ex. Pre Appointment COVID-19 screening questionaire
1. Opera DDS-requires that you create an account with them. It included their online forms, secure email w attachments, and teledentistry triage. https://operadds.com/forms/
2. Adobe Acrobat online forms- I converted most of our forms which can be emailed or texted, but recipients have to either download Adobe Acobat on their pc, or phone to be able to sign things digitally and email back to us. The big advantage of this is no monthly fees.
3. Solution Reach Intake- similar to Opera DDS and still requires that we manually email or text the forms using their platform. Also doesn't have secure email or teledentistry triage.
Please let me know if you have a major preference after you experience the above .
Thank you, Dr. Tang
May 13, 2020
Thank you for being a part of our dental family. These are challenging times and I hope that you are doing well.
We are reopening for business again starting May 20, 2020 with modified hours. If you have an urgent dental concern, please call us or click the link below. We are prioritizing urgent treatment during the first few weeks in our schedule. Therefore, all previous appointments will be rescheduled until we catch up on the most critical dental concerns.
To keep you (and my staff) safe as we provide you with the best dentistry that is available, there will be several changes which will affect your patient experience. We ask for your understanding and flexibility as we adapt to a COVID-19 dental world
The below changes are based on guidelines from the CDC, OSHA, and ADA.
- When you schedule an appointment, our front office staff will ask you screening questions to determine your current state of health.
- To maintain social distancing and minimize contact, please call our office at 949 252-1889 when you arrive in the parking lot. If you need to sit in the waiting area, we request that only patients with scheduled appointments (or only one parent if we are seeing your child), come into the office.
- We will call you on your mobile phone when we are ready to seat you in a treatment room. Please wear a mask or face covering when you enter our office and continue to wear it until we are ready to begin treatment.
- Our staff will take your temperature and ask you the screening questions again. They will be wearing masks and protective eyewear when they greet you in the reception area.
- For all AGPs (Aerosol Generating Procedures include cleaning with an ultrasonic scaler, teeth polishing, fillings, crowns, root canals, oral or periodontal surgery, etc.), we will be charging an infection control fee of $15 per appointment to help offset the increased costs for COVID-19 of disposable gowns/jackets, N95 masks, barriers, disinfection supplies, and other disposables.
- Before any AGP, we will be having you rinse with a 1.5% hydrogen peroxide solution for 60 seconds.
- After an AGP, we will have to shut down the treatment room for a specified period of time to allow our HEPA air purifiers to scrub the air.
- If you are having a cleaning and exam visit, we will NOT be routinely using an ultrasonic scaler or polishing your teeth to minimize aerosols generated. There will not be a separate infection control fee unless you require use of an ultrasonic scaler or insist we use the above items during your visit.
- If you are having fillings done, we will be placing an isolation mask onto the area we are working after getting you numb, but before we begin treatment. Please remind us if you have a latex allergy.
- If you are having a crown, bridge, oral surgery, or other procedure in which we cannot use an isolation mask, we will be using auxiliary suction devices to minimize aerosols as we perform the procedure.
- At the completion of the treatment, please wait until we hand you a routing slip and notes for the front office to know what was done and what to schedule for your next visit. My back office staff and I have to remove our PPE (personal protective equipment) according to OSHA protocols before we can exit the treatment area which will delay us. While we will have our walkie talkies to communicate with the front office staff, we can only do so when cross contamination will not be a problem.
- I apologize that according to the current recommendations, my staff and I will be wearing masks and other PPE for your entire appointment. I would suggest that if you have concerns that you would like to discuss that do not require clinical assessment, let’s set up a Teledentistry visit. This would not apply to issues that we would have to take x-rays or perform tests to evaluate. If the concern is visible, please take a photo of it and email it to us.
While some of you may be consider delaying dental care, please be advised that your mouth and teeth are connected to the rest of your body and the consequences of delayed treatment will affect your overall health. Studies prove that there is a direct link between poor dental health and heart disease, diabetes, and other chronic illnesses. Dental neglect also lowers your immunity to infectious diseases like COVID-19.
In the last recession back in 2008, I noticed that my patients who delayed dental care ended up needing root canals, crowns, extractions, and implants as their cavities, fractures, and other dental issues continued to deteriorate. It is always less costly in both time and money to treat dental issues in the early stages. If finances are an issue, please discuss your concerns with my financial coordinator, Jasmine, and let us help you.
We appreciate your cooperation with these changes and look forward to seeing you at your next dental visit.
All the Best,
Dr. Keith Tang & Staff
May 1, 2020
We hope you are well and taking good care of yourselves as we weather through the pandemic.
Even though we don’t have a definite date that our office will be able to see patient for all dental procedures, my staff and I have been diligently working on our Re-Opening Plan. As of today, my plan is 5 pages long and I add to it or provide more details as the recommendations from CDC, CalOSHA, CDA, and the ADA continue to evolve. Every webinar that I watch or news release prefaces with these are the latest recommendations that are subject to change as more information is obtained.
Some of the things we are doing include:
- Purchasing needed PPE (Personal Protective Equipment) and other recommended items in short supply such as masks, face shields, disinfectant sprays and wipes, disposable gowns/jackets, hydrogen peroxide, antibacterial soap, hand sanitizers, etc.
- Working out scheduling intervals with increased time for additional infection control practices and staggering appointments with hygiene to reduce patient contact in the front office area and provide for social distancing.
- Screening Protocols to see only healthy patients. When you schedule an appointment we will ask you a series of questions and when you come for your appointment we will ask you these questions again.
- Infrared temperature checks for both staff and all patients.
- Carside check-in (call when you arrive but wait until we call you to let you know we are ready to seat you). We ask that only the patient (one parent w a child) with an appointment enter our office to minimize contact w other people and allow social distancing.
- Analysis of AGP (Aerosol Generating Procedures) and ways to reduce them. Some of the changes we have been considering include elimination vs selective use of ultrasonic scalers, use of auxiliary high speed suction devices for crowns (Mr. Thirsty, Ivory ReLeaf, etc.), use of rubber dam isolation for fillings from the start of the procedure, and cleanings with no polish to reduce splatter.
- Use of 1.5% Hydrogen peroxide pre-rinse for all AGPs to reduce pathogens
- Many practice consultants are recommending a separate infection control fee for AGPs to help offset some of the costs required to keep you safe. The cost per patient for PPE to follow CDC and OSHA recommendations is significant including N95 masks at $5/each x 2, disposable gowns at $3/each x 2, and the increased number of barriers and disposables which are yet to be determined.
- HEPA air purifiers and working out the time intervals between patient for the treatment room after an AGP.
- Disinfection of the waiting area after a patient has sat there. Elimination of coffee, toys, gaming and magazines in the waiting area.
In addition to text, email and phone calls individually with team members, I have been continuing to meet with my staff weekly via Zoom to discuss the changes as I hear about them. We have always been on top of the OSHA and CDC guidelines for dental offices but have added multiple items to our regiment with COVID-19. Before we reopen, we will be practicing and working on implementing these changes into our usual office protocols. Like the changes that occurred to the airlines industry with 911, our world has changed forever, but we will adapt and get through this together.
All the Best,
Dr. Keith S Tang & Staff
April 13, 2020
I hope that you are staying healthy and enjoying time with your families.
As we are at the start of another week of the Governor’s Shelter-In-Place order, I wanted you to know that we are already making plans to reopen even though we don’t have a definite date. I have been watching an average of 2-4 webinars per day on COVID-19, having Zoom staff meetings, talking, texting and emailing my staff to make necessary preparations and changes.
Your safety is our highest priority! When we are able to reopen, these are some of the changes we have been discussing and working on:
- HEPA Air Purifiers in our treatment rooms with Medical Grade filters.
- Curbside Check-In by phone while you wait in your car or outside. We will call or text you when we are ready to seat you.
- Patient screening questions over the phone when patients make an appointment to be sure people are healthy before coming to our office.
- Use of an Infrared no-touch thermometer to check for a fever and other screening protocols before you are seated for treatment. We may ask if you have any cold or flu-like symptoms like a cough or sore throat; GI upset like diarrhea, nausea or abdominal pain; have they been in contact with anyone who is sick; or if they have traveled in the last 14 days.
- Removal of magazines in the waiting area and disinfection of the waiting area furniture after each patient sitting in the waiting area.
- Use of face-masks in addition to eye-wear and masks by my staff to increase protection from COVID-19. Even my front office staff may be wearing face-masks.
- Use of my Panorex x-ray machine in BW mode for severe gaggers to reduce coughing.
- Limited use of our ultrasonic scalers to reduce aerosols.
- Flexible payment and financing options.
- Specials for patient without dental insurance with roll back prices
- Online payments through our website
- Teledentistry appointments using Doxy.me which is HIPPA compliant. This will allow us to triage visits for dental issues that are visible and don’t require an x-ray, in office testing, or palliative treatment. For example, Gums issues, abscessed teeth, fractured or chipped teeth, broken fillings, follow up visits, monitoring of our Invisalign patients, etc.
Please note that I currently have staff in my office Monday through Thursday with limited hours to answer phone calls and prepare for our re-opening. Please continue to call 949 252-1889, email: [email protected] (for dental issues) or [email protected] (for all other concerns), or page me at 949 657-2244 in this order if you need to contact us.
All the Best,
Dr. Keith S Tang & Staff
March 27, 2020
We hope this message finds you and yours healthy as the COVID-19 coronavirus impacts our community.
I wanted to check in with you and let you know that our office is currently open for dental emergencies only. Thus my staff and I are available at the office for limited hours Monday to Thursday. If you or a friend (not currently a patient in our office) experience a dental emergency, please use the following steps to contact us.
Contact Us In This Order
1. Phone: 949 252-1889 My staff will check messages Monday to Thursday mornings.
2. Email: [email protected] for treatment related questions for Dr. Tang or [email protected] for financial, scheduling, or other concerns.
3. Pager: 949 657-2244 If I have not responded to your email in 2 hrs, page me and leave a message. Please speak your name and phone number slowly twice and the nature of the dental issue. Sometimes, it is difficult to hear a person’s name or phone number to call back.
IMPORTANT: If you are infected with COVID-19 or think you may have been infected, please contact us before coming in. This way we can instruct you on where to go and how to proceed for the safety of all.
I can also be emailed for teledentistry. Please take photos of the dental issue and email me at [email protected] I also have Zoom, Google Hangouts, FaceTime, etc. for video conferencing if you have a dental concern that you need to discuss. Note that I will check my email several times a day, 7 day/week until we have normal business hours.
Please make sure you stay Opted-In for text AND email. Note that due to texting law regulations, we are severely limited in what we can text and have a very small character limit. Those who opt-in for email will receive much more information about the latest events in my practice.
Please don’t hesitate to call us if you have any questions or concerns. We will work with you regarding any issues that arise and together we will get through this worldwide crisis.
Dr. Keith S. Tang & Staff
March 20, 2020
Announcement from Keith S. Tang, DDS, Inc.
NOTICE OF TEMPORARY CLOSURE
In light of the evolving pandemic and the Executive Order from Governor Gavin Newsom yesterday, we have made the difficult decision to temporarily close our practice starting March 20, 2020. We do not make this decision lightly, however our top priority is the health and well-being of our patients, families, staff and community.
Please disregard any text or email messages confirming appointments unless you have spoken to someone from my office. As soon as we are able to see patients again, our office will be in touch to help reschedule your appointment.
In the case of emergency situations, please page me at 949 657-2244. Please understand that if your dental emergency requires that I have a staff member to assist me in caring for you, I will have to arrange a time that all of us can meet at the office.
We will continue to monitor the situation as it evolves and the guidance from the county, state and the CDC. For now, we will determine on a day by day basis when it is appropriate for us to return to our normal business hours.
Again, please understand that we are making this decision with the health and well-being of our patients, our families, our team and our community in mind.
We thank you for your patience during this challenging time and wish all of you continued health.
Dr. Keith S. Tang and Staff