Welcome Back – We Missed You (Post Shelter-in-Place Protocols)

We hope this finds you and your family in good health. Our community has been through a lot over the last couple of months, and all of us are looking forward to resuming our normal habits and routines. While many things have changed, one thing has remained the same: our commitment to your safety and continuation of care.  Please take a moment to register and book your future appointment and any paperwork using our new Todorthodontics Smile Studio Portal.

Infection control has always been a top priority for our practice and you may have seen this during your visits to our office. Our infection control processes are made so that when you receive care, it’s both safe and comfortable. We want to tell you about the infection control procedures we follow in our practice to keep both patients and our team members safe. Our office follows infection control recommendations made by the American Association of Orthodontists (AAO), American Dental Association (ADA), California Dental Association (CDA), San Francisco Dental Society (SFDS), the U.S. Centers for Disease Control and Prevention (CDC), and the Occupational Safety and Health Administration (OSHA). We follow the activities of these agencies so that we are up-to-date on any new rulings or guidance that may be issued. We do this to make sure that our infection control procedures are current, based on science, and adhere to each agencies’ recommendations. We, dentist/orthodontists, are the infection control specialists with rigorous training and years of experience protecting the health of our patients.

Although the San Francisco shelter-in-place was extended, social distancing did not mean disconnection among us, our team, and our patients.  Our physical office has been closed for several weeks, but our practice has been up and running, albeit in a much different way.  We continue to meet virtually to talk through treatment plan executions and changes we are implementing during the COVID-19 worldwide crisis.

You may see some changes when it is time for your next appointment. We made these changes to help protect both our patients and our team members:

• Appointment Confirmation: All appointments (Virtual and In-Person) need to be confirmed and a response is required to secure the allotted time.  Appointments will be managed to allow for social distancing between patients. That might mean that you are offered fewer options for scheduling your appointment.  We allow greater time between patients to reduce waiting times for you, as well as to reduce the number of patients in the reception area to one patient at a time.  Please be on time or we may need to reschedule you.
• Screening Questions for In-Person Appointments: We would love to see you in person.  We would also kindly ask you to answer the following screening questions a day before your scheduled in-person appointment. You will be asked those same questions again when you are in the office.  Any positive response to the questions below requires rescheduling of your appointment.  This is done to protect everyone involved in your care as well as the rest of our patients:
• Within the last 10 days have you been diagnosed with COVID-19 or had a test confirming you have the virus?
• Do you live in the same household with, or have you had close contact* with someone who in the past 14 days has been in isolation for COVID-19 or had a test confirming they have the virus? (* Lived or stayed overnight with you, Was your intimate sex partner, Took care of you or you took care of them, Stayed within 6 feet of you for more than 10 minutes while they were not wearing a face mask, Exposed you to direct contact with their body fluids or secretions (e.g., coughed or sneezed on you) while you were not wearing a face mask, gown, and gloves)
• Have you had any one or more of the following symptoms today or within the past 24 hours which is new or not explained by a pre-existing condition?
• Fever, Chills, or Repeated Shaking/Shivering?
• Cough?
• Sore Throat?
• Shortness of Breath, Difficulty Breathing?
• Unusually Weak or Fatigued?
• Loss of Taste or Smell?
• Muscle Pain?
• Headache?
• Runny or Congested Nose?
• Diarrhea or other gastrointestinal problems?
• Is your age over 60?
• Do you have heart disease, lung disease, kidney disease, diabetes or any auto-immune disorders?
• Have you traveled in the past 14 days to any regions affected  by COVID-19 (as relevant to your location)?

• Personal Protective Equipment (PPE)/Hygiene: We have hand sanitizer that we will ask you to use when you enter the office. You will also find some in the reception area and other places in the office for you to use as needed.  As always there will be soap at sinks and tissues throughout the office. You may see that our waiting room will no longer offer magazines, cups, beverages, or any other communal objects since those items are difficult to clean and disinfect.  Our team will be wearing N95 masks, face shields, goggles, disposable gowns, masks, and gloves that are changed and discarded after every patient. Medical-grade HEPA filtration has been installed and hand sanitation stations are placed throughout the office. All team members have been tested for COVID19 and their temperature is being monitored daily.  We have also installed plexiglass dividers at our reception and have gone digital to minimize any paperwork.  Please expect to fill out any required forms on our new Todorthodontics Smile Studio Portal as well as expect to be asked to provide a credit card to be saved in a secure file to avoid any exchange of objects. We are minimizing or eliminating any human contact outside of the operatories.

• Check-In Protocol: Please limit extra companions on your trip to our office to only essential people (yourself unless you are minor) in order to reduce the number of people in the reception area. Everyone should wear a mask or cloth face covering when entering the office. You will be asked to use hand sanitizer (at least 70% alcohol) upon entry.  Your temperature will be taken as well. No hand shaking, or physical contact please. You’ll be asked those same screening questions again when you are in the office.  In addition, you will be asked to sign a consent form before being seated unless already done remotely via the portal.  Finally, you will be asked to rinse with 1.5% oral hydrogen peroxide rinse before the doctor can proceed with the exam. We may ask patients to enter through one door and exit another, so that a safer flow is maintained.

• Options for Your Upcoming Appointments:

1) In-Person Appointments (new and existing patients): following protocols explained above

2) Virtual Appointments (new and existing patients):  for new patients, we can perform a virtual exam and create a customized treatment plan; for existing orthodontic patients we can either mail or curbside deliver your next set of aligners and follow up with a virtual conference to assess your aligner tracking and overall progress, answer any lingering questions both clinical and financial.

• Free COVID-19 Testing: anyone interested in being tested, San Francisco offers free testing for anyone living or working in San Francisco with or without symptoms. You can make a drive through or walk through appointment at sf.gov/GetTestedSF

We look forward to seeing you again and are happy to answer any questions you may have about the steps we take to keep you, and every patient, safe in our practice. Please do not hesitate to email us at smile@todorthodontics.com, text 415.634.7473, or visit our website Todorthodontics Smile Studio to schedule an appointment.  We are also transitioning to a completely digital practice at would like to encourage you register with our new Todorthodontics Smile Studio Patient Portal.  We have given you permission to access the portal as of this week.

Thank you for being our patient. We value your trust and loyalty and look forward to welcoming back our patients, neighbors and friends.

Sincerely,

– Dr. Todor Stavrev, Karen, Jacob, and our bodyguard Zlato (Todorthodontics Team)