Dr. Ravichandra Juluri, an Illinois Periodontist, discusses treating emergency patients during COVID-19. He mentions the YouTube video he made in which he demonstrates how to effectively convert a regular surgical mask into a better sealed, more tight-fitting mask. He also talks about his 4 years using StellaLife in his practice, how it has helped relieve pain for his patients, and says that he recommends StellaLife to each of his patients. Dr. Juluri has seen the amount of opioids and NSAID's he prescribes decrease drastically since implementing StellaLife in his practice.
Liz Lundry, RDH - Hi, I'm Liz Lundry, the clinical education manager for StellaLife. Thank you for joining us for our Innovator Series today. We know that some of you are opening your dental practices and as you're doing that, you're facing many challenges. So today we're going to be hearing from Dr. Ravichandra Juluri, a periodontist and oral implantologist in Dunlap, Illinois, who has kept his office open since day one of the pandemic to treat emergency patients to reduce the burden for the ER's that are in his community. So he's going to be sharing with us how he's dealing with the issues all of us are facing right now as we return to our practices. Dr. Juluri completed dental school in India and came to the US in 2002. He has his master's in oral biology and did his residency at Temple University Dental School. He was the director of Implantology at Meharry Dental School in Nashville from 2008 to 2012 and he's currently in private practice and adjunct faculty at the General Practice Residency program at St. Francis Medical Center in Peoria. He served as a delegate for the ADA and the Illinois Dental Society. He also designs instruments and has authored implant research articles and case reports. So let's hear from this wonderful innovator and let's welcome Dr. Juluri.
Dr. Ravichandra Juluri - Thank you, Liz. Thanks for introducing me and thank you StellaLife for inviting me to speak. I'm Ravi Juluri. I'm a periodontist and I'm practicing in Peoria. I'm two and a half hours south of Chicago. But StellaLife approached me to present and talk about my experience during covid times. I've been treating patients for dental emergencies and like you've seen, like a lot of States, there have been restricting dentists and a lot of businesses are closed due to the shutdown. So same way, like even in Illinois, a lot of practices are closed because of covid. So we've seen a lot of patients calling and asking about treatment. So we decided to have our office open just for dental emergencies. So the reason we did that is it's going to help out the community and patients, they don't have to be in pain until the dentist opens the practice, and also it would take the load out of the hospital emergency rooms. So we have a few other specialists in town; oral surgeons, endodontists, and other periodontists. We have our offices open and basically we're treating emergencies. So what's different than before? It's now in the practice. Basically, I'm doing emergency care. Mostly it's been extractions and treat patients with a fractured tooth or a broken filling or anything, try to get them out of pain and do the treatment and then refer them back to their general dentists. I'm not doing it to get more patients or make more money or stuff like that, so it's mostly to help out the community and take care of patients and any patients that come to us. Basically, we are treating them and sending them back to their dentists or if they have any other problems, they can still reach out and patients they're facing a challenge because a lot of offices are closed and not every office has remote answering facility or some of them are not equipped to handle emergencies. Even when I treat the patients I'm seeing and I mentioned what all is needed and I send them back. I'm still diagnosing everything and letting them know what's needed. And the challenges we are facing now is the main challenge is, like, the PPE. I still don't have any N95 masks, so even the one or two that I got, they're done, I've used it a lot so you can't use it anymore. So I made a video to show because some of my friends and my wife, they've been talking about how people are converting the regular surgical masks to make it fit better and have a tight fit, so I made a video and I posted it on YouTube.
Dr. Ravichandra Juluri - I'm Dr. Ravichandra Juluri, I'm a periodontist and I routinely use surgical masks. But what I found is we don't have a proper seal with the surgical mask on the sides, especially in this area, so I just want to make a video and show you guys how to get a better seal out of a regular surgical mask. So it's going to end up being like this. So what you have to do is take the mask and make a knot on the edge, same knots on both the sides. It doesn't take too long, it's really quick, so you're not going to spend too much time between patients or you don't need much planning for it. Just make a loop like this and after that, just push this part in so it ends up being like this, and both the sides. So it's a regular surgical mask that you can convert it and you can get a good seal on the sides. It's more sealed on the sides and you get a better seal on the part around your neck also. And you don't have much learning curve because we are all used to the surgical masks. Thank you.
Dr. Ravichandra Juluri - So I've been using StellaLife for almost like three and a half to four years now. How I started was I was asked to evaluate the product and get the product aside and use it for some time and I started on a patient who always has a lot of pain. So two weeks after that, she came back saying, this is the first time I don't have any pain and I've been using it since then. I recommend it to every patient. So during the covid time, I've been recommending it even more and my opiate prescriptions have gone down a lot. And during covid, initially they were saying NSAIDs can increase your chances for getting the disease or having complications, so that's the reason I stopped. I restricted the prescriptions for NSAIDs also. So instead of asking them to take the larger dose, I've been asking them to take 200 milligrams and if needed a tylenol in between. But to strictly stay with StellaLife Vega gel and most of my patients haven't complained so it's doing its job. So while treating emergencies, there are things like, it's different than before because earlier, I used to have a treatment plan and have everything planned out before I started the treatment. Now, I get patients like, last week I saw a patient that came in and I had to do an extraction and the patient didn't want to come in too many times. Then I said like, "If we had to replace and have a permanent option, then the option is to do an implant now" and the patient said, "okay, let's go ahead and do the implant" so I extracted the tooth and placement implant and place the healing abutment and bonded the tooth to the edge, the fractured tooth to the edges and teeth. So in that way that's limited the number of visits the patient will be coming to the office. So instead of her coming, extraction, and then again come back again for a radiograph to check the bone healing and then place an implant and a healing abutment, should I place the immediate implant healing abutment? Patient was happy. So the next time I'll be seeing her is for suture removal and another radiograph to check the healing in five months, four to five months, and then send the patient to her general dentist. So there are things that have changed definitely. We have to be prepared to change the treatment or stop the treatment. So the main thing is we are trying to limit the patient's visit because we don't want to use up all the PPE that we have just for post-ops and also we're telling the patients to give us a call if they're in pain beyond one or two weeks, and most of them they don't have any issues, like 90%, they don't have any problems, so they'll be going back to their dentist for the care. And the updates or changes to the practice. We are restricting the number of people that can wait in the waiting rooms. So we have the patients call us and then come in and make sure they go in straight to the treatment rooms, we don't have any waiting in the area and there's a lot of clean up. We had to change the furniture in the office, get rid of the comfortable sofas and all and put like regular chairs that can be cleaned easily and the seating position had to be changed to accommodate social distancing. And again, what I'll be, like someone asked me for advice, what I'll do different. I'll be doing the same thing and the only thing that's extra precautions and extra PPEs and that's going to add to the cost of treatment, cost of the expenditure in the office. So we had to buy additional stuff and there's still a lot of unknowns we don't know. There's a lot of discussion about who's going to pay for it, is the insurance is paying or do we add on the cost of the patients? For now, we're not adding the cost of the patient or billing out insurance, but we have to come up with something, as professionals, something has to happen. With the extra time I have now, I'm working on some instrument designs. So earlier, I developed curettes for soft tissue surgery, so now for periodontic plastic surgery. Now, I'm working on the insertion tool to get better access to prevent the graft issue and all. So there are a lot of things that I'm trying to work on, and I'm sure every dentist will be planning on getting back to work. So I'm just waiting to get back to work and get back to normal dentistry again. During this time, I've been working on some case reports, cases that I always wanted to publish. So I'm working on those to publish those and spending some more time with family. That's it. That's all I have for today and thank you, Liz, for giving me an opportunity to speak. Thank you.
Liz Lundry, RDH - Thank you Dr. Juluri, we really appreciate hearing about your experience. Now, we at StellaLife really want to support all of you as you're returning to your businesses and we want to send you new patients. So please contact us so we can tell you all about how we can do that and join us again next Friday at twelve Pacific, 3 o'clock Eastern, for our next installment of the Innovators Series to get some encouragement and to learn something new. Please stay safe and healthy and have a wonderful week. Thank you so much.