ADA Says Non-Emergency Treatment Should Be Postponed

Richard Gawel


The ADA is calling upon dentists nationwide to postpone elective procedures and restrict treatment to emergency and other necessary procedures for the next three weeks, and other professional organizations concur.

The ADA’s Recommendations

According to the ADA, concentrating on emergency care will allow dental professionals to care for their emergency patients and alleviate the burden that dental emergencies would place on hospital emergency departments.

Further, the ADA said, it is up to dentists to make well-informed decisions about their patients and practices. The organization said it is committed to providing the latest information to the profession in a timely manner and will update its recommendations on an ongoing basis.

For more information, dental professionals are encouraged to visit the ADA’s website on the coronavirus, visit its FAQs page, or email msc@ada.org.

The Illinois State Dental Society

The Illinois State Dental Society (ISDS) concurs with the ADA’s recommendations and notes that dentists are in one of the highest risk categories for transmitting and contracting the virus, with many routine dental procedures potentially transmitting it via aerosolization of fluids.

In addition to only treating patients requiring emergency dental procedures and postponing elective dental treatment and procedures, the ISDS strongly urges practices to preserve personal protective equipment (PPE) for emergency dental situations. This will also help ensure that PPE is available for urgent and more complex medical care elsewhere in healthcare.

Plus, the ISDS says dental professionals should communicate the utmost importance of the health and safety of their patients, dental team, and community in implementing these measures. Its further recommendations for treatment during this time include:

  • Prescreen patients by phone prior to visits by asking about recent travel history and current health. Patients who have fever, coughing, and shortness of breath should be referred to their primary care physician.
  • When possible, ask patients to remain in their cars instead of coming into the waiting room. They can be notified by cell phone when their treatment room is ready.
  • Minimize the number of patients in the reception area and maintain space between patients per Centers for Disease Control and Prevention guidelines.
  • Take the temperature of all patients immediately upon arrival.
  • Have patients wash their hands in the operatory and rinse with 1% hydrogen peroxide solution.
  • Clean and disinfect public areas frequently, including door handles, chairs, and bathrooms.
  • Remove all reading materials and children’s toys and books from waiting rooms.
  • Visit the ISDS’s COVID-19 toolkit for more resources.

The California Dental Association

The California Dental Association (CDA) also strongly recommends that dentists practicing in California voluntarily suspend nonessential or nonurgent dental care.

The organization says it does not make this request lightly and is doing so out of an abundance of caution during this historic health emergency. It also says that dentists can help “flatten the curve” by following sound, scientific advice to help limit infections and slow the spread.

“We believe by taking these extraordinary precautions, dentists can make a difference in helping to preserve the limited supply of personal protective equipment critical for emergency dental care and frontline healthcare personnel responding to the pandemic,” said CDA president Richard Nagy, DDS.

“CDA recognizes the gravity of these extreme measures and is sensitive to the economic impact of such actions on California dentists and their teams,” Nagy said.

The CDA also said that the profession’s collective actions now will determine the spread of COVID-19 and that its recommendation was made after careful deliberation and in consultation with state and national public health experts.

Dentists who have questions about what to do next are invited to visit cda.org/covid19 or contact CDA Practice Support at (800) 232-7645.

The Royal College of Dental Surgeons of Ontario

The Royal College of Dental Surgeons of Ontario (RCDSO) is strongly recommending that all non-essential and elective dental services be suspended immediately as well. Emergency treatment, though, should continue. Further, the RCDSO says it will revisit this recommendation in April.

The RCDSO says that it made this decision after receiving many calls from dentists and hygienists concerned about keeping dental practices open and putting their patients, communities, and staff at risk.

Also, the organization notes that many healthcare providers in community settings have not been able to secure a reasonable supply of PPE that would be required to actively treat COVID-19 cases.

These factors along with a spike in new cases and the call for social distancing make it clear that bold action is required, the RCDSO says. However, the RCDSO also advises practices owners to consult employment lawyers considering the impact such a suspension will have on staff.

In addition, the RCDSO says it will continue to enforce the Standard on Infection Prevention and Control in cooperation with public health. All in-person meetings at the RCDSO have been suspended until further notice as well, with virtual meetings set up as needed.

All speaking engagements and presentations by RCDSO staff are cancelled until further notice. All business travel for staff has been canceled. Renewals of existing facility permits and Certificates of Authorization are suspended. And, the Quality Assurance program is suspended.

For RCDSO Practice Advisory Service will continue to take calls and emails at (416) 934-5614 and practiceadvisory@rcdso.org. The RCDSO offers further advice related to COVID-19 online.

Other Groups

Many other state groups are joining the ADA in its guidance, including Massachusetts, Ohio, Vermont, and Minnesota.

The Texas Dental Association notes the ADA’s recommendations and encourages its members to review available resources and apply that information to their individual situations when deciding whether to keep open and triage non-emergency dental care. A free training module in managing dental care under the pandemic is now available online as well.

Also, the TDA says, dental offices that remain open should implement heightened levels of disinfection. Patients who show fever, cough, or shortness of breath as well as a history of significant chronic illness, a compromised immune system, and other factors should not have elective procedures.

The Georgia Dental Association (GDA) concurs with the ADA’s recommendations as well, noting that emergency dental care may include any treatment for pain, swelling, or infection; chipped, cracked, and broken teeth; and loose or displaced restorations.

“Patients with emergency dental care concerns should contact their dentist for further evaluation,” said GDA president Dr. Evis Babo. “Dental practices in Georgiawill be taking every precaution to implement procedures and protocols to ensure the safety of those patients that do come in for emergency appointments.”

The Virginia Dental Association (VDA) is sharing the ADA’s recommendations with its members, explaining that they were made with guidance from the American College of Surgeons and the United States Surgeon General. The VDA also recognizes the economic impact that the suspension of elective treatment will have on practices.

“No one would ever put anyone else at risk, but the concern is that we cannot always identify those who are infected, and our intent is to limit that contact and spread,” said Dr. Elizabeth Reynolds, president of the VDA.

“We believe that our collective actions now can have a significant impact on the spread of COVID-19, and this recommendation is being made after careful deliberation and in consultation with state and national public health experts,” Reynolds said.

 

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