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ADA offers interim guidance as some states consider reopening

April 18, 2020

By David Burger

 Reopening after COVID image

“To aid dentists who may be reopening their practices when state mandates are lifted,” the ADA issued an updated statement and interim guidance April 18 on the personal protective equipment recommended in order to practice during this pandemic and minimize the risk of virus transmission.

“In states that are considering reopening, the ADA believes dentists should exercise professional judgment and carefully consider the availability of appropriate PPE to minimize risk of virus transmission,” according to the statement. “The ADA is communicating with the Federal Emergency Management Agency, other federal agencies, and relevant organizations to advocate that dentists, as essential health care workers, are prioritized for PPE.

The ADA also sent out an Issues Alert from President Chad P. Gehani April 18 that went to dentists nationwide letting them know of the statement and interim guidance.

Beginning on March 16, the ADA called on dentists nationwide to postpone non-urgent dental procedures through April 30 in order to help slow the spread of COVID-19. The intent of the recommendation was to support shelter in home mandates, help mitigate the spread of the novel coronavirus, conserve essential personal protective equipment for medical frontline colleagues and yet allow for provision of emergency or urgent dental care to avoid the need for patients requiring such treatment to go to overburdened hospital emergency departments.

According to the latest statement, “The ADA recognizes that local or state government decisions regarding closures, including restrictions regarding elective health care, supersede ADA recommendations. In addition, local and state health departments, state dental societies and, in some cases, large urban local dental societies may better understand local disease transmission rates and conditions and make more informed recommendations regarding elective dental care availability.”

The ADA wants to help dentists minimize the risk of COVID-19 transmission when seeing patients by using the appropriate PPE. As of April 16, FDA-approved tests for COVID-19 are not available to dentists in the U.S., according to the statement. Therefore, dentists should be aware that asymptomatic healthy appearing patients cannot be assumed to be COVID-19 free.

The ADA released this interim guidance to assist dentists in making treatment protocol decisions with regard to the use of masks and face shields or goggles. Dentists are urged to use the highest level of PPE available when treating patients to reduce the risk of exposure. If masks and either goggles or face shields are not available, there is a higher risk for infection; therefore, the use of professional judgment is key along with knowing the patient’s risk factors.

A new chart called “Understanding Face Masks” from the ADA highlights the characteristics of several common types of mask and their appropriate uses, defining and differentiating between them. The chart also addresses mask fit protocols and usage limitations.

President Donald Trump has indicated many states can reopen by May 1, and on April 16 shared federal guidelines for loosening the restrictions. Some state and local governments are now considering reopening certain businesses considered “essential,” including dental practices, as they phase their communities back into normal operations.

The ADA statement concludes, “The longer dental practices remain closed to preventive care and treatment for early forms of dental disease, the more likely that patients’ untreated disease will progress, increasing the complexity and cost for treatment down the road. The safety of patients, dentists and dental team members has been and always will be ADA’s utmost concern.”

With its newly formed ADA Recovery Task Force, the ADA will be adding additional resources in the near future. Get all ADA guidance at ADA.org/virus.