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ADA releases coronavirus handout for dentists based on CDC guidelines

Dentists should follow standard precautions at all times

February 24, 2020

By Mary Beth Versaci

The American Dental Association has released an informational handout for dentists on the coronavirus disease, now named COVID-19.

The handout covers strategies for helping prevent the transmission of suspected respiratory disease in the dental health care setting and answers frequently asked questions related to the virus, based on guidelines from the Centers for Disease Control and Prevention.

Similar to patients with other flu-like illnesses, patients with COVID-19 have reported mild to severe symptoms such as fever, cough and shortness of breath. Within 14 days of symptom onset, they also may have had close contact with a confirmed COVID-19 patient or a history of travel from affected geographic areas.

Patients with an acute respiratory illness may seek treatment at outpatient dental settings. The ADA recommends following standard precautions with all patients, at all times.

Dental health care personnel should be alert and identify patients with an acute respiratory illness when they arrive, give them a disposable surgical face mask to wear and isolate them in a single-patient room with the door kept closed to limit their contact with other patients and personnel. Isolated patients should wear their masks outside their rooms.

To help prevent the transmission of all respiratory infections, dental practices should adhere to respiratory hygiene/cough etiquette infection control measures, such as performing hand hygiene, providing tissues and no-touch receptacles to throw away used tissues and offering face masks to patients who are coughing. Offices also should follow routine cleaning and disinfection strategies used during flu season.

Dental personnel assessing a patient with a flu-like or other respiratory illness should wear a disposable surgical face mask, nonsterile gloves, gown and eye protection to prevent exposure. Because recommendations for COVID-19 could change as more information becomes available about the disease, the ADA suggests checking for updates on the CDC's coronavirus infection control page for health care professionals.

The CDC has not changed its guidance on single-use disposable face masks, which should be worn once and discarded. The agency urges dental personnel who are concerned about the supply of personal protective equipment to monitor the CDC's health care supply of personal protective equipment webpage for updated guidance.

The CDC's Guidelines for Infection Control in Dental Health-Care Settings—2003 note dental personnel may consider postponing nonemergency or elective dental procedures until a patient is no longer contagious with diseases that can be transmitted through airborne, droplet or contact transmission.

If urgent dental treatment is necessary, dental personnel and medical providers should work together to determine the appropriate precautions to take on a case-by-case basis and decide whether the dental facility is an appropriate setting to provide the necessary services to the potentially infectious patient, as dental settings are not typically designed to carry out all of the transmission-based precautions recommended for hospital and other ambulatory care settings.

The CDC recommends all health care workers, including dentists and staff, receive the flu vaccine, and personnel experiencing a flu-like illness should not report to work.

The coronavirus has led to tens of thousands of cases of respiratory illness in China, where the virus was first detected in Wuhan, and infections have been reported in many other countries as well, including the U.S. Coronaviruses are a large family of viruses that are common in animals and people, causing the common cold or more severe illnesses, such as SARS and MERS.

As of March 6, there were 213 cases of COVID-19 in the U.S. and 11 deaths, according to the CDC. The cases include 36 that were travel related, 18 that spread person to person and 110 that are under investigation, as well as three people who were evacuated from Wuhan and another 46 who were evacuated from the Diamond Princess cruise ship in Japan.

Because of the growing number of cases and reach of the disease, the International Health Regulations Emergency Committee of the World Health Organization declared the outbreak a "public health emergency of international concern" on Jan. 30. The next day, the U.S. Department of Health and Human Services secretary declared it a U.S. public health emergency.

The immediate health risk from the coronavirus to most of the American public was still considered low as of March 3, but the CDC warned that global circumstances at that time — with countries other than China reporting community spread, including some parts of the U.S. — suggested it was likely the virus would cause a pandemic, which could change the risk assessment.

For more information, visit the CDC's COVID-19 webpage.