Health Law Monitor
Professional Dental Associations and States Issue COVID-19 Recommendations to Dentists
March 18, 2020
By: Ross T. Yates
With the recent outbreak of the Coronavirus (COVID-19) in the United States and the significant governmental actions being taken at federal, state and local levels, dentists around the country are seeking guidance on how to continue to treat patients while ensuring that the health of their employees and patients are protected.
In addition to evolving executive branch recommendations regarding social distancing, multiple professional dental associations and states have recommended or mandated that dentists confine their care to urgent and emergent situations and have established what are considered non-essential or elective services. While many dental specialty associations and states are navigating their individual response guidelines, the following have issued recommendations:
- The American Dental Association (ADA) recommends all dentists postpone elective procedures for the next three weeks, stating that “concentrating on emergency dental care will allow us to care for our emergency patients and alleviate the burden that dental emergencies would place on hospital emergency departments.” However, the ADA notes that as health care professionals, it is up to individual dentists to make “well-informed decisions” regarding their patients and practices.1
- The American Association of Oral and Maxillofacial Surgeons (AAOMS) recommends OMS practices use all available patient information, CDC guidelines, extensive discussions with patients and family members and best practitioner judgement in determining if surgical need is essential and immediate. AAOMS recommends that emergency and urgent care should be provided in an environment appropriate to each patient’s condition. Patients testing positive for COVID-19 who have acute oral and maxillofacial infections, disease or injuries requiring immediate treatment should receive care in a facility where appropriate personal protective equipment, including N-95 masks, are available. During the next three weeks, procedures that are determined by the treating surgeon to be elective should be deferred.2
- The American Academy of Pediatric Dentistry urges pediatric dentists to “be advised and be wise” and to follow and adhere to the recommendations of federal and state government and professional licensing bodies in treating patients.3
- The West Virginia Board of Dentistry held an emergency meeting on March 16 regarding COVID-19 and recommends that any elective procedure be rescheduled for a period of at least 14 and up to 30 days. The Board recognizes that the situation is fluid and its recommendations are intended for the dentist to use their professional judgment to determine the level of risk a patient poses, whether the treatment is on an urgent or non-urgent basis, and whether to treat or reschedule the patient.4
- The Kentucky Board of Dentistry is asking that all health care providers (including dentists, dental specialists and hygienists) reschedule all elective dental care which will not negatively affect the patient - effective immediately and until advised otherwise by the Department of Health. Further, the Board highly encourages its licensees to utilize rubber dam or similar isolation whenever possible for patients that must be seen.5
- The Ohio State Dental Board issued Advisory 2020-01 on March 16, stating that all elective procedures should be rescheduled, including but not limited to, any cosmetic or aesthetic procedure (i.e., veneers, teeth bleaching, cosmetic bonding); all routine hygiene appointments; any orthodontic procedures (not including those that relieve pain and infection, restore oral function or are trauma-related); initiation of any crowns, bridges, or dentures that do not address or prevent pain or restore normal oral functioning; any periodontal plastic surgery; extraction of asymptomatic non-carious teeth; and recall visits for periodontally healthy patients. Further, all non-emergency appointments for all high-risk patients (including ASA 2 and 3 patients) should be rescheduled.6
As dentists and their practices navigate the evolving guidance regarding treatment from professional associations, federal officials and state regulators - the obvious financial impact of the recommendations are significant. Providers should continuously evaluate their practice cash flow needs, debt service and commercial contract obligations during this pandemic. If providers elect to continue to treat or must see and treat emergency patients, additional protective measures should be evaluated and implemented on an ongoing basis.
For additional information regarding this topic or any health care business issue, please contact Ross T. Yates, the Jackson Kelly Business Law Practice Group leader Charles A. Compton or the Health Care Industry Group leader Robby J. Aliff.
1 ADA Calls Upon Dentists to Postpone Elective Procedures (https://www.ada.org/en/press-room/news-releases/2020-archives/march/ada-calls-upon-dentists-to-postpone-elective-procedures), 16-Mar-20.
2 AAOMS COVID-19 Guidance for OMS Practices, 17-Mar-20.
3 Latest from AAPD on COVID-19 (https://www.aapd.org/about/about-aapd/news-room/covid-19/), 16-Mar-20.
4 West Virginia Board of Dentistry, Novel Coronavirus Disease 2019 (COVID-19), 16-Mar-20.
5 Kentucky Board of Dentistry, News Alert, 16-Mar-20.
6 Ohio State Dental Board COVID-19 Advisory 2020-1. 16-Mar-20.