COVID-19 Guidance for Dentists
COVID-19 Guidance for Emergent Dental Procedures
In light of on-going COVID-19 concerns and Governor Hutchinson’s recent State of Emergency Declaration, the Arkansas Department of Health is following the recommendation of the Arkansas State Board of Dental Examiners and the American Dental Association that only urgent and emergent dental care take place, and non-emergent dental care be suspended until further notice.This recommendation is subject to change based on the progression of the COVID-19 pandemic.
The only dental care to be provided at this time should be emergency or urgent in nature that specifically addresses oral pain and/or oral infection management. Recommended guidelines suggest delaying treatment for high-risk patients who meet any of the following criteria:
- recently returned from overseas travel;
- present with a fever of 100.4+oF, cough, shortness of breath or other symptom typical of COVID-19
- aged 65 and older;
- have compromised immune systems and/or present with chronic disease (ASA 2 and above)
Management of Patients deemed to have an emergent or urgent dental issue requiring treatment.
Universal precautions are to be strictly followed in order to minimize the possibility of disease transmission. Because of the frequent production of aerosols during emergency or urgent dental treatments, the following recommendations are advised:
- Reception rooms
- only the patient should be allowed; or, parent/guardian if a child is the patient
- request patient remains in automobile until summoned into the office
- screen all patients as indicated above
- all magazines and journals removed
- If treatment requires the use of a dental handpiece:
- utilize the dental dam to isolate the treatment area
- place HVE (high-volume evacuation) as close to the surgical site as possible in order to capture the generated aerosols
- Potentially contaminated aerosols may linger in the treatment room up to two hours
- if at all possible, close room until proper disinfectant protocols can be performed
- all surfaces wiped down, barriers replaced and sign indicating room is cleared
- Change masks and follow proper disinfection protocol (including eyewear) between patients
- Dental staff (including dentists) should record their own temperatures and physical status daily
Patients with an acute respiratory illness may present for dental treatment at outpatient dental settings. It may not be possible to know the cause of any patient’s illness, so it is important to follow this guidance and standard precautions at all times.
• Seek to prevent the transmission of respiratory infections in healthcare settings by adhering to respiratory hygiene/cough etiquette
• Patients with an acute respiratory illness should be identified during a phone screening interview and asked to remain in their automobile until summoned to the treatment area.
• Offer a disposable surgical mask to persons who are coughing to reduce production of respiratory droplets; provide tissues and no-touch receptacles for used tissue disposal.
• Dental healthcare personnel assessing a patient with influenza-like or other respiratory illness should wear disposable surgical facemask, non-sterile gloves, gown, and eye protection (e.g., goggles) to prevent exposure.
• Patient and dental healthcare workers should perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand rub, or antiseptic handwash) after possible contact with respiratory secretions and contaminated objects/materials.
• Routine cleaning and disinfection strategies used during influenza seasons can be applied to the environmental management for COVID-19. More information can be found here.
Collective actions taken by the dental community can help deter the proliferation of the COVID-19 virus in Arkansas. By rescheduling elective procedures, dental health professionals can do their part to prevent community spread, as well as help to preserve the limited supply of personal protective equipment that is critical for frontline healthcare personnel responding to this pandemic.
Click here to download the Directive for Dentists.