Healthy Communities

COVID-19 Guidance for Dentists

Updated January 5, 2022

Due to concerns regarding increased transmissibility of the SARS-CoV-2 Omicron variant, this guidance is updated to enhance protection for healthcare personnel (HCP) and patients are given the upsurge of SARS-CoV-2 infections.

  • Update recommendation regarding when HCP with SARS-CoV-2 infection could return to work
  • Added options that allow asymptomatic HCP with a higher-risk exposure who have not received all COVID-19 vaccine doses, including booster dose as recommended by CDC, to return to work prior to the previously recommended 14-day post-exposure period of work restriction, assuming they do not develop or test positive for SARS-CoV-2.

Full details are found here.

Screening Guidelines

Screen all patients and HCP entering the facility for signs/symptoms of COVID-19 (fever, cough, sore throat, headache, muscle pain) and recommend those who meet the criteria should delay treatment or remain at home until such symptoms abate, or:

  • Had close contact with a person known to be infected with COVID-19 within the previous 5 days, unless they themselves are fully vaccinated,
  • Awaiting a pending COVID-19 test result OR had a positive test for COVID-19 in the last 5 days.

Management of Patients

  • Identify patients with an acute respiratory illness and defer treatment unless it is an emergency case. Ask such an emergency patient to remain in their automobile until summoned directly to the treatment area with a preferred time toward latter part of the day’s schedule.
  • Reception room considerations:
    • CDC recommends that all healthcare facilities should continue to have everyone present wear masks and practice physical distancing.
    • Request patients limit the number of visitors that accompany them to their dental appointment. 
    • Provide alcohol-based hand sanitizer with at least 60% alcohol, tissues, and no-touch receptacles for waste disposal

Treatment Considerations of Patients

While maintaining adherence to the proper screening and disinfectant protocols that have been established, the dentist should use their own professional judgment regarding patient flow and treatments that are performed. Because many dental treatments are aerosol-generating procedures (AGP), the Department of Health offers the following recommendations (in addition to established universal precautions) to minimize the possibility of disease transmission:

  • N95 respirators, or comparable type, is recommended for the treatment team (dentist, dental hygienist, dental assistant) which provides the lowest risk of infection against the COVID-19 virus for the DHCP. 
    • A type 1 surgical mask along with a face shield or goggles is considered an optional PPE although the protection afforded is less than provided by N95 respirators.
  • Preprocedural rinses with antimicrobial product (chlorhexidine gluconate, cetylpyridinium chloride, or 0.2% povidone-iodine) to reduce levels of oral microorganisms present in aerosols.
  • Treatment requiring the use of a dental instrument resulting in AGP:
    • Along with eye protection (face shield or goggles), masks, and gloves, the ADH recommends clinical team members utilize a long sleeve jacket or disposable gown.
      • Cloth gowns can be laundered and reused indefinitely,
      • Reuse disposable gowns unless visibly soiled or the integrity of the gown is compromised.
    • Recommend using a dental dam for the best isolation of the treatment area.
      • Place high-volume evacuation (HV) as close to the surgical site to capture the generated aerosols,
      • When a dental dam is not feasible when ultrasonic or piezo instrumentation is utilized, recommend the usage of a four-handed approach to better capture generated aerosols. 
        • HVE devises such as Dry Shied, Isolite, SafetySuction, Zirc Mr. Thirsty are deemed suitable substitutes.

Resources:

 
 

Public Health Accrediation Board
Arkansas Department of Health
© 2017 Arkansas Department of Health. All Rights Reserved. www.healthy.arkansas.gov
4815 W. Markham, Little Rock, AR 72205-3867
1-800-462-0599