The current American Dental Association (ADA) recommendation for dentists to keep their offices closed to all but emergency care expires on April 6. The new interim recommendation from the ADA is that dentists keep their offices closed to all but urgent and emergency procedures until April 30 at the earliest.
The rate of COVID-19 transmissions is on the rise in most states. The new interim ADA recommendation is in keeping with the recent U.S. Centers for Disease Control and Prevention’s recommendation to perform only emergency or urgent dental care until April 30, 2020 and must be taken seriously by all dental professionals. The ADA believes individual dentists should exercise professional judgment and carefully consider the risks outlined in the ADA’s interim guidance and weigh those risks against any possible benefit to the patient, the practice employees, the community at large, and the practitioner. Critically important is the availability of appropriate personal protective equipment (PPE) to minimize any risk of transmission during emergency and urgent care. Due to the proximity of individuals during dental procedures, and the generation of aerosols, dentists, staff and patients are at high risk of transmission.
The ADA also recognizes that existing and future local or state government mandates supersede ADA recommendations. In addition, state dental associations may best understand local challenges being faced and make recommendations appropriate to members in their areas.
The PPE required to reduce the risk of transmission during dental treatment to its lowest levels (as noted in algorithm 3), are scarce. Asymptomatic patients cannot be assumed to be COVID-19 free. As of March 31, point of care tests exist, but are extremely difficult to obtain. Unless point of care tests are readily available to the dental practice, no one can be assured that they are treating a non-infected individual. The safety of their patients, staff and themselves should be foremost when dentists exercise their professional judgment, and information regarding the relative risks is available from the ADA, via the Interim Guidance, to assist in making those decisions.