Several significant developments have occurred during the last 36 hours regarding the operation of dental offices and the spread of COVID-19. Read below for the highlights:
Should I Keep My Office Open?
FOR emergencies or urgent care only. Governor Philip D. Murphy issued an Executive Order yesterday, March 21, 2020, which stated, in part: “Nothing in this Order shall be construed to limit, prohibit, or restrict in any way the provision of health care or medical services to members of the public.” However, the NJ State Board of Dentistry sent an advisory, the same day, with recommendations “designed to mitigate the spread of COVID-19; protect the public, patients, dental staff, and practitioners; allow for treatment of dental emergencies; and help alleviate the burdens placed on hospital emergency departments where patients with oral pain might otherwise go. “Dentists should provide emergency care to their existing patients and others seeking urgent care”
What Dental Services Should Be Provided?
The State Board “strongly urges” practitioners to “cancel or postpone any elective procedure or ‘routine’ service until at least April 20, 2020”. More specifically, “if a procedure can be delayed for 30 days without, in the clinical judgment of the dentist, running an undue risk of harm to the patient, it is non-essential.” Refer to the ADA’s list of essential vs. nonessential here – and the board will refer to the clinician exercising their own judgement in these situations.
Are There Office Protocols That Should Be Followed?
The State Board made recommendations in its Advisory that are “designed to mitigate the spread of COVID-19; protect the public, patients, dental staff, and practitioners; allow for emergency treatment or urgent care,” utilizing the following:
- Patient Screening: Patients should be asked if they have a fever, cough or shortness of breath and whether they had direct contact during the past 14 days with a person with suspected or confirmed COVID-19. In addition, many practices take the temperature of a patient to determine if it is 100.4 degrees Fahrenheit or greater.
- Staff Screening: Dentists are urged to monitor the health of staff and recommends that any dentist or staff member should stay home if sick or showing symptoms, or if a member of their household is ill. Also, follow the same protocol in those instances in which a 14 day self-quarantine has been imposed or recommended.
- Office Disinfection: In addition to common surfaces, in a dental office setting, COVID-19 may be spread by aerosol transmission. To reduce exposure, sanitizing products should frequently be used on common surfaces. For procedures involving the use of either ultrasonic units or rotary devices, support should be provided by high volume evacuation.
- Use of PPE: According to the CDC on 3/20/20 it is advised that “surgical masks approved by the FDA are not sufficient protection to completely protect treating personnel of transmission from non-symptomatic infected individuals – only N95 masks with face shields and intensive surface disinfection and complete coverage of limited dental team members with disposable PPE, in a negative air flow environment that is designed for airborne pathogen containment, would truly mitigate the risk to you and your dental teams.”
What to do if a Dental Healthcare Provider is infected?
On Saturday, March 21, 2020, the NJDA learned that a Dental Hygienist in New Jersey tested positive to COVID-19. She treated patients a week prior to her diagnosis. In an example like this, dentists should contact their local Board of Health to determine the protocol regarding notification that should be followed.
Will There Be Further Guidance?
According to the ADA, “CDC guidelines regarding dental specific Covid-19 recommendations are coming out Monday [March 23, 2020]”. We will keep you updated as new information continues to become available.
I have extra supplies, can I donate them?
The NJDA is asking all member dentists to help us rise-up to meet this challenge by voluntarily donating any extra PPE you may have. Any PPE donation is appreciated, no matter how big or small. You can do so by at NDJA’s site by completing this brief survey.
Be well and stay tunes for updates from Riverside Oral Surgery.
-Source credit, NJDA.org