In carefully worded directives intended to slow the spread of COVID-19 and conserve protective equipment, government health officials are urging U.S. dental clinics to postpone most procedures.
Without personal protective equipment (PPE), even routine oral health services can easily expose workers and patients to transmission of a variety disease. Providers and patients are face-to-face; instruments used in the procedures generate droplets containing water, saliva, blood and microorganisms, as the Centers for Disease Control and Prevention (CDC) notes in new infection control guidelines for providing dental care during the COVID-19 emergency. But patients who have or may have COVID-19 present additional risks, according to the agency.
“Caring for patients requiring transmission-based precautions is not possible in most dental settings as they are not designed for or equipped to provide this standard of care,” it said. “For example, most dental settings do not have airborne infection isolation rooms or single-patient rooms, do not have a respiratory protection program, and do not routinely stock N95 respirators.”
In recommendations updated March 27, the CDC urged the nation’s dental providers to “postpone elective procedures, surgeries, and non-urgent dental visits and prioritize urgent and emergency visits and procedures now and for the coming several weeks.”
In emergency cases, the CDC instructed oral health and medical providers to work together to determine an appropriate course of treatment for patients with known or suspected COVID-19.
“The urgency and need for a procedure are decisions based on clinical judgment and should be made on a case-by-case basis,” the agency stated.
Citing concerns about COVID-19, the American Dental Association (ADA) in a mid-March letter also called upon dentists nationwide to postpone elective procedures for the coming three weeks. The organization said it would continue to assess the situation.
“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,” said the organization, which represents 163,000 member dentists. The group said that it would update the recommendation as new information becomes available.
Even during normal times, millions of Americans face challenges finding dental services due to poverty, provider shortages, lack of benefits and other factors. While most emergency rooms are not set up to provide dental care, hundreds of thousands of times a year, people turn to them for temporary relief from dental pain and other oral health problems.
As the pandemic unfolds, oral health advocates are stepping up efforts to steer patients with urgent needs to dental providers who are prepared to help them.
“To make it easier for people with dental needs to find a practice or a clinic that can help them during these unprecedented times, the North Carolina Oral Health Collaborative has developed a map showing the status of providers across the state,” writes Anne Blythe, in a new piece for North Carolina Health News.
In Washington State, where Gov. Jay Inslee last month mandated the closure of dental offices for elective procedures, the nonprofit Arcora Foundation is offering its free DentistLink referral service to help connect patients find providers available to alleviate pain and treat dental emergencies until dental offices resume normal operations.
For reporters interested in learning more about how the COVID-19 emergency is impacting dental care in their states, the nonprofit National Network for Oral Health Access has compiled resources that include a spreadsheet with updated state directives related to the provision of dental care during the pandemic.
And the nonprofit Community Catalyst has assembled this guide that includes links to professional organizations and public health agencies responding to oral health concerns during the pandemic: COVID-19 Resources for Oral Health Professionals and Advocates.