In this advisory:
- Dentistry and COVID-19 transmission
- Patient care, staff screening, and cleaning
- Current PPE availability and requesting resources
- Infection control and PPE recommendations
*Guidance is compiled from CDC and ADA sources. See Resources section for full links to source documents. Source guidance is subject to updating without notice. You are strongly encouraged to review those source documents and track them for updates. For questions regarding clinical guidance, please contact your local dental society, WSDA, or ADA.
Dentistry and COVID-19 transmission
SARS-CoV-2, the virus that causes COVID-19, is thought to be spread primarily through respiratory droplets when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease and we are still learning about how it spreads and the severity of illness it causes. The virus has been shown to survive in aerosols for hours and on some surfaces for days. There are also indications that patients may be able to spread the virus while pre-symptomatic or asymptomatic.
According to the CDC, to date in the United States, clusters of healthcare workers positive for COVID-19 have been identified in hospital settings and long-term care facilities, but no clusters have yet been reported in dental settings or personnel. The Occupational Safety and Health Administration’s Guidance on Preparing Workplaces for COVID-19 places dental health care providers in the very high exposure risk category, as their jobs are those with high potential for exposure to known or suspected sources of the virus that causes COVID-19 during specific procedures.
See more: https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html
Dental health care providers should review COVID-19 Safety and Clinical Resources available from the American Dental Association.
Patient care, staff screening, and cleaning
If, after their care, a patient reports signs or symptoms of COVID-19, refer the patient to their medical provider for assessment and follow CDC’s Healthcare Personnel with Potential Exposure Guidance.
People with COVID-19 who have ended home isolation can receive emergency dental care.
It is important to screen and monitor staff for symptoms of COVID-19. Those showing signs of illness should go home. Information about when a dental health care provider with suspected or confirmed COVID-19 may return to work is available in the Interim Guidance on Criteria for Return to Work for Healthcare Personnel with Confirmed or Suspected COVID-19.
Maintain frequent hand hygiene by washing hands before and after all patient contact, all contact with potentially infectious material, and before putting on and after removing PPE. Hand hygiene supplies should be readily available for all staff and patients.
Clean and disinfect rooms and equipment according to the Guidelines for Infection Control in Dental Health Care Settings. Refer to List Nexternal on the EPA website for EPA-registered disinfectants that have qualified under EPA’s emerging viral pathogens program for use against SARS-CoV-2. Manage laundry and medical waste in accordance with routine procedures. Clean and disinfect all reusable dental equipment used for patient care according to manufacturer’s instructions and facility policies.
Current PPE availability and requesting resources
Dentists should follow PPE conservation strategies. Dental clinics are considered Tier 2 by the Department of Health. We encourage all dentists to make reasonable requests in order that all practices in Snohomish County are safely stocked and able to re-open.
- Severe PPE shortages are most significant in gowns, disinfectant wipes, N95s, and surgical/procedure masks.
- Basic “procedure masks” are more readily available.
- In the event that all Tier 1 organizations have acceptable levels of N95s, dental offices may have access to masks.
- Requests for PPE should be made using the request forms available online at https://www.snohd.org/514/How-to-Make-a-Resource-Request. Please be sure to select the form for “Dental Clinic, Outpatient Clinic, or Doctor’s Office.”
Infection control and PPE recommendations
When practicing in the absence of airborne precautions, the risk of SARS-CoV-2 transmission during aerosol generating dental procedures cannot be eliminated. For guidelines when considering aerosol procedures, please refer to CDC’s Interim Infection Prevention and Control Guidance for Dental Settings During the COVID-19 Response.
As part of source control efforts, dental health care providers should wear a facemask at all times while they are in the dental setting. Staff should receive training as needed on how to use and dispose of PPE. More information is available in the CDC guidelines on Using Personal Protective Equipment. For details on appropriate use of N-95 and other filtering facepiece respirators, see the American Dental Association’s guidance on respiratory protection.
Dental health care providers also should review and utilize Strategies to Optimize the Supply of PPE and Equipment.