The California Department of Public Health (CDPH) has released its Guidance for Resuming Deferred and Preventive Dental Care. Dental healthcare personnel (DHCP) face very high risks to exposure to SARS-CoV-2 during certain procedures that generate aerosols, the CDPH said, requiring heightened awareness, training, preparation, and adherence to standard and transmission-based precautions.
First, the CDPH notes that patients with active COVID-19 infection should not receive dental treatment in a dental office. Dentists and medical providers should work together to determine an appropriate facility for treatment. Procedures on patients with COVID-19 should be carried out in accordance with Cal/OSHA’s Aerosol Transmissible Diseases (ATD) Standard.
Under the guidance’s general considerations, the CDPH notes that practices should follow local orders pertaining to reopening based on their region’s level of risk. Practices also should have a minimum of a two-week supply of personal protective equipment and require its use. Patients and staff should be screened for the virus and addressed accordingly. Signage should instruct staff and visitors about hygiene protocols as well.
As part of its considerations specific to dentistry, the CDPH advises practices to mind the Centers for Disease Control and Prevention guidance for resuming services as well as the ADA’s toolkit for returning to work. Practices should evaluate the necessity of dental care based on urgency. As transmission rates drop and PPE supplies increase, preventive services may be considered. Also, practices should enact scheduling and flow protocols to minimize exposure.
The CDPH further says that practices should avoid procedures that generate aerosols whenever possible. When they are necessary, aerosol management tools such as four-handed dentistry and high-evacuation suction should be used. Appropriate respiratory protection also should be employed. Engineering control measures and work practices, in addition to appropriate infection control measures, should be in place as well.
Room surfaces should be cleaned and disinfected promptly after care is completed. These cleaning and disinfection procedures should be followed consistently and correctly. The CDPH notes that the Environmental Protection Agency has compiled a list of registered disinfectants that have qualified for use against SARS-CoV-2. Laundry and medical waste should be managed in accordance with routine procedures.
Finally, the CDPH urges dental providers to regularly check with their local health departments for information and updates related to COVID-19. Practices can request supplies through their local Medical and Health Operational Area Coordinator when the supply chain is disrupted. Supplies will be granted on a priority basis. Full details about the CDPH’s guidance for resuming deferred and preventive care are available online.
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