CDC Guidance for Dental Settings During COVID-19: Five Key Points

On Aug. 28, 2020, the Centers for Disease Control and Prevention (CDC) updated its guidance on specific infection control considerations for dental offices during the COVID-19 pandemic.

This updated guidance complements previous CDC recommendations, including infection control recommendations for healthcare settings and a framework for healthcare systems providing non-COVID-19 clinical care. It describes how dental professionals can help protect patients and dental staff when providing dental services, particularly as dental settings have unique characteristics differentiating them from other healthcare facilities and therefore require certain additional considerations.

Dental practices are encouraged to balance necessary services while minimizing the risk of spreading COVID-19 to patients and dental healthcare personnel (DHCP). CDC recommends that DHCP regularly consult state dental boards and state or local health departments for current information related to providing dental care within their jurisdictions, as local guidelines may change based on community transmission and region-specific COVID-19 trends.

Below are five key takeaways from CDC’s recent guidance about providing dental services during COVID-19:

1. Consider postponing elective procedures, surgeries and non-urgent outpatient visits. Dental providers should provide dental treatment only after assessing the patient’s COVID-19 transmission risk, both to and from the patient. For example, if the dental provider does not have adequate personal protective equipment (PPE), then dental care should be prioritized by patient need, with providers treating first those patients most at most risk if they do not receive dental care.
   
   
2. Implement teledentistry and triage protocols. Before patients come in to the office for treatment, dental providers should screen them via telephone for symptoms consistent with COVID-19. If the screen suggests COVID-19 symptoms, then the parties should postpone non-urgent treatment, ideally until the patient completes quarantine. If it is appropriate, consider using teledentistry services. For patients who plan to come in to the office, the dental provider should also (a) ask patients to limit the number of visitors who accompany them to the office to include only necessary individuals; (b) remind patients that they, and anyone with them, must wear face coverings when they enter the office; and (c) inform patients that they will be screened for fevers and COVID-19 symptoms before treatment.
   
   
3. Implement policies and procedures related to COVID-19. Dental providers should take steps to ensure policies and procedures are in place to limit COVID-19 transmission. This includes (a) posting signs, posters and other visual reminders to practice respiratory and hand hygiene; (b) removing toys, magazines and other objects from waiting rooms; (c) installing physical barriers in reception areas; and (d) providing supplies, such as masks and hand sanitizer, in waiting rooms and entrance areas.
   
   
4. DHCP should follow certain protocols to limit self-exposure and reduce spread. DHCP should wear face masks at all times in the office, including break rooms or other spaces where they may meet other people. During patient encounters, DHCP should wear eye protection in addition to face masks, and they should use N95 respirators or equivalent/better protection during aerosol-generating procedures. However, CDC has noted that protective eyewear that allows space between eyewear and the face (such as safety glasses and trauma glasses) may not protect the wearer’s eyes from all potential exposure. Additionally, dental providers should offer sick leave policies for DHCP that are “flexible, non-punitive, and consistent with public health guidance.” Further, DHCP should continue to be alert for any symptoms that are consistent with COVID-19 and, if symptoms develop, DHCP should stay home.
   
   
5. Implement physical distancing. While the nature of dental procedures requires close physical proximity, CDC guidance includes examples of effective physical distancing strategies in dental settings. These include (a) minimizing the number of patients in the facility by limiting concurrent dental appointments and asking patients to wait outside the dental facility before their procedures; (b) restricting the number of people accompanying patients to their appointments; and (c) ensuring a minimum distance of 6 feet between seats in waiting rooms.

CDC has continued to update its guidance periodically throughout the COVID-19 pandemic. Even as dental practices begin re-engaging in the full range of dental services and resume elective procedures in accordance with local and state guidance, CDC recommends that dental practices continue to follow these precautions and best practices as part of the ongoing response to the COVID-19 pandemic. Dental providers should ensure they monitor CDC’s guidance to maintain compliance with the latest recommendations. Dental providers should consult with state and local health department guidance as well.

For additional information, please consult one of the authors. McGuireWoods has published additional thought leadership on how companies across various industries can address crucial coronavirus-related business and legal issues. The firm’s COVID-19 response team stands ready to help clients navigate urgent and evolving legal and business issues arising from the COVID-19 pandemic. 

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