New Guidance from the CDC in Dental Settings - updated August 4, 2020
The CDC Guidance for Dental Settings During the COVID-19 Response has been updated. Most recommendations in the updated guidance have been rearranged for clarity and are not new. Recent updates include:
- How to respond to SARS-CoV-2 exposures among dental healthcare personnel (DHCP) and patients, and guidance on physical distancing.
- The definition of fever changed to either a measured temperature ≥100.0°F or subjective fever to align with CDC’s Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings.
- In areas with moderate to substantial community transmission, during encounters with patients not suspected of SARS-CoV-2 infection, CDC recommends that DHCP:
- Wear eye protection in addition to their facemask to ensure the eyes, nose, and mouth are all protected from exposure to respiratory secretions, including those where splashes and sprays are not anticipated.
- Use an N95 respirator or a respirator that offers an equivalent or higher level of protection during aerosol generating procedures.
- Added language that protective eyewear (e.g., safety glasses, trauma glasses) with gaps between glasses and the face likely do not protect eyes from all splashes and sprays.
It is unknown at this time how COVID-19 may permanently change infection control practices in dental health care settings. CDC continually assesses emerging scientific evidence for developing policies, guidelines, and recommendations. You can find the most up-to-date information about infection prevention and control practices on CDC’s COVID-19 page. This is an emerging, rapidly changing situation, and CDC will update this guidance as additional information becomes available.
American Dental Association Provides a Patient Communication Resource Center to Help Welcome Patients - updated July 7, 2020
The American Dental Association launched a customizable patient return resource center July 7, designed to help its member dentists communicate changes with their patients amid reopening.
The 10-page guide consists of:
- A comprehensive visual guide to show patients what the new care process will look like
- A detailed FAQ to address common patient concerns
- Social media post templates
- Four office signage templates
- Email and text message templates to communicate the office's infection control procedures before patients' appointments
Dental School Graduates and the Issuance of Provisional Licenses - updated July 1, 2020
If I am a dental school graduate, or soon to be graduate, may I apply for and be issued a license without taking the required national examinations, including the clinical examinations? While Governor Ducey's 2020-17 initially allowed for licensing agencies to issue provisional licenses without taking the required national examinations, it also stated that graduates would be required to take and pass the national examinations when testing centers re-open. Now that testing centers have re-opened and have even made allowances for examinations using manikin based tests, the Arizona State Board of Dental Examiners ("Board") will no longer be issuing provisional licenses - beginning July 1, 2020.
Applications must complete all requirements under Arizona Law, including the national and clinical exams. Please note that the Board is still waiving all required application fees thru December 31, 2020.
The tests are for health care workers and first responders and are being funded by the State of Arizona. According to their guidance, an individual licensed by Arizona Board of Dental Examiners is included in their list of health care workers.
Governor Ducey Issues Executive Order Directing Employers to Create Policies - updated May 12, 2020
In an effort to limit and mitigate the spread of COVID-19, Governor Ducey issued Executive Order 2020-36 directing employers to develop, establish and implement policies based on guidance from the CDC, Department of Labor, Occupational Safety and Health Administration (OSHA) and ADHS. The policies should include the following:
a. Promoting healthy hygiene practices;
b. Intensifying cleaning, disinfection and ventilation practices;
c. Monitoring for sickness;
d. Ensuring physical distancing;
e. Providing necessary protective equipment;
f. Allowing for and encouraging teleworking where feasible;
g. Providing plans, where possible, to return to work in phases; and
h. Limiting the congregation of groups of no more than 10 persons when feasible and in relation to the size of the location.
FREE Continuing Education RE: PPE - updated May 12, 2020
Increasing healthcare worker safety is essential in our new unknowns regarding COVID-19. Dental workers (including dentists, hygienists, dental assistants, and other office staff) are at risk of infectious disease through patient contact and contact with the patient care environment. Employers are required to train workers about the necessity of PPE, including how to use it, put it on, remove it, and safely dispose of it. For a free, OSHA funded online training that focuses on the safety of the worker and addresses the Centers for Disease Control and Prevention’s recommended donning and doffing procedures for PPE, please see https://ppetraining.org/. Proper techniques are crucial to prevent the spread of infectious disease to workers on the front-lines of patient care. The training includes strategies and techniques so that workers can protect themselves against these serious workplace safety hazards.
Recycling PPE - updated May 5, 2020
The Arizona Department of Health Services (AZDHS) is excited to announce the pending arrival of the Battelle Critical Care Decontamination System™ (Battelle CCDS™) to aid frontline workers in Arizona in extending the use of disposable respirators and PPE. AZDHS and the Board appreciate your participation.
"Re-Opening" - Dentistry Guidance - updated April 27, 2020
Following the guidance from our state leadership, which comes at a crucial time for our community, and given the latest Executive Order 2020-32, the Governor's Office, in collaboration with the Arizona Department of Health Services, developed an FAQ page for dentists and hygienists to follow to "re-open" on May 1. Please reference the FAQ link beginning on page 5 for specific direction regarding dental providers. The Board appreciates and recognizes all the efforts of the Governor's Office and AZDHS for providing this direction and allowing for the re-opening of dentistry on May 1.
What Next? What can you do now to prepare your business, employees, etc.? Click here for help.
Governor Ducey Announces New Guidance on "Elective Surgeries" - updated April 22, 2020
Governor Ducey announces and issues a new Executive Order to allow for elective surgeries. Under the new order, hospitals, dental offices and other health facilities can resume conducting elective surgeries on May 1 if they can show they have implemented measures intended to keep health care workers and patients safe. These include:
Demonstrating greater than a 14 day supply of PPE;
Ensuring adequate staffing and beds;
Testing patients prior to surgery and all at-risk health care workers;
Ensuring appropriate discharge plans for patients being transferred to nursing care facilities, including diagnostic testing for COVID-19;
Implementing a universal symptom screening process for staff, patients, and visitors;
Establishing an enhanced cleaning process for waiting areas;
And prioritizing the restart of elective surgeries based on urgency.
Facilities that meet the specified standards will need to complete and exemption request and receive approval from the Arizona Department of Health Services before resuming elective surgeries. The order shall be considered for repeal or revision every two weeks.
Frequently Asked Questions - updated April 10, 2020
The Board met on April 10, 2020 and among other things discussed the economic impact of COVID-19/Coronavirus on the dental community. As such, and to coincide with Governor Ducey's 2020-17 Executive Order, the Board voted to waive many of its fees through the remainder of the 2020 calendar year. Please review this FAQs document for more information respective to your fee concern(s). Additionally, the FAQs also addresses other matters, such as renewal extensions, examinations for initial licensure, provisional licenses and more. The granting of a provisional license may help in obtaining employment, but the Board makes no assurances that a provisional license will guarantee employment, the receipt of insurance from an insurance carrier or a DEA Certificate of Registration to dispense drugs and/or devices.
Report a COVID-19 Related Concern
Please use this link to report a concern related to the practice of dentistry during the COVID-19 pandemic. Once submitted, the concern will be raised, with the compliance team, to determine whether or not the licensee is committing any conduct or practice that constitutes a danger to the health, welfare or safety of the patient or the public in spite of the Governor's Executive Orders. Please note that not all complaints will merit an investigation and not all investigations warrant discipline even though the complainant's perception is that it should.
Register as a Volunteer Health Professional for a Public Health Emergency
The Board staff has fielded numerous phone calls and emails from our healthcare professionals who are interested in volunteering for the COVID-19 Response. The Arizona Department of Health Services (ADHS) has recently responded and needs emergency response volunteers to call upon during a time of need. The knowledge and skills you have can help make a difference during this or any disaster. The first step in volunteering is to register with the Arizona Emergency System for the Advance Registration of Volunteer Health Professionals (AZ-ESAR-VHP or https://esar-vhp.health.azdhs.gov/). Once registered, request membership into the COVID-19 Response or other categories of interest. You can also get involved with opportunities by connecting with your local medical reserve corps by visiting https://mrc.hhs.gov/FindMRC.
Additionally, if a healthcare professional wishes to donate any medical supplies, including PPE, all items can be donated directly to their local county health departments or healthcare facilities.
Specifically, if you wish to donate to the Maricopa County Department of Public Health (MCDPH), who depends on the generosity of community members like you, they have implemented a donation management program to allow for individuals and/or organizations to donate. Follow this link for donation drop off location and times, and help spread the word.
Governor Ducey Announces Latest COVID-19 Actions
Governor Ducey announces and issues an Executive Order that halts all elective surgeries in the state of Arizona to free up medical resources and maintain the capacity for hospitals and providers to continue offering vital services. The Executive Order includes dental surgeries.
Governor Ducey announces ArizonaTogether.org - a COVID-19 information and resources website - update March 31, 2020
Governor Ducey latest Executive Order Stay Home, Stay Healthy, Stay Connected - updated March 30, 2020
Governor Ducey issued another Executive Order that eases several burdens regarding licensure, including, but not limited to: extending expiration dates of licenses expiring, suspending rules that limit the amount of continuing education hours you can take online and deferring continuing education. - updated March 26, 2020
Please click here for the newest information coming from Governor Ducey's office. - updated March 25, 2020
Governor Ducey issues Executive Order Prohibiting the Closure of Essential Services. - updated March 23, 2020
This will help keep critical personal protective equipment (PPE) available for the fight against COVID-19.
CDC Recommendation: Postpone Non-Urgent Dental Procedures, Surgeries, and Visits - updated March 20, 2020
What Constitutes a Dental Emergency - American Dental Association
Arizona Dental Associations' resources regarding COVID-19, including the donation of PPE equipment.
Arizona State Board Dental Examiners’ COVID-19 Statement:
As the facts and situation around COVID-19 (Coronavirus) continue to evolve, the Arizona State Board of Dental Examiners is requesting the cooperation of all Arizona dental licensees and is issuing the following guidance below. This recommendation is being made after careful deliberation and in consultation with state and national public health experts, and in line with our mission to protect the public.
The Arizona State Board of Dental Examiners supports the American Dental Association’s (“ADA”) recommendation(s). To quote the ADA, “As healthcare professionals, it is up to dentists to make well-informed decisions about their patients and practices.” As always, the Board hopes and urges its licensees to continue to be available as needed for essential and/or emergency care and services, but to take appropriate and enhanced precautionary measures for patient safety, as well as the safety of their staffs and themselves.
The Board does not make this request lightly, but out of an abundance of caution during this historic public health emergency. As health care professionals, we all have a role to play in "flattening the curve" in order to follow sound, scientific public health advice to help limit infections and slow the spread of the virus.
Our collective actions now will determine the spread of COVID-19. We believe by taking these extraordinary precautions, dental practitioners can make a difference in helping to preserve the limited supply of personal protective equipment critical for emergency dental care and frontline health care personnel responding to the pandemic. We recognize the gravity of these extreme measures and are sensitive to the economic impact of such actions. Rest assured that the Board will advocate on behalf of all dental licensees in Arizona for economic relief packages.
We understand you will have questions about what to do next following this announcement. As licensed dental practitioners we urge you to do what is best for the communities you serve, including your staff and your patients. For the most up-to-date information and support, continue checking this webpage.
In addition, the Board Recommends the following protocols:
Patients should be screened for active disease prior to providing dental care in the office. Please take note of:
To reduce the production of aerosols during dental treatment, which is also advised during this time of increased transmissibility:
- Avoid or minimize operations that can produce droplets or aerosols; use rubber dams as much as possible.
- Rinse the oral cavity slowly, avoiding unnecessary splatter.
- Use high-speed evacuation for all dental procedures producing an aerosol.
- Have patient use an antimicrobial rinse before starting a dental procedure; ADA suggests using 1% hydrogen peroxide.
- Avoid or minimize procedures that may induce coughing, such as taking routine intraoral X-rays.
Interim CDC guidance for businesses and employers recommends that:
- Employers encourage employees who report symptoms of acute respiratory illness to stay home and not return to work until they are free of symptoms for at least 24 hours without the use of fever relieving or symptom altering medications.
- If an employee appears to be sick upon arrival to work, they should be separated from other employees and sent home immediately.
- Employees cover a cough or sneeze with a tissue and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
- Employees wash hands often with soap and water for at least 20 seconds. If soap and water are not readily available, an alcohol-based hand sanitizer with at least 60% alcohol can be used.
- Clean and disinfect public areas frequently, including door handles, chairs and bathrooms.
CDC recommends healthcare facilities, including dental offices, screen patients before
proceeding with an appointment. Information to take note of:
- Any individual who exhibits or reports signs of acute respiratory illness such as coughing, fever and shortness of breath.
- Recent travel to any locations that have a Level 3 Travel Health Notice for COVID-19. Verify when the patient returned to the United States. If the patient reports that at least two weeks have passed since their return from one of the identified regions and no symptoms have presented, the dental office can proceed with the appointment. When local, state or federal public health officials declare the disease is at the community level, screening for travel is not necessary.
- Close contact with an individual diagnosed with COVID-19.
Lastly, and for some guidance in how your office(s) should protect the public exposure and its staff, you may want to consider requesting your patients to complete a Medical History Addendum. Click here for an example.