In March 2020, only three days after President Trump called on American citizens to quarantine at home to prevent the spread of COVID-19, the American Dental Association (ADA) issued a recommendation that dentists postpone all services except urgent and emergency procedures. The ADA was one of the first professional health associations to give such guidance, and the organization spent the subsequent 6 weeks developing science-based guidance to build upon the already strong infection control protocols used in dentistry.
Oral health is an integral part of overall health
When the initial postponement recommendation expired, it was not extended because “dental care is essential care,” an assessment echoed by the CDC. Neglected oral health has been linked to a number of diseases and preventable conditions.  , including pneumonia. Seniors are especially susceptible to many of these conditions. Dental care that’s compliant with ADA and CDC guidelines likely creates much less risk for elderly residents of nursing facilities than continued postponement.
The ADA’s guidance calls for the most protective PPE available, including masks, goggles, face shields, and gowns to protect both patients and dental care providers. However, it also goes beyond to create further protections, including, wherever possible, the implementation of equipment and practices to minimize the spread of aerosols:
- Use of rubber dams
- Implementation of high-velocity suction
- Hand scaling during teeth cleaning, rather than ultrasonic scaling
Before, During, and After Care
Additional recommendations guide patient interactions, including procedural considerations for office staff. In the days before appointments, dental staff should contact patients or their caregivers to screen for symptoms. Health screening questions are necessary immediately before an appointment as well, along with a temperature check. Limiting the number of individuals present during the appointment to only those essential is another key practice for minimizing infection risk.
During the appointment, items that are touched by the patient and the dentist are to be wiped down with disinfectant, including pens, clipboards, and furniture. Providing hand sanitizer for patient use is another recommendation.
After the appointment, dental team staff carefully disinfect any areas or equipment used by patients, using cleaners specifically designed to kill the COVID-19 virus.
Guideline-Compliant Dental Care is an Essential Service for Seniors
In spite of the close contact necessary to care for patients’ oral health, it appears ADA guidelines are quite effective in minimizing infection transmission: The Journal of the American Dental Association finds the prevalence of the virus among dentists to be less than one percent.
ADA President Chad Gehani sets the risk in perspective: “Millions of patients have safely visited their dentists in the past few months for the full range of dental services. With appropriate PPE, dental care should continue to be delivered during global pandemics or other disaster situations,” he said.