UPDATE: NYS Offers Guidance for Dental Practices during COVID-19 Pandemic
Updated: Mar 26, 2020
Governor Cuomo's most recent executive order changes the recommendation that dental offices only respond to emergency services to a New York State mandate. As of this Sunday, March 22, you will be in violation if you are treating anything other than emergencies in your office and can be subject to a fine. Read the full statement here.
The emergence of a new infectious disease reemphasizes the importance of vigilance relative to all aspects of infection control for Dental Healthcare Workers. Dental specific infection control information may be referenced at the CDC website.
American Dental Association (ADA) is offering guidance in determining what is considered “emergency” versus “non-emergency.” The ADA recognizes that state governments and state dental a
ssociations may be best positioned to recommend to the dentists in their regions the amount of time to keep their offices closed to all but emergency care. This is a fluid situation, and those closest to the issue may best understand the local challenges being faced.
This guidance may change as the COVID-19 pandemic progresses, and dentists should use their professional judgment in determining a patient’s need for urgent or emergency care.
1. Dental emergency
Dental emergencies are potentially life threatening and require immediate treatment to stop ongoing tissue bleeding, alleviate severe pain or infection, and include:
Cellulitis or a diffuse soft tissue bacterial infection with intra-oral or extra-oral swelling that potentially compromise the patient’s airway
Trauma involving facial bones, potentially compromising the patient’s airway
Urgent dental care focuses on the management of conditions that require immediate attention to relieve severe pain and/or risk of infection and to alleviate the burden on hospital emergency departments. These should be treated as minimally invasively as possible.
Severe dental pain from pulpal inflammation
Pericoronitis or third-molar pain
Surgical post-operative osteitis, dry socket dressing changes
Abscess, or localized bacterial infection resulting in localized pain and swelling
Tooth fracture resulting in pain or causing soft tissue trauma
Dental trauma with avulsion/luxation
Dental treatment required prior to critical medical procedures
Final crown/bridge cementation if the temporary restoration is lost, broken or causing gingival irritation
Other urgent dental care:
Extensive dental caries or defective restorations causing pain--Manage with interim restorative techniques when possible (silver diamine fluoride, glass ionomers)
Denture adjustment on radiation/oncology patients
Denture adjustments or repairs when function impeded
Replacing temporary filling on endo access openings in patients experiencing pain
Snipping or adjustment of an orthodontic wire or appliances piercing or ulcerating the oral mucosa
2. Dental non-emergency procedures
Routine or non-urgent dental procedures include but are not limited to:
Initial or periodic oral examinations and recall visits, including routine radiographs
Routine dental cleaning and preventive therapies
Orthodontic procedures other than those to address acute issues (e.g. pain, infection, trauma)
Extraction of asymptomatic teeth
Restorative dentistry including treatment of asymptomatic carious lesions
Aesthetic dental procedures
The ADA is committed to providing the latest information to the profession in a useful and timely manner. Please visit ADA.org/virus for the latest information.