Dear DSDS Members,

After careful consideration and consultation with the Division of Public Health, below are the modifications to our original guidance:

1. In addition to providing emergency/urgent dental care, Delaware dentists are advised to treat previously-diagnosed oral conditions where, in the clinician’s opinion, harm would occur to the patient if left untreated. We will defer any elective or preventive services, such as dental hygiene, until Delaware gets to Phase 1 of the State’s COVID-19 recovery plan. We recognize that by limiting our practices to these services, general dentists will only treat 30-40% of their normal patient volume and specialty offices will decrease their normal patient volume as well.
2. In order to safely re-open our dental offices, the DSDS recommends that all dentists utilize the ADA Interim Guidance for Minimizing Risk of COVD-19 Transmission and the ADA Return to Work Interim Guidance Toolkit to establish office protocols to ensure the safety of all staff and patients. At a minimum, all dentists will adhere to the guidelines listed below and to the Governor’s State of Emergency protocols:
   
   
   • Pre-screen every patient for COVID-19 risk factors using a comprehensive questionnaire until accurate testing is available.
   • Reduce the number of in-person appointments by utilizing telephone triage and other remote strategies to address specific patient concerns.
   • Stagger patient appointments to minimize patient-to-patient contact. To facilitate adequate distancing, it is strongly recommended to limit one patient per dental care provider. Observing these guidelines will regulate the number of patients within an office/clinic at any given time.
   • Social distancing will be observed in the dental offices and waiting areas. To help adequate distancing, it is strongly recommended to limit one patient per dental care provider. Observing these guidelines will regulate the total number of patients seen in a day and the number of patients within an office/clinic at any given time.
   • Schedule patients ensuring that sufficient time is allocated for appropriate disinfection between patients as recommended in the ADA toolkit.
   • Patients should come alone for appointments (except where necessary for interpreters, guardians of minors, and others needing assistance).
   • Record body temperatures for every patient when they arrive for their appointment.
   • Patients reporting or exhibiting COVID-19 symptoms are to be advised to contact their primary care physician immediately and placed in quarantine as appropriate.
   • Dentists should secure COVID-19 test reports where available for patients and staff.
   • All staff members should have their temperatures taken upon arriving at work and a record maintained at the dental office.
   • Staff members who report or exhibit any COVID-19 symptoms should self-quarantine and contact their primary care physician immediately and follow their advice.
   • All dental personnel shall use appropriate PPE as dictated by the procedure performed, consistent with guidelines from the CDC and the American Dental Association, including masks, face shields, fluid-resistant gowns and hair cover if applicable.
   • Dental providers should use high volume evacuators and isolation strategies including rubber dams when appropriate to limit exposure to aerosols.
   • All surfaces must be disinfected between patients in accordance with the OSHA/CDC guidelines.
   • Dentists are encouraged to work with the Division of Public Health regarding necessary screening and reporting requirements.
   • These guidelines will continue to be updated as needed.

In summary:

Until Delaware gets to Phase 1 of the State’s COVID-19 recovery plan, we advise Delaware dentists to do the following:

1. Provide treatment of previously-diagnosed oral conditions where, in the clinician’s opinion, harm would occur to the patient if left untreated.
2. Defer all elective and preventive services, including dental cleanings
3. Only treat 30-40% of normal patient volume

Please feel free to email me with any questions or concerns at cathyharrisdmd@hotmail.com.

Sincerely,



Cathy Harris, DMD
DSDS President