Hello, everyone. Life is starting to return to a new normal as many of us are slowly re-opening our practices. Over the last week, I have received numerous questions and requests for clarification regarding our guidance. Our guidance was made in consultation with the Division of Public Health (DPH,) and they recently posted their COVID-19 Dental Emergency Service Guidelines on their website… https://coronavirus.delaware.gov/wp-content/uploads/sites/177/2020/05/DPH-COVID-19-Dental-Emergency-Service-Guidelines.pdf?fbclid=IwAR2LA9VEIhuT-gjXts-8quyHlvo8KYbT04q34GjJQIcmFtopOqMsAEhxncY…

As stated, this document is intended to serve as guidance.  In the emails and phone calls I’ve received, many of you have referred to this guidance as a mandate. I just want to clarify for everyone that the guidance and guidelines issued by both the DSDS and DPH are not government mandates. It is, therefore, imperative that all dentists exercise independent professional judgment as they utilize this guidance to decide when and how to safely reopen their offices. As always, safety is an absolute priority. We need to ensure that we are keeping ourselves, our staff and our patients safe, but we also have a responsibility for maintaining the oral health of our patients. We need to make individual clinical decisions that reflect that. As stated in the guidance, and as stated in the DPH document, “DPH supports dentists in providing care for previously diagnosed oral health conditions where, in the clinician’s opinion, harm would occur to the patient if left untreated.” This statement will refer to different procedures for different practitioners/specialists. For example, a patient who is actively being treated for periodontal disease may need to be seen for periodontal maintenance before Phase 1 if the dentist feels the condition will become urgent if left untreated. Similarly, silver diamine fluoride (SDF) treatment for bottle decay in a 2-year-old may be recommended now to arrest the decay if the dentist feels the child is in danger of acquiring a dental infection if not treated promptly.  In both of these examples, the proposed procedures are categorized as preventive, yet they are time-sensitive procedures necessary to prevent significant disease progression to the patient. As you can see, there are numerous scenarios that may present for different providers, in different specialties. To reiterate, the DSDS and DPH guidance will require providers to use their own professional judgment to provide necessary, timely treatment to prevent harm to their patients.

We also need to be very mindful of the fact that reopening our offices during this pandemic will require a renewed sense of teamwork. Open communication with your staff is a key component to re-entering practice successfully. Connect with your team members and give them the opportunity to voice their concerns about returning to work. As Dr. Gehani, ADA President, stated in his 4/30/20 message, dentists need to be forthcoming with the facts and honest about what is speculation. Everyone’s safety matters.

A few other updates and reminders:

1. License renewal: Don’t forget to renew your dental license if you haven’t done so already as they expire at the end of May. With all the chaos of the last several weeks, we don’t want to forget these important tasks that may have gotten pushed aside.
2. Amalgam separators: The EPA deadline for amalgam compliance is July 14, 2020. As I mentioned previously, the ADA has approached EPA for an extension due to COVID-19, but that still has not happened and I’m not sure if it ever will. Please plan accordingly.
3. KN95 masks: Earlier this week, the FDA rescinded its approval of certain manufacturers of KN95 masks to be used during the COVID-19 pandemic. Please review the following link to FDA’s updated list of approved manufacturers of KN95 masks. We strongly discourage members from using masks from manufacturers that are not on this list. The ADA also released a document with tips on how to avoid purchasing counterfeit masks (see below).

https://www.fda.gov/media/136663/download

https://success.ada.org/~/media/CPS/Files/COVID/ADA_TipsToAvoidCounterfeitMasks.pdf

As always, I welcome your comments, questions and concerns, so please continue to email me at cathyharrisdmd@hotmail.com.

Sincerely,



Cathy Harris, DMD
DSDS President