Bioterrorism
Policy Statement
The tragic events of September 11, 2001 alerted our nation to the potential for terrorism attacks on our civilian population and highlighted the need for greater preparation in order to respond to such attacks. Both the ADA and the CDA have responded by urging the inclusion of dentistry in bioterrorism response planning efforts, expressing the conviction that dentistry has important assets in personnel and facilities to contribute to the country’s capability to respond to bioterrorist events.
Historically, dentists have provided forensic services whenever the need arises. However, dentists also have professional skills and training which enable them to assist their communities in a broader capacity in the event of a bioterrorism emergency. Notably, with very little additional training, dentists could be activated to prescribe and distribute medications and administer vaccinations.
Furthermore, dental offices are located throughout any given community and have many of the resources that hospital facilities have, including sterilization equipment, air and gas lines, suction equipment, radiology capabilities, etc. Certainly, one of the possibilities is for dental offices to be activated to serve as “mini-hospitals” when local hospital facilities become overwhelmed or when a concentration of patients at one site is to be avoided. Pre-designated dental offices may act as storage sites for materials and supplies to be distributed in the event of an emergency resulting from bioterrorism.
In 2002, the CDA formed a bioterrorism workgroup charged with creating two mass disaster response teams – a Dental Identification Team and a Bioterrorism Response Team. The Dental Identification Team, known as CALDIT, has completed development of an operations manual and training program, and are prepared to respond should the need arise.
The model for the Bioterrorism Response Team continues to develop, as research is conducted to determine the most effective method for establishing dentists as responders in a bioterrorism emergency. A variety of experts from California emergency response agencies, the American Dental Association, and other states have been consulted. There is wide-spread agreement among designated bioterrorism responders in California that dentists would be very valuable to local response efforts for mass vaccinations and prophylactic prescription writing. However, consistent with ADA resolution 2002:398, consensus is that existing restrictions in the Dental Practice Act and issues of responder liability must be addressed legislatively to provide an optimum environment for progressing on this issue.
Currently, CDA participates on a statewide workgroup to establish a volunteer registry for healthcare professionals that could be activated for local, state and/or federal disaster response. This system, know as the Emergency System for Advance Registration of Volunteer Healthcare Professionals (ESAR-VHP) is a state-based, national effort, to develop a structure that allows for the advance credentialing, and organized and effective use of volunteer clinicians for emergency response. ESAR-VHP goals include identification and pursuit of legislative changes needed to allow full and appropriate use of volunteer healthcare professionals, including the scope of practice and liability issues identified by CDA.
We anticipate that legislative amendments, along with the maturation of planning within the various state departments charged with bioterrorist emergency response preparation, will open the door wider for dentists to become emergency responders. CDA remains committed to participating in these efforts and discovering the best way to achieve this goal.
July 2005