Testing and Dentists’ Scope of Practice
In California, COVID-19 testing is within the scope of practice for dentists when used for screening for COVID-19 rather than providing a formal COVID-19 diagnosis. This means that once dental offices have obtained the appropriate lab licensure, dentists can incorporate COVID-19 testing as part of their patient screening process to determine whether the patient is able to safely undergo dental treatment. Furthermore, Cal/OSHA requires employers provide respiratory protection for employees exposed to procedures that aerosolize saliva or other potentially infectious materials unless patients test negative for COVID-19.
CDA has confirmed that a dentist with a laboratory license may administer and process waived tests for their workers in addition to testing patients for the purpose of screening for COVID-19.
Use of Rapid Testing in the Dental Office
Beyond dental treatment or referral decisions, COVID-19 rapid testing at the dental office has the additional advantage of identifying potentially positive individuals early in the disease process, facilitating referral to a medical professional for diagnosis and intervention. The value of testing as a public health tool has been well-documented in various studies and by the Centers for Disease Control and Prevention. When a dentist determines that individual tests positive for COVID-19, the dentist should route the individual into medical care, such as the individual’s primary care physician, for an evaluation and confirmation of a COVID-19 diagnosis.
Testing and the Standard of Care
It is no longer necessary to test patients prior to dental treatment but a dental practice may choose to do so. If a dental practice does provide testing for screening purposes, the practice may rely on the results to determine the need for respiratory protection for its employees.
Dentists should take the appropriate precautions regarding respiratory protection, PPE, and infection control regardless of whether rapid tests are employed as part of the patient pre-procedure screening process.
CDA’s updated COVID-19 Resource Center has a wide array of resources to keep dental practices in compliance and safe for patients and staff.
Testing Technology for COVID-19
Nasal swab tests are the most common COVID-19 tests on the market currently.
When ordering tests, dentists should verify whether they are FDA-approved or authorized and are CLIA-waived. Laboratory tests are categorized as “high complexity,” “medium complexity” and “waived.” California dentists are authorized to administer and process waived tests.
- FDA authorized molecular tests (e.g., PCR test).
- FDA authorized antigen tests (“rapid tests”)
- FDA list of tests that should no longer be used or distributed
- CDC tips for self-testing
The California Department of Public Health (CDPH) updated January 2024 its COVID-19 testing guidance in describing available tests and detailing diagnostic testing, screening testing, post-exposure testing, and pre-entry testing.