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California dentists ask state for clear COVID-19 guidance on patient care protocols

CDA sent the following statement today to the media and members of Gov. Gavin Newsom’s administration in order to highlight the need for clear, unambiguous guidance for oral health providers and their teams during the COVID-19 crisis. Many of you have expressed concerns and asked very important questions that must be addressed. Know that CDA has worked tirelessly with public health officials at every level for several weeks asking for guidance and providing draft recommendations, direction and other information in an attempt to assist public health authorities to order clear, explicit guidance. 

In the meantime, without clear guidance, CDA strongly recommends dentists only see urgent and emergency care patients if they have the supplies and PPE to do so. If a practice does not have the supplies or PPE, CDA recommends all emergency patients be referred to a hospital emergency department. As the state develops clear guidance, we will revise these recommendations accordingly. 

California Dentists to State Officials: Help Us With Clear COVID-19 Guidance

The following statement reflects the deep concern of the California Dental Association’s 27,000 members and all 36,000 licensed dentists in California for the health and safety of their patients, staff, families and communities:

California has been taking several aggressive measures to address COVID-19. However, there continues to be a lack of clarity and guidance from federal public health officials on basic instruction for dentists and their teams in regard to the COVID-19 crisis. Therefore, we need state officials to take clear action. The disease is easily transmitted via close contact with others, whether symptoms are present or not, which is a basic reality of care in a dental office and requires specific protection equipment to manage.

Federal public health officials have released statements “suggesting” or “recommending” that dentists only see patients with urgent needs. Just yesterday, the Centers for Medicare & Medicaid Services released a conflicting advisory that first limited “all dental procedures” and then later called on dentists to postpone “non-essential dental exams and procedures.” This example of muddled guidance falls short of clear, concise guidelines that can prompt decisive actions from dentists.

Over the course of the last week, the California Dental Association has made daily, repeated requests to public health authorities for additional clarity on how to best protect patients and has even provided draft guidelines for consideration. Each time a new guidance is issued by the federal government, it only generates more questions and makes state public health officials’ jobs that much more difficult for a workforce that will desperately be needed in the coming days.

In addition, there has been a concerning lack of clarity from the CDC in regard to personal protective equipment, especially in light of PPE shortages. Clear direction and guidance from state officials can help quickly preserve these valuable resources.

These are the questions and issues that must be addressed by state authorities immediately for the health and well-being of patients and dental professionals moving forward:

  • Should dentists be providing dental care at all? If so, under what circumstances?
  • If dentists are to provide care, what are specific protocols for the use of PPE? To the extent that the use of PPE is different than standard precautions, clarifying guidance and direction will be necessary.
  • If dentists are restricted from providing urgent dental care, what is the government’s plan to see to these emergency needs?
  • If dentists are to continue to provide urgent care, how will supplies be made available for those dentists?

In the meantime, without clear guidance, CDA strongly recommends dentists only see urgent and emergency care patients if they have the supplies and PPE to do so. If a practice does not have the supplies or PPE, we recommend all emergency patients be referred to a hospital emergency department. As the state develops clear guidance, we will revise these recommendations accordingly. 

Dentists are highly trained health care providers. With the proper guidance, they can and will provide thousands of more helping hands here in California as the health care system prepares to address the COVID-19 caseload. They and their facilities should be included in the health care worker surge preparedness planning.

But we must have clear guidance.

We are deeply concerned with the near-term implications of the physical health of dentists, their teams, patients and the general public. On behalf of our members, we are also deeply concerned and engaged in the longer-term impacts of this crisis from a practice continuity standpoint and will be working with state and federal officials on how to address these concerns and ensure the provision of dental services after the public health crisis has ended.

To that end, we are also engaged and advocating for fiscal relief for dentists, dental teams and practices, many of whom as small businesses are a significant part of their communities. Allowing many thousands of dentists to close their practice doors and lay off staff will create long-term, hugely negative health consequences for California.

We will be advocating for long-term, no-interest business continuity loans. We will be advocating to ensure dental benefit companies step up and provide relief and financial support to keep their provider networks healthy, vibrant and available to patients.

For now, many thousands of highly skilled providers await clarity and guidance from our government officials who the public entrusts to lead us through a time of crisis.

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