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What ‘shelter-in-place’ means for dentists

Several counties in California have ordered their residents to ‘shelter-in-place.’ Here’s what that means for dentists.

March 18, 2020 50695

Residents of nine counties in California are now under orders to shelter-in-place for three weeks to help curb the spread of the new coronavirus. The orders took effect the morning of March 17 in Alameda, Contra Costa, Marin, San Francisco, San Mateo, Santa Clara and Santa Cruz counties, which currently have the largest number of confirmed COVID-19 cases in the state.

Late afternoon Tuesday, Monterey and Sonoma counties became the latest counties to issue shelter-in-place orders. Sacramento and Yolo counties plus the city of Davis stopped short of issuing legal orders Tuesday but asked residents to “only leave their homes for essential purposes.”

What do the orders, which are enforceable by law, mean for dentists who practice in one of those counties?

  • Dentists and other health care providers are considered essential personnel and are exempt from the order to shelter-in-place.
  • Likewise, individuals who require essential health care services are exempt from the order to shelter-in-place and may leave their work or residence to obtain care. According to the order, that exemption is “applied broadly to avoid any impacts to the delivery of healthcare.”

Although dentists who reside in the nine counties are exempt from the order to self-isolate in their place of residence and are allowed by law to continue the practice of dentistry during the order’s enforcement, the California Dental Association urges California dentists to voluntarily suspend non-urgent or non-emergency dental care until at least March 29 per guidance the association issued March 15.

CDA’s guidance is intended to help “flatten the curve” of new coronavirus infections and is aligned with the most recent state and federal guidance, including Gov. Gavin Newsom’s recommendation that seniors age 65 and older and individuals with heart or lung disease self-isolate at home for 14 days. The governor on March 15 also strengthened social-distancing practices, asking night clubs in the state to close and restaurants and breweries to limit their service to delivery and take-out.

The ADA on March 16 issued guidance similar to CDA’s, calling on dentists nationwide to “postpone elective procedures in response to the spread of the coronavirus disease, COVID-19, across the country.”

Determining urgent or emergency care

Dentists throughout California, including the current nine counties under the shelter-in-place order, should proceed with providing dental treatment if:

  • A patient is in pain.
  • Infection is present.
  • Nontreatment would severely inhibit normal operation of a patient’s teeth and mouth or negatively impact their health in the next three to six months. Dentists have the jurisdiction to use their professional judgment on treatments that meet the latter requirement.

Patients who have received recent treatment requiring the removal of sutures would also be considered appropriate for treatment.

CDA asks dentists to delay all other treatments until the COVID-19 crisis has eased.

Returning to work

If the current shelter-in-place order ends April 7, dentists in the nine counties will still want to assess the risks of returning to work and consider continued local, state and federal guidance. If public health officials see positive indications of slow disease spread and possible containment, the recommendations for social distancing may ease, as might the demand for face masks and other personal protective equipment needed for health care personnel who are responding to and treating COVID-19 patients.

Find CDA Practice Support FAQ on dental office closures, employee and sick leave and more at CDA’s regularly updated COVID-19 information center for dentists.

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