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.
Since the original publication of this toolkit in November 2020, state and local health officials have issued orders requiring dentist employers to have their staff tested weekly if they cannot provide proof of full vaccination. 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.
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, and contributing to public health surveillance and contact tracing efforts. 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 an 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.
Appropriately screening patients prior to performing the dental treatment is the standard of care and a Cal/OSHA requirement; however, absent federal or state guidance, determining how that screening occurs and whether to implement in-office rapid tests is at the dentist’s discretion.
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.
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.
The California Department of Public Health (CDPH) updated June 2021 its COVID-19 testing guidance describing available tests and detailing diagnostic testing, screening testing, post-exposure testing, and pre-entry testing.