The Ohio State Dental Board released the following advisory today regarding the spread of COVID-19:

The State Dental Board has been closely monitoring the spread of the coronavirus. As Dentists, Hygienists & staff we are a part of the healthcare community and have a responsibility in the prevention and mitigation efforts of the administration during this outbreak. Dentists are also in of the highest risk categories for both transmission and contraction of the Coronavirus as a majority of the procedures we perform creates significant aerosols in the operatories. As a part of the healthcare community and the community at large, we have to protect the safety of our patients and staff. The OSDB is closely monitoring the situation and decided to have these recommendations to the practicing dentists. This is a very difficult decision, but it comes at a critical time and it is our responsibility to take leadership in this situation and have protocols in place to reduce the spread and impact of Coronavirus amongst the communities we practice and live. The plan & recommendations will change as the situation demands and evolves.

These recommendations to the dental profession are intended to reduce the risk of patients' exposure to COVID-19 and to preserve PPE and supplies, while still allowing access to necessary and emergency dental services that will maintain the oral health of the citizens of Ohio and keep them out of the hospital ER.

Governor Mike DeWine contacted the Board and the Ohio Dental Association and asked for our help in addressing the spread of COVID-19. As integral parts of the medical community, we are being called to review our inventories and appointment books, and make the adjustments to provide mutual aid and relief to our partners in the medical and surgical communities.

Governor DeWine has requested the following:

A review of inventories and identification of any surplus personal protective equipment and supplies.

Once identified, contact your local Emergency Management Agency about sharing these goods with local hospitals and medical clinics for COVID-19 patients and clinicians. 

Please reschedule elective procedures including but not limited to:

• Any cosmetic or aesthetic procedures, such as veneers, teeth bleaching, or cosmetic bonding
• All routine hygiene appointments
• Any orthodontic procedures not including those that relieve pain and infection or restore oral function or are trauma-related
• Initiation of any crowns, bridges, or dentures that do not address or prevent pain or restore normal oral functioning
• Any periodontal plastic surgery
• Extraction of asymptomatic non-carious teeth
• Recall visits for periodontally healthy patients
• Delay all appointments for high risk patients, including ASA 2 and 3 patients, unless it is an emergency
By sharing supplies we are directly supporting our fellow clinicians as they undertake the greatest viral threat in modern history. By rescheduling elective procedures we are doing our part to prevent community spread. We urge you to undertake the two above strategies and consider the following additional measures:
o Use cell phone triage - use the cell phone to take a picture of the area and text to the dentist
o Have a detailed questionnaire/conversation before scheduling appointments and prior to any procedure about flu like symptoms, travel abroad for self and family/friends/co-workers etc. to permit a thorough evaluation of the patient
o Consider taking the temperature of the patient at the outset
o Reconsider scheduling high risk patients unless they need emergency treatment
o Careful evaluation of the need for scheduling of ASA 2 & 3 patients
o Use of 1 % hydrogen peroxide rinse prior to examination of the oral cavity by the patient to reduce microbial load
o Use of rubber dam isolation & high volume suction to limit aerosol in treatment procedures
o Proper disinfection protocol between patients with a possible repeat of the protocol for a 2nd time.
To prevent over-crowding of waiting areas or the possible spread of infection:
  • Consider having patients wait in their cars instead of the waiting areas to prevent inadvertent spread of the virus (call patient when surgical area is ready for treatment)
  • Consider staggering appointment times to reduce waiting room exposure
  • Consider rescheduling elective procedures on ASA 2 & 3 patients (https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system)
  • Have front desk staff take measures to prevent exposure
    Have sterilization staff, lab technicians and auxiliary staff take adequate measures to prevent exposure
  • Limit access to waiting room use to only patients. Accompanying individuals have to wait in their respective transportation
  • Remove all magazines/toys etc. from waiting area to prevent contamination
If you have questions regarding the COVID-19 announcement by the Ohio State Dental board, please kindly contact a member of Reminger's Dental Liability Practice Group.

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