The Massachusetts Dental Society is advising dentists across the state to delay patients’ elective and non-urgent care until May 18 amid the ongoing COVID-19 pandemic.
The recommendation was posted Monday to the society’s website.
The site says the organization “strongly recommends that Massachusetts dentists close their practices to patients seeking elective and non-urgent care until May 18.”
Governor Charlie Baker’s emergency order shuttering nonessential businesses and advising people to stay home except to get necessary items such as food and medication was extended Tuesday from May 4 until May 18. The order exempts medical facilities such as dental offices.
In a phone interview Tuesday, Dr. Janis Moriarty, president of the dental society, said, “We know for sure that it’s going to look very different” in dental offices going forward.
She said offices will have to maintain social distancing to the greatest extent possible, and “there certainly will not be crowded waiting rooms anymore." In addition, she said, “there may not be as many staff in the office at once.”
Moriarty said employees will be outfitted with protective gear including masks, gloves, gowns, and shoe and hair covers, and offices may have to consider extended hours and staggered work shifts to accommodate social distancing. She said individual dentists have the discretion to decide when they want to expand their offices to begin offering elective and non-urgent care again.
Asked about Baker’s extension of his emergency order to May 18, Moriarty said, “It does give us a nice amount of time to acquire the [protective gear] that we need to safely see patients. ... I think the majority of dentists hopefully will be ready to branch out and see more people come May 18.”
In a prior advisory, the society listed a number of procedures classified as “not immediately necessary,” including routine fillings that don’t address or prevent pain or restore normal oral functioning; crown and bridge cases that don’t involve severe decay or pain; recall exams and cleaning; dentures; all orthodontic procedures, including aligner therapy, that don’t address infection or restore oral function, aren’t related to trauma, or don’t relieve pain; cosmetic and aesthetic dentistry; and teeth whitening.
The advisory said procedures that are necessary and could be viewed as emergencies to be addressed immediately include toothaches involving fractured teeth with associated pain and severe decay; symptomatic endodontics; completion of cases, at a doctor’s discretion, that are in temporary stages; periodontal and endodontic abscesses; suture removal; orthodontics limited to trauma and trauma from orthodontic appliances such as wires and brackets; fractured prosthesis and limited adjustments; and extraction of symptomatic teeth “that likely do not require surgical intervention.”
“We strongly encourage dentists to consider all non-interventional treatments — such as prescribing antibiotics, appropriate pain killers, anti-microbial mouth rinses — prior to initiating any treatments,” the advisory said.
If treatment is necessary, the notice said, dental offices should take “added infection control mechanisms” including pre-operative mouthwash for patients; comprehensive use of rubber dam isolation and high-speed evacuation; strict adherence to OSHA materials guidelines; and strict adherence to proper hand hygiene and protocols for clinical gown and personal protective equipment use.
The advisory said patients with COVID-19 symptoms, as outlined by the Centers for Disease Control and Prevention and the state Department of Public Health, must delay dental treatment and seek immediate medical care.
“Please consider using all prescriptive tools necessary to delay treatment until further clearance and understanding of the COVID-19 pandemic is conveyed, and more supplies and training are available,” the advisory said. “Providers, staff, and patients should discuss the possibility of asymptomatic spread of COVID-19, without known exposures or contacts prior to initiating any dental treatment.”