Ohio dentists under order to delay all non-emergency care

All licensed Ohio dentists are currently under an order to provide only emergency care in order to preserve personal protection equipment (PPE) and reduce the chance of exposure to coronavirus (COVID-19). Over the last month, Gov. Mike DeWine and Director of the Ohio Department of Health Dr. Amy Acton have taken a series of steps to reduce the potential spread of coronavirus and preserve PPE and, in furtherance of those goals, on March 17, 2020, the state of Ohio announced that “all non-essential or elective surgeries and procedures that utilize PPE should not be conducted.”

The Ohio State Dental Board issued a directive to dentists with guidance on providing patient care during the state of emergency. The directive states that the following procedures should be delayed:

  • 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

The Ohio State Dental Board also urged dentists to consider the following additional measures:

  • Use cell phone triage – use the cell phone to take a picture of the area and text to the dentist
  • 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
  • Consider taking the temperature of the patient at the outset
  • Reconsider scheduling high risk patients unless they need emergency treatment
  • Careful evaluation of the need for scheduling of ASA 2 & 3 patients
  • Use of 1% hydrogen peroxide rinse prior to examination of the oral cavity by the patient to reduce microbial load
  • Use of rubber dam isolation & high volume suction to limit aerosol in treatment procedures
  • Proper disinfection protocol between patients with a possible repeat of the protocol for a second time.

Finally, the OSDB provided this list of ideas 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 (see 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.

The order to delay all non-essential surgeries or procedures remains “in full force and effect until the State of Emergency declared by the Governor no longer exists, or the Director of the Ohio Department of Health rescinds or modifies” the order.

For the latest updates on this order and other information related to COVID-19, visit https://www.oda.org/member-center/resources/covid-19/.