The ODA continues to advocate for restoration of oral health services

Over the weekend, the ODA continued its advocacy to responsibly restore dentists’ ability to provide the full range of oral health services for Ohioans.
In order to preserve personal protective equipment (PPE) for the fight against the coronavirus, on March 17, the State of Ohio directed all health care providers, including Ohio’s dentists, to delay all non-essential procedures and surgeries. All dental offices were practically shut down overnight, only opening occasionally to provide emergency dental surgery to their patients to keep them out of hospital emergency rooms which are dealing with coronavirus patients. As PPE becomes more available, with additional production and importation of equipment and supplies, and the expansion of the ability to disinfect masks and other protective wear, the ODA is advocating that the Order to delay important health care procedures should be lifted.
On April 14, the ODA issued a statement to the Ohio House of Representatives Economic Recovery Task Force arguing for the lifting of the state Order delaying all non-essential health care procedures and surgeries.
The ODA statement makes clear:
“These small business dental offices, which work with high overhead because of the cost of equipment, materials, and staff, and narrow margins, are now teetering on the brink of insolvency. The state of Ohio cannot allow the destruction of the dental delivery system. These dentists are doing their part to assist with the coronavirus crisis by temporarily shutting down their businesses except for emergencies in order to preserve PPE per the State’s order. As soon as possible, these practices must be allowed to open up and provide the full range of treatment that Ohioans need.”
You can read the ODA’s full statement here.
Today (April 27), certain members of the Ohio House of Representatives released their plan: “Open Ohio Responsibly Framework – A Data Driven, Applied Science Approach for Opening Ohio for ALL Ohioans.” This framework is only a proposal and will need further discussion but it is a sign that Ohio is moving toward reopening its businesses, including dental offices.
The “Open Ohio Responsibly Framework” addresses some of the same themes the ODA addressed in its public statement to the House Economic Recovery Task Force including the following:
“We respect past concerns regarding not overwhelming our hospitals, health systems, front line healthcare workers and first responders as well as ensuring there is an adequate supply of Personal Protective Equipment for them. In Ohio, we believe we are now past that stage of concern.”
The “Open Ohio Responsibly Framework” concludes “We believe it is time to trust Ohioans. They have respectfully followed the guidelines and NOW is the time to responsibly open all businesses.”
You can read the “Open Ohio Responsibly Framework” here.
The ODA has also been working with the DeWine administration as it tries to balance considerations related to controlling the spread of COVID-19, including preservation of PPE, with opening up Ohio’s businesses and the economy. We have steadfastly reminded the administration that while we appreciate the concerns over COVID-19, we also believe there needs to be a strategy to allow dental practices to responsibly reopen so that Ohioans can get the important oral health services that they need.
On April 18, the DeWine administration specifically asked for the ODA’s recommendations for restarting non-essential and elective procedures. On April 19, the ODA reconvened its Task Force that had been dealing with COVID-19 issues to develop a framework for restoring oral health services in Ohio. The Task Force made up of ODA leaders sought input from the private practicing community, dental education, the Ohio State Dental Board and the ADA’s Task Force working on similar issues. Both general dentists and specialists were represented on the Task Force.
On April 21, the ODA submitted a proposed framework to Governor DeWine that is designed to allow expanded access to dental services for Ohioans. The ODA framework states:
“As Ohio begins the process to reopen its economy and businesses, the order to delay non-essential care should be lifted in order to ensure Ohioans have access to the full range of necessary health services including oral health care diagnosis and treatment. Studies show that good oral health care is essential to overall health and that untreated dental disease can lead to poor oral health outcomes, more invasive dental surgeries, and, eventually, aggravate systemic health issues. By lifting the restrictions, Ohio dentists will be able to reopen their businesses and bring their staff back to work. Most importantly, Ohioans will again have access to the dental care they need.”
The Framework includes both near term guidelines for providing dental care during the current COVID-19 pandemic and long term guidelines. In addition to many other near term recommendations, the framework includes the following:
  • Screen all patients for COVID-10 risk factors and take the temperature of all patients.
  • Have appropriate strategies related to scheduling patient appointments and in-office patient flow in order to minimize patient-to-patient contact and follow social distancing protocols.
  • Reiterate that all dental personnel must use appropriate PPE as dictated by the procedure performed, consistent with guidelines from the CDC and the American Dental Association, including masks, face shields, goggles, and fluid-impermeable gowns if applicable.
  • Reiterate that all dental offices must follow appropriate infection control protocols consistent with CDC guidelines.
  • Ensure that patients come alone for appointments (except for necessary interpreters, guardians of minors, and others needing assistance).
  • Utilize telephone triage and other strategies using remote technology to address specific patient concerns when appropriate, thereby reducing the number of unnecessary in-person appointments.
  • Utilize high volume suction and isolation strategies, such as rubber dams, when appropriate to limit exposure to aerosols.
  • Have specific protocols for patients with pre-existing comorbidities, or are immunocompromised or are otherwise high risk.
The long term guidelines include a recommendation that dentists should be authorized to administer any newly developed and authorized tests to determine whether a person has developed COVID-19 antibodies. The ODA framework points out that dental offices are uniquely positioned to assist in this area since they are located in nearly every community in Ohio. Such serology testing will be crucial to further expand economic activity and may help determine whether patients are eligible to donate plasma for COVID-19 treatments. The results of the testing may also benefit patients as they get dental and other health care services by giving providers important information to determine the appropriate precautions (including related to PPE, etc.).
Over this past weekend, when social media posts provided conflicting versions of what would be expected of dental offices if they are allowed to reopen, the ODA reiterated its message to policymakers that the ODA recommends that all dental offices follow PPE and infection control guidelines established by the CDC and the American Dental Association. The Ohio State Dental Board’s rules have mandated that dentists follow such guidelines for decades. Those guidelines have been updated to provide guidance in the current COVID-19 pandemic, and will continue to be updated as the science evolves.
Ultimately, it will be up to the state to decide when to lift its order delaying non-essential health care procedures and surgeries. The ODA has provided the state with a responsible framework that allows dental offices to re-open to provide the dental care that Ohioans need with appropriate protocols that ensure patient and dental worker safety.