The AAPD has joined other dental and medical organizations in a letter to the Centers for Disease Control and Prevention (CDC) to endorse the inclusion of dental, laboratory and autopsy personnel in the recommendation of the Advisory Committee on Immunization Practices to give health care personnel priority access to COVID-19 vaccines. The letter strongly urges that this clarification be reflected in the Vaccination Playbook for Jurisdictional Operations, a guidance document on the national strategy for vaccine response during the COVID-19 pandemic. Click here to read more.
Update: The Centers for Disease Control and Prevention (CDC) clarified the definition of healthcare personnel in a new guidance document on vaccine allocation to healthcare workers. The definition includes dentists, dental assistants and dental hygienists, as well as all other healthcare workers who have direct contact with patients and potentially infectious materials. Click here for more information.
The U.S. Department of Health and Human Services (HHS) is providing more than $24 billion in new relief to more than 70,000 healthcare providers, according to a December 16 news release, which can be accessed here.
The HHS has completed its review of Phase 3 applications from the Provider Relief Fund program, and the next round of payment distributions is now underway and will continue through January, 2021. Up from the $20 billion originally planned, the addition of another $4.5 billion in funding is being used to satisfy close to 90 percent of each applicant’s reported lost revenues and net change in expenses caused by the coronavirus pandemic in the first half of 2020.
The HHS provides a state-by-state breakdown on the first batch of Phase 3 payments that will be updated until distribution closes at the end of January.
The AAPD has worked closely with the ADA and other dental organizations to ensure dentists were included in the Provider Relief Fund through HHS and the Health Resources and Services Administration, which administers the fund. For more information on the Phase 3 distributions and advocacy efforts, view the ADA News article here.
Along with over 500 national and state/regional trade associations, the AAPD has urged Congress to take action to reverse an IRS technical rule, IRS Notice 2020-32 to preserve the original intent of the Paycheck Protection Program (PPP) through the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The rule being challenged indicates, “no deduction is allowed under the Internal Revenue Code…if the payment of the expense results in forgiveness of a covered loan pursuant to section 1106(b) of the [CARES ACT].” In effect, the surprise notice alters the original agreement that PPE loans will be forgiven in a tax-free manner. Click here to read the letter.
Results from the latest ADA HPI COVID-19 poll show that dentists are experiencing an economic and emotional toll from the COVID-19 pandemic as practices report lower patient volumes, decreases in profitability and moderate to substantial increases in the costs of operations. The survey has an accompanying webinar for curious dentists and practice managers on the significance of these results. This week’s topics include an update on the latest data, potential retirement trends, the COVID-19 impact on profitability, strategies to reduce aerosols, student loan repayment and more. Click here to watch.
You have your finger on the pulse of your own practice, but how are your colleagues faring – within your own state as well as across the country? The AAPD Pediatric Oral Health Research and Policy Center is proud to offer Re-emergence: A Report on Pediatric Dental Practice Re-entry into Practice During the COVID-19 Pandemic. This visually appealing report is based on a survey to members of the AAPD Public Policy Advocate Initiative during the first wave of the COVID-19 pandemic. Intended to assess the pandemic’s impact on pediatric dental care, the survey honed in on significant questions of the moment to inform us on what we can expect looking forward. Click here to read.
Newly released data from the Centers for Medicare & Medicaid Services (CMS) provide a snapshot of the impact of COVID-19 on service utilization for children enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). The preliminary findings show that services for children have dropped across a number of health care fields, including oral health.
While enrollment in Medicaid and CHIP has increased, the data show a decline in service use among children in March through May of this year compared to the same period last year in the following key domains:
- 69 percent fewer (7.6 million) dental services
- 44 percent fewer (3.2 million) child screening services
- 22 percent fewer (1.7 million) vaccinations for children under age 2
- 44 percent fewer (6.9 million) outpatient mental health services
Medicaid and CHIP cover nearly 40 million children, including those living in low-income families and those with special health care needs. More information on the newly released CMS data can be found here.
On August 28, the Centers for Disease Control and Prevention (CDC) updated its Guidance for Dental Settings: Interim Infection Prevention and Control Guidance for Dental Settings During the COVID-19.
The AAPD and ADA engage in ongoing communications with the CDC to help ensure consistency between the CDC guidance, ADA toolkit and AAPD practice re-emergence checklist.
The recent changes to the update are summarized as follows:
- The definition of fever was updated to either measured temperature ≥100.0°F or subjective fever to align with CDC’s Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 Pandemic.
- In areas with moderate to substantial community transmission, during patient encounters with patients not suspected of SARS-CoV-2 infection, the CDC recommends that dental healthcare personnel use an N95 respirator or a respirator that offers an equivalent or higher level of protection during aerosol generating procedures; and wear eye protection in addition to their facemask to ensure the eyes, nose, and mouth are all protected from exposure to respiratory secretions during patient care encounters, including those where splashes and sprays are not anticipated.
- New language states that protective eyewear (e.g., safety glasses, trauma glasses) with gaps between glasses and the face likely do not protect eyes from all splashes and sprays.
- The update includes additional guidance on physical distancing and how to respond to SARS-CoV-2 exposures among DHCP and others.
This updated guidance complements the following CDC guidance documents:
- Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic
- Framework for Healthcare Systems Providing Non-COVID-19 Clinical Care During the COVID-19 Pandemic
The American Academy of Pediatric Dentistry (AAPD) opposes the August 3rd World Health Organization’s (WHO) recommendation to delay “routine” oral health care – including dental check-ups, cleanings and preventive care – until there has been further reduction in COVID-19 transmissions.
“Now more than ever, we want our patients’ families to know that dental care for children is a medical necessity,” stated AAPD President Jessica Y. Lee, DDS, MPH, PhD. “We continue to provide the highest quality of care possible while keeping children, staff and ourselves safe.”
The American Dental Association (ADA) respectfully yet strong disagrees with the WHO recommendation, as do other U.S. dental organizations. “Oral health is integral to overall health. Dentistry is essential health care because of its role in evaluating, diagnosing, preventing or treating oral diseases, which can affect systemic health,” according to ADA President Chad P. Gehani, D.D.S. “Millions of patients have safely visited their dentists in the past few months for the full range of dental services. With appropriate PPE, dental care should continue to be delivered during global pandemics or other disaster situations.” Read more here.
In a responding email to global leaders on August 13, WHO Chief Dental Officer Benoit Varenne, Ph.D., expressed his concerns about media coverage of the interim guidance: "A number of media headlines…did not mention that the recommendation to delay routine oral health care is only suggested in an intense uncontrolled community transmission scenario. A scenario that [does] not fit with the current situation of [most countries] around the world. Please be aware of the missing information sometimes disseminated by the media that could increase fear and concern of patients seeking oral health care."
“Pediatric dentistry has an impeccable history of evidence-based knowledge and practice in infection control, and we continue working hard to reduce the spread of germs among our patients in our office,” Lee said. “During this pandemic, we have stepped up our cleaning practices along with our personal protective equipment to protect patients and staff from potential exposure to COVID-19.”
The AAPD urges pediatric dentists to follow the highest level of infection control guidance from the U.S. Centers for Disease Control and Prevention (CDC). Pediatric oral health providers must provide necessary services while minimizing risk to patients and personnel, as well as consult their state dental boards and health departments for local practice requirements. Learn more here.
The AAPD offers continual updates on the impact of COVID-19 on pediatric practice, and its Re-emergence Pediatric Dentistry Practice Checklist, a comprehensive online publication features up-to-the-minute information on how to protect patients, families and staff from COVID-19.
The ADA’s Advisory Task Force for Dental Practice Recovery has developed a free toolkit for members offering interim guidance on measures to help protect patients, staff and dentists from COVID-19 as dental practices re-engage in providing the full range of oral health care. The toolkit includes:
- Sample letter to patients
- Guidance on pre-appointment screening
- In-office patient registration procedures
- Reception area preparation strategies
- Chairside checklist
- Staff protection strategies
- Supplies shopping list
To receive a copy, visit this ADA site and fill out the form for a link to the toolkit.
The AAPD has joined the Organized Dentistry Coalition in a letter to the leaders of the U.S. Senate and House of Representatives that outlines policy priorities to be included in the next COVID-19 relief package. The letter can be accessed here. This request for important support to dental practices includes:
- Tax credits to small businesses for the purchase of additional personal protective equipment (PPE) and safety improvements
- Temporary and targeted liability protection to small businesses
- Additional flexibility for the Paycheck Protection Program (PPP) loans
- Incentives for health care practitioners to work in health-disadvantaged communities that have been further undermined by COVID-19
In view of the success of previous advocacy efforts, the AAPD predicts a positive step forward in Congressional efforts to combat the challenging effects of the COVID-19 pandemic on pediatric dentistry.
Please join the APPD on Tuesday 6/9 at 9:00am (CST) for the upcoming Pedo Teeth Talk, Taking care of Yourself, Your Mental Health and Wellbeing. In this exceptionally important podcast, Dr. Sheela Raja, Clinical Psychologist, and expert on post-traumatic stress, talks with us about doing a survey of ourselves and our well-being, helping us deal with difficult feelings and times, and how to get help for ourselves and others. We ARE all in this together and Dr. Raja is here to help us get through some of the most challenging times in generations. Join us on Tuesday or listen any time after at your convenience. Click here to listen.
Substance Abuse and Mental Health Services Administration National Helpline, 1-800-662-HELP (4357), or TTY: 1-800-487-4889
Many children are at a greater risk for child abuse and neglect (CAN) due to stay-at-home orders. As each state resumes dental care, pediatric dentists are in a unique position to identify CAN. In fact, two to three out of four CAN cases involve trauma to mouth, face, and head. This report by Dr. Homa Amini, DDS, MPH, MS of The Ohio State University and Nationwide Children’s Hospital illustrates a severe case of CAN.
What to say to families coming back to your practice? This new AAPD resource gives concise positive answers to parent questions about treatment, appointments, dental emergencies and other topics related to the oral health care of their children. It lets families know that even though the office may look a bit different, you continue to provide the highest quality of care possible while keeping children safe and comfortable during the dental visit. You can use the fact sheet in conversations with parents, email it to families, and post it on your website and Facebook page. It can be adopted as is or modified to suit your practice. And don’t forget to share it with your referring dental and medical offices.
AAPD COVID-19 Resources
AAPD has provided additional resources regarding infection control, practice and staff management, emergency care, office closures/limited services and COVID-19 status.