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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
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The U.S. Department of Health and Human Services (HHS) has announced the deadline to apply for Phase 2 General Distribution Funding has been extended to September 13, 2020. This deadline applies to:
- Dentists who have directly billed their state Medicaid/Children’s Health Insurance Programs or Medicaid managed care plans for oral health care services
- Dentists who have directly billed health insurance companies for oral health care services
- Dentists who do not accept insurance and have directly billed patients for oral health care services
Dentists are eligible for these relief funds even if previously receiving Small Business Administration EIDL and/or PPP loans. These have no impact on the HHS relief funds.
For more information on the application deadline extension click here.
The AAPD and ADA recommend that dentists who participate in Medicaid and CHIP programs apply for the Medicaid and CHIP Distribution. A fact sheet is available here.
For dentists who don’t participate in Medicaid/CHIP, the AAPD and ADA recommend application through the Enhanced Provider Relief Payment Portal.
Note that for either application, the same portal is used.
HHS has updated its FAQs to address common questions, including expanded information on eligibility, application, payment process, and more. HHS also offers webinar recordings, available here: HHS Webinar Recordings
For help with the application process, HHS has set up a Provider Support Line, 866- 569-3522, to assist with questions. The hours of operation are 7 a.m. to 10 p.m. CST, Monday – Friday.
The ADA has also prepared a FAQ for dentists concerning the relief funds. -
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.
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On August 4, 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 Response originally released on May 21, 2020. The AAPD and ADA have engaged in ongoing communications with the CDC to help ensure consistency between the CDC guidance, ADA toolkit and AAPD practice re-emergence checklist.
The key points of the update are summarized as follows:
- Recognize dental settings have unique characteristics that warrant specific infection control considerations.
- Prioritize the most critical dental services and provide care in a way that minimizes harm to patients from delaying care and harm to personnel and patients from potential exposure to SARS-CoV-2 infection.
- Proactively communicate to both personnel and patients the need for them to stay at home if sick.
- Know the steps to take if a patient with COVID-19 symptoms enters your facility.
This updated guidance complements the following CDC guidance documents:
- Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings
- Framework for Healthcare Systems Providing Non-COVID-19 Clinical Care During the COVID-19 Pandemic
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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.
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On June 5, the President signed into law the Paycheck Protection Program Flexibility Act, which will reform the Paycheck Protection Program (PPP) to give small businesses more time and flexibility to use their funds. Advocated by the AAPD and the Organized Dentistry Coalition, the bipartisan legislation passed the House on May 28 and the Senate on June 3. The new act applies to pediatric dentists who have or will receive funds from the PPP — a loan established by the Coronavirus Aid, Relief, and Economic Security Act. This act will extend the following benefits:
- Increase the Paycheck Protection Program loan forgiveness coverage period from eight weeks to 24 weeks
- Defer payroll tax for borrowers
- Deferring Paycheck Protection Program loan repayment for 10 months instead of 6 months
- Allowing borrowers to use 40 percent of PPP funds to pay for non-payroll expenses
- Extending the rehiring deadline for dental practice employees
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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.
Helpful Resources:
Substance Abuse and Mental Health Services Administration National Helpline, 1-800-662-HELP (4357), or TTY: 1-800-487-4889
Anxiety and Depression Association of America
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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.
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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.
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The AAPD Safety Committee is proud to offer its new guide for re-entry into practice uniquely designed for pediatric dentists. This comprehensive online publication will answer many of your most pressing questions to protect patients, families and staff from COVID-19 – including recommendations about personal protective equipment. It will help you prepare for re-emergence in view of the far-reaching effects of the pandemic. Topics:
- Pre-Emergence Processes
- Practice Ramp Up Schedule Considerations
- Situations Unique to the Specialty of Pediatric Dentistry
- Point-of-Care Considerations/Operatory Environment
- Business and Practice Administration Considerations
Follow this checklist to get back to caring for children in ways that are safe for them, their families, your staff and yourselves. Click here to view the checklist.
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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.
Coming Wednesday: The AAPD Safety Committee will offer its Re-emergence Pediatric Dentistry Practice Checklist: A guide for re-entry into practice for pediatric dentists during the SARS-CoV-2 pandemic. To be located on this website, this comprehensive online publication will answer many of your most pressing re-opening questions. The toolkit and its contents will be discussed in "AAPD Townhall: Sound Science for Reopening Your Practice" to be held Tuesday, April 28, 5:30 PM Central Time. Register here.
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.