At this live webinar/call on Wednesday, 6/3 from 2:00pm-3:00pm (ET), a panel from the CDC Division of Oral Health, the Infection Control Team and Worker Safety Team will review the updated guidance for dental offices that includes non-emergency dental care guidelines. Participants can engage with the panel through a Q&A session following the discussion. Slides will be available following the webinar/call, and interested parties who are not available for the live discussion can also find it recorded on the Clinician Outreach and Communication Activity (COCA) webpage, here.
The Centers for Disease Control and Prevention (CDC) released new Guidance for Dental Settings: Interim Infection Prevention and Control Guidance for Dental Settings During the COVID-19 Response 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 recent changes are summarized as follows:
- Recommendations are provided for resuming non-emergency dental care during the COVID-19 pandemic.
- New information is included regarding facility and equipment considerations, sterilization and disinfection, and considerations for the use of test-based strategies to inform patient care.
- Expanded recommendations for provision of dental care to both patients with COVID-19 and patients without COVID-19.
This guidance is a supporting document for these earlier CDC recommendations:
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.
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.
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.
On April 23, the House of Representatives passed a new coronavirus relief bill calling for additional funding for federal loan programs to help dental practices, as well as other businesses, recover from the economic fallout of the pandemic, which was signed into law by the President the following day. The Paycheck Protection Program and Health Care Enhancement Act infuses $370 billion into the Paycheck Protection Program, Economic Injury Disaster Loans, and emergency Economic Injury Disaster Loans grants. Learn more here.
Visit the SBA website here to determine the current status for new applications for the Paycheck Protection Program and the Economic Injury Disaster Loan (including Advances) based on available appropriations funding. Applicants who have already submitted their applications will continue to be processed on a first-come, first-served basis.
The following article summarizes the two Small Business Administration (SBA) loans available to dental practices. View the article here.
Immediately after passage of the CARES Act both ADA and AAPD strongly urged dentists to apply quickly for the SBA EIDL and then PPP loan, because funding was on a first come/first serve basis, and funds might runs out. This was emphasized in the April 1 AAPD podcast of Pedo Teeth Talk where Dr. Joel Berg interviewed Mike Graham, head of the ADA Washington D.C. office.
The AAPD continues to participate in efforts with the ADA to modify the PPP legislation to provide additional funding, streamline the SBA loan application process and allow dental practices to choose the 8-week period for which they can seek loan forgiveness and rehire staff. Learn more about the letter sent by a strong dental coalition consisting of the AAPD and many of our state pediatric dentistry chapters here.
In related news, the AAPD joined a strong coalition of dental organizations in a request for immediate financial assistance for dentists across the country from the Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services. The letter strongly recommends that HHS provide immediate access to capital by releasing funding from the CARES Act Provider Relief Fund to dentists that are Medicaid providers and serve as critical access points for oral health care to lower income Americans. Learn more here.
The Coronavirus Aid, Relief and Economic Security (CARES) Act includes a significant increase in funding of $349 billion to the Small Business Administration (SBA) to guarantee loans to small businesses to help alleviate economic injury directly caused by the coronavirus. These loans may be used to pay for employees’ COVID-19-related sick leave, mortgage or rent, and other overhead expenses. For the latest information from the ADA about these loans and the circumstances in which they must be utilized, click here.
The SBA COVID-19 Economic Injury Disaster Loan (EIDL) is now available to employers in all U.S. states, Washington D.C., and territories. It offers small business owners impacted by COVID-19 the opportunity to obtain up to a $10,000 Advance on their EIDL. To ensure that the greatest number of applicants can receive assistance, Advance amounts will be determined by the number of employees as of January 31, 2020. The Advance will provide $1,000 per employee up to a maximum of $10,000.
Since the EIDL 7(b) loans are awarded on a first-come, first-served basis, online applications should be completed promptly. You will find the updated EIDL Application page here. If the SBA website is overloaded, the ADA recommends it may be best to apply after 9 p.m.
The CARES Act also created a new Paycheck Protection Program (PPP) Loan. Starting April 3, 2020, small businesses and sole proprietorships can apply for and receive PPA loans to cover their payroll and other certain expenses through existing SBA lenders. Understanding these options and determining what is best for your practice can be confusing. We strongly encourage that you review this fact sheet prepared by the ADA and Academy of Dental CPAs. In addition, the SBA has released the loan application for the PPP. Comprehensive information from the SBA on loan opportunities can be found here.
Any information you may have seen suggesting that both EIDL and the PPP Loan cannot both be applied for is incorrect. A former draft of the CARES Act would have prohibited this, but last minute negotiations changed that prohibition. Further, the ADA understands that you can roll your EIDL loan into the PPP loan. An EIDL grant/advance of up to $10,000 will be deducted from any loan forgiveness someone receives if they roll the EIDL into the PPP, but not the full EIDL amount. ADA encourages dentists to get both and then roll in the EIDL for better loan terms on any of the remaining balance from the combined loan after receiving assistance.
The AAPD also supports efforts by the ADA to modify the PPP legislation to allow for more flexibility in timing for use of the funds. Click here to learn more.
The U.S. Chamber of Commerce has also provided a Coronavirus Emergency Loans Small Business Guide and Checklist, which can be accessed here.
The AAPD continues to strongly recommend that you should also contact your main practice lender bank for other sources of relief from current loan payments such as deferred payment, interest-only payments, and/or short-term low interest loans. Pediatric dentists have reported favorable outcomes utilizing this approach.
Information on the COVID-19/Coronavirus changes almost daily and the American Academy of Pediatric Dentistry urges its members to keep current on the evolving science and best practices to protect themselves and the families they care for. The fast spread of this illness and the world’s inexperience with it make staying current even more important:
- Keep abreast of changes in understanding and addressing the virus. This means following the course of the virus every day. Government and professional health organizations provide the most up-to-date and accurate information. Some sites you may find useful are:
- Avoid claims and information from non-mainstream and non-reliable or unverified sources which may provide erroneous and even dangerous advice or recommendations.
- Evaluate the need for precautions and changes in your personal behavior based on sound information. Work, travel, meeting attendance, and other potential sources of exposure are usually addressed in guidance by reliable sources. AAPD will advise its members of changes and precautions related to meetings and other events, based on sound science and best practices in advance. We are looking to the CDC and WHO to provide recommendations on travel. At this time, there are no bans or suggestions not to travel within the U.S. Learn more here.
- Practice-related precautions should follow the advice of recognized authorities. Members should keep abreast of recommendations at the local, state, and national level that relate directly to their individual circumstances. State and county health departments are good sources of information relative to local circumstances.
- This virus has demonstrated the need for personal responsibility in controlling its spread. This means attention to your own risk status, current health, and the health of your family. This is especially important for those who are at greater risk of infection, such as the elderly and those with weakened immune systems. Taking recommended steps to minimize spread of infection while ensuring that you seek and receive the appropriate care is the best advice. Your personal physician and local health authorities remain the best sources of information should you have questions about or require care for suspected infection.
AAPD will closely monitor information as it emerges and when necessary, advise members of changes and recommendations that will protect them, their families and their patients, and help them plan for future events.
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.