Dental practices across the nation are just one category of small businesses that have suffered, both economically and logistically, due to the near-national shutdown in response to the COVID-19 pandemic. And as lawmakers are working on the next relief package, the American Dental Association, on behalf of its 163,000 members, is urging Congress to include language to assist the dental industry in the process of recovery.

The ADA is making a few key recommendations to legislators:

1. Increase flexibility within the Paycheck Protection Program. ADA representatives are asking that the loan forgiveness guidelines allow individual small businesses to make their own decisions regarding payroll and staffing based on individual plans to reopen.

Dentists would like to see Paycheck Protection Program (PPP) loan funds allowed for purchasing additional personal protective equipment (PPE), making safety improvements to offices, and qualifying for tax credit.

2. Allow nonprofit dental and medical organizations to have access to the Paycheck Protection Program or future small business loan programs.

3. Execute better oversight for the distribution and loan forgiveness process in the Coronavirus Aid, Relief, and Economic Security (CARES) Act for PPP loans to guarantee that only those small businesses that were economically distressed as a result of the pandemic receive the funds and forgiveness.

4. Ramp up the production of PPE with more focused distribution to healthcare workers, including dentists.

5. And a big one:Extend the Department of Health and Human Services’ authority to allow licensed dentists to conduct FDA-authorized COVID-19 diagnostic tests until the end of the year.

This last recommendation is an important one as it would help alleviate the burden of hospital emergency rooms across the country who are coping with the pandemic.

Dentists can visit the Legislative Action Center to contact their legislators today regarding these recommendations. For the latest information on COVID-19, visit ADA.org/virus.

To help assist and guide dentists across the nation who are reopening their practices as state mandates are lifted, the ADA issued an updated statement and interim guidance April 18 on the specific personal protective equipment recommended in order to practice during the COVID-19 pandemic as well as guidance on ways to minimize the risk of virus transmission.

The ADA is regularly communicating with the Federal Emergency Management Agency and other relevant organizations to advocate that dentists should be prioritized for PPE as essential healthcare workers.

Beginning on March 16, the governing organization asked dentists nationwide to postpone non-urgent dental procedures through the end of April in order to help slow the spread of COVID-19. The recommendation was also made to conserve essential PPE for medical frontline colleagues and first responders. These measures would also keep those patients away from overburdened hospital emergency departments. In other words, emergency dental cases could still be seen in dental practices.

According to the April 18 statement, “The ADA recognizes that local or state government decisions regarding closures, including restrictions regarding elective health care, supersede ADA recommendations. In addition, local and state health departments, state dental societies and, in some cases, large urban local dental societies may better understand local disease transmission rates and conditions and make more informed recommendations regarding elective dental care availability.”

In his daily press conference, President Donald Trump recently indicated that many states will be able to reopen by May 1. On April 16, he shared federal guidelines for loosening some restrictions. State and local governments in some states are now considering reopening certain businesses considered “essential,” which include dental practices, as they slow-roll their communities back into normal operations.

The ADA statement sums it up this way: “The longer dental practices remain closed to preventive care and treatment for early forms of dental disease, the more likely that patients’ untreated disease will progress, increasing the complexity and cost for treatment down the road. The safety of patients, dentists and dental team members has been and always will be ADA’s utmost concern.”

With its recently formed ADA Recovery Task Force, the ADA is adding additional resources regularly. You can find all ADA guidance at ADA.org/virus.

As with most medical practices in America today, the vast majority of dental practices are limiting care to urgent and emergency cases to limit exposure to COVID-19, preserve personal protection equipment (PPE) and reduce the burden on the healthcare system at large.

But as these recommendations and restrictions are put in place, some dental practices might not be sure about what qualifies as urgent and emergency treatment — or what to do once these patients come into their offices.

As you know, oral health is closely connected to overall health. So, if a patient has a dental emergency, the possibility does exist that it is potentially life-threatening and requires immediate attention from a dental professional. Postponing non-essential procedures during this time of social distancing allows dentists to focus on patients who need emergency care during the coronavirus pandemic of 2020.

If you haven’t already done so, communicate to your patient base that patients should postpone all non-emergency dental examinations, including but not limited to routine cleanings, aesthetic dental procedures and restorative dentistry.

Reserve your appointments for true dental emergencies. These can include people experiencing severe dental pain, those who have dental infection symptoms such as bleeding and swelling and/or those experiencing a dental infection-related fever. Let patients know if they are experiencing any of these symptoms, they should contact your office immediately for an emergency appointment.

If your clinical team needs help determining whether or not a patient’s issue is emergent, consider the following list of questions to ask patients before scheduling an appointment, per American Association of Endodontists President Keith V. Krell:

• What symptoms are you experiencing?
• Do you have a fever?
• Is your tooth sensitive to hot and cold foods?
• Are you experiencing bleeding or swelling in your mouth, gums, etc.?
• On a scale of 1 (lowest) to 10 (highest), how much pain are you experiencing in your tooth?
• Is the pain spontaneous, constant or provoked by temperature, chewing, etc.?

If a patient’s issue is deemed to be a true dental emergency that needs to be addressed, the following tips can help make sure everyone involved — your clinical team and your patients — stay safe during an appointment.

• Ask screening questions about travel history and signs or symptoms of infection.
• If a patient is experiencing signs of acute respiratory illness upon arrival, patient should be given a disposable surgical mask and placed in a single-patient room with the door closed.

For more information on recommendations on managing treatment during the coronavirus outbreak, visit the website of your local state authorities as well as: