About ADHA

ADHA COVID-19 Updates for Dental Hygienists

The health and wellness of the dental hygiene community and the patients you serve is our top priority. ADHA has been engaged with the CDC Division of Oral Health (DOH) advocating for clear guidance for dental practices. On March 27, 2020, the DOH released COVID-19 guidance for dental settings. .

CDC: Interim Infection Prevention and Control Guidance for Dental Settings During the COVID-19 Response

3/27/2020

Key Concepts

  • Dental settings have unique characteristics that warrant additional infection control considerations.
  • Postpone elective procedures, surgeries, and non-urgent dental visits, and contact patients prior to emergency procedures. Stay at home if sick and know steps to take if a patient with COVID-19 symptoms enters your facility.
  • Click here for a summary of statements made by federal officials regarding COVID-19 and oral health.

      In a March 17, 2020, White House Coronavirus Task Force press briefing, White House COVID-19 response coordinator Dr. Deborah Birx recommended that hospitals and dentists cancel all elective surgeries over the next two weeks in order to free up hospital beds and space. The task force has stated that its recommendations are not mandatory. [Source: White House Press Briefing ]

      On March 18, 2020, the Centers for Medicare & Medicaid Services (CMS) released recommendations to conserve personal protective equipment, beds and ventilators and limit the exposure of patients and staff to COVID-19. CMS recommended that all non-essential dental exams and procedures be postponed until further notice. CMS also recommended postponing or canceling non-essential adult elective surgery and medical and surgical procedures, and making case-by-case evaluations on whether a planned surgery should proceed. CMS suggested considering a number of factors, such as the patient’s health and age and the urgency of the procedure. CMS also provided examples of surgeries and procedures that would be appropriate to delay and others that would be permissible to continue to perform.

      On March 19th, this was further clarified during a press briefing when the CMS Director announced the following: “To aggressively address COVID-19, CMS recognizes that conservation of critical resources such as ventilators and Personal Protective Equipment (PPE) is essential, as well as limiting exposure of patients and staff to the SARS-CoV-2 virus. Attached is guidance to limit non-essential adult elective surgery and medical and surgical procedures, including all dental procedures. These considerations will assist in the management of vital healthcare resources during this public health emergency. Dental procedures use PPE and have one of the highest risks of transmission due to the close proximity of the healthcare provider to the patient. To reduce the risk of spread and to preserve PPE, we are recommending that all non-essential dental exams and procedures be postponed until further notice.” [Source: https://www.cms.gov/files/document/31820-cms-adult-elective-surgery-and-procedures-recommendations.pdf]

      On March 20th, the Centers for Disease Control and Prevention (CDC) followed both of the above recommendations to further clarify their previous guidance by recommending that “dental facilities postpone elective procedures, surgeries, and non-urgent dental visits, and prioritize urgent and emergency visits and procedures now and for the coming several weeks.” [Source: https://www.cdc.gov/oralhealth/infectioncontrol/statement-COVID.html]. We are expecting new guidance specific to dental practices and professionals to be issued by the CDC Division of Oral Health in the next few days, but the statement on March 20th made it clear postponing dental procedures applies to all dental patients, not just those patients who have signs or symptoms of respiratory illness as stated in our March 18th guidance.

      On March 22nd, the Surgeon General of the U.S., Vice Admiral Jerome Adams, reiterated this call to postpone dental procedures in an interview with USA Today, stating: “As a member of the president’s Coronavirus Task Force — and a practicing physician — I am calling on all hospital systems to heed federal recommendations and cancel or delay nonessential elective procedures in a way that minimizes potential harm to patients. These include dental procedures as well.” He then outlined the reasons that this postponement was needed and emphasized that this is a temporary issue. [Source: Official Surgeon General Twitter Account]

In addition to ongoing communication with CDC and other federal agencies, we are also listening to individuals. As we respond to a high volume of calls, emails and messages, we want to assure you that you are being heard. Your concerns are real — and critically important. We are unwavering in our commitment to support dental hygienists everywhere, and to provide answers and the leadership you deserve as we navigate this challenging time.

ADHA recognizes the extraordinary circumstances dental hygienists and all health care professionals face related to COVID-19.

ADHA Action Center

Ways you can make a difference and elevate the voice of our profession during this critical time.

  • Congressional Campaign - 3/26/2020 - Thank you to all the dental hygienists who participated in the congressional campaign urging Senators and Representatives to include dental hygienists in economic relief legislation. The legislation has passed the U.S. Senate with unanimous approval and is expected to be considered by the U.S. House of Representatives soon. 21,470 dental hygienists participated in the campaign and they sent 64,457 messages to their Senators and Representatives.
  • Campaign to urge Governors - 3/17/2020 to take action to postpone non-essential procedures and protect the health and safety of all of us


ADHA Advocacy

ADHA is in ongoing communication with the federal government to advocate strongly for the interests of dental hygienists nationwide.


ADHA COVID-19 Policy

3/16/2020

To mitigate the spread of COVID-19, the ADHA strongly recommends:

  • dental practices nationwide postpone non-emergency and elective procedures
  • dental practices remain available for patients with urgent needs

ADHA is deeply concerned for the health and well-being of the public, dental hygienists and the entire dental team.

As health care professionals, dental hygienists are committed to providing oral health care services in practice settings that utilize universal precautions and comply with federal guidelines.

ADHA is committed to providing the latest information to the profession in a useful and timely manner. ADHA is continually evaluating and will update its recommendation on an ongoing basis as new information becomes available.


COVID-19 Resources

Updated - 3/27/2020

CDC Resources

More Resources

If you have COVID-19 specific questions, please share them with us at RDHCovidInfo@adha.net.

Frequently Asked Questions

Updated - 4/1/2020

What Is ADHA Doing to Address Concerns of Dental Hygienists?

  • Q: What is ADHA doing to help relieve the economic burden for its members?

      A: The COVID-19 crisis has brought uncertainty and hardship to many dental hygienists. For ADHA members on our quarterly payment plan, your payment scheduled for April 1 has been postponed to May 27.

      While your membership has never been more important as we advocate at the highest levels for the health and safety of all dental hygienists, we want to offer some needed relief during this difficult time.

      This is an opportunity for us to come together, and come out stronger, as a united community. Thank you for supporting ADHA. If you have questions about your membership, please email member.services@adha.net.

  • Q: Why doesn’t ADHA mandate that dental offices close during this time?

      A: As a national association, ADHA does not have the authority to close a dental office or any place of business. Rest assured that we are raising your concerns with federal agencies as they consider the best course of action to maintain the health and safety of you and your patients, while addressing critical oral health needs.

      To mitigate the spread of COVID-19, ADHA strongly recommends:

      • dental practices nationwide postpone non-emergency and elective procedures
      • dental practices remain available for patients with urgent needs

      We are committed to providing the latest information to the profession in a useful and timely manner, and we will update recommendations on an ongoing basis as new information becomes available.

      Breaking news: From White House Coronavirus Task Force Briefing on March 17, 2020.
      “If I could just say one other thing to the hospitals and dentists out there . . . things that don’t need to be done over the next two weeks, don’t get it done. If you’re a person with an elective surgery, you don’t want to go into a hospital right now…so let’s all be responsible and cancel things that we can cancel to really free up hospital beds and space and then let’s do everything that we can to ensure that we don’t need the ventilators because we protected the people who would have needed to use them.”
      - Dr. Deborah Birx, White House coronavirus response coordinator

  • Q: What can I do to advocate for safety for my patients, my colleagues and myself during the COVID-19 pandemic?

      A: Employers are obligated to provide workers with appropriate personal protective equipment (PPE) to keep them safe while performing their jobs. Newly released guidance from the U.S. Department of Labor, Occupational Safety and Health Administration (OSHA) states, “Workers, including those who work within 6 feet of patients known to be, or suspected of being, infected with SARS-CoV-2 and those performing aerosol-generating procedures, need to use respirators.“

      Contact your state governor today. Implore the governor to protect the safety and well-being of your patients, your colleagues and you. While these are unprecedented times, the governor has the responsibility and authority to protect his or her citizenry.

      ADHA has developed an advocacy campaign urging governors to use their authority over state commerce to limit dental practices to providing emergency services only during the COVID-19 pandemic. Taking action is easy and takes less than two minutes!
      Start by clicking here to launch the advocacy tool.

  • Q: Should we be taking additional precautions? What proactive steps can we take to keep our workplace healthy and safe?

      A: The General Duty Clause of the Occupational Safety and Health Act (OSHA) requires employers to furnish “employment and a place of employment which are free from recognized hazards that are causing or likely to cause the death or serious harm to employees.”

      In addition, in certain health care professions and other workplaces where employees are subject to bloodborne pathogens, federal workplace safety law further requires the employer to make an immediate confidential medical evaluation and follow-up available for employees who have had an exposure incident.

      Employers should communicate with their employees to reiterate existing workplace rules, and outline any additional temporary rules, related to ensuring workplace health and safety. Employers should consider preparing a written communication to employees that outlines these policies and expectations to keep employees healthy and safe in connection with the COVID-19 outbreak.

      Information courtesy of ADHA Washington Counsel, McDermott Will & Emery LLP

Report a COVID-19 Related Violation

  • Q: How can dental hygienists report alleged violations or concerns and about dental practices not following mandates or recommendations set by governors, dental boards and public health officials?

      A: From the desk of Dr. Robert Zena
      President of the American Association of Dental Boards

      The American Association of Dental Boards encourages everyone to practice social distancing. As health care professionals, the dental community must not only follow all directives from the White House Task Force, CDC, USPHS, National Institute of Allergy and Epidemiology, etc. but also be exemplary. The edicts pertaining to emergent care must be adhered to in order to minimize the spread of the Covid-19 virus. Anyone who ignores these guidelines negates the sacrifices by other practices who are doing their part to "flatten the curve". Those who ignore these efforts not only unnecessarily endanger themselves and their staff, but more importantly endanger the entire community. As a Nation, we must all do our part.

      To protect our professionals on the front lines, the public, and promote social distancing, we encourage the use of Teledentistry as much as possible to minimize exposure. Additionally, in conjunction with digital means, employing Immediate Vicinity Access to Care (IVAC) will better minimize risks. For example, patients may be triaged in parking areas, curbside, sidewalks, etc. in order to decrease the number of patients that actually enter the practice facility. Some may only need prescriptions to delay treatment to a future date, emergency cases that need hands-on care could be filtered through the IVAC buffer. We at the AADB encourage any suggestions from the dental community that would help improve our struggle with the Covid-19 virus to share them with the AADB Central Office.

      In an effort to protect the public, we are offering a means to report alleged violations. Reporting may be made by clicking on the following button:

      Report a Violation

Donation and Volunteer Assistance Requests

Personal Protective Equipment (PPE)

  • Q: What about the use of homemade masks?

      A: The CDC does not considered homemade masks personal protective equipment (PPE). In order to protect staff and preserve personal protective equipment and patient care supplies, as well as expand available hospital capacity during the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) recommends that dental facilities postpone elective procedures, surgeries, and non-urgent dental visits, and prioritize urgent and emergency visits and procedures now and for the coming several weeks.

  • Q: I am concerned about mask shortages. What can we do?

      A: The increased worldwide demand for personal protective equipment (PPE) has resulted in apparent regional areas of shortage in the United States. The U.S. Food and Drug Administration (FDA) regulates and monitors the availability of medical devices, including masks, and continues to closely monitor the supply chain for the components needed to manufacture PPE.

      While FDA acknowledged that it has heard reports of increased market demand and supply challenges for certain PPE, the agency has said that it is not aware of specific widespread shortages of medical devices. CDC and other U.S. partners report having seen increased ordering of some medical products through distributors as some health care facilities in the U.S. prepare for anticipated needs in the event of a more severe outbreak. FDA also reported that the agency has taken proactive steps to establish and remain in contact with medical device manufacturers and others in the supply chain.

      FDA encourages manufacturers and health care facilities to report supply disruptions to the device shortages mailbox: deviceshortages@fda.hhs.gov. The agency reports that the mailbox is closely monitored and is an important surveillance resource to augment FDA efforts to detect and mitigate potential supply chain disruption.

  • Q: Should masks be only single use?

      A: CDC's guidance for single-use disposable facemasks has not changed. These masks are tested and regulated by FDA to be single use. CDC's position is that a new facemask should be used for each patient. CDC's specific guidance for facemasks includes these directives:

      • Wear a surgical mask and eye protection with solid side shields or a face shield to protect mucous membranes of the eyes, nose and mouth during procedures likely to generate splashing or spattering of blood or other body fluids;
      • Change masks between patients, or during patient treatment if the mask becomes wet.

  • Q: What’s the difference among ASTM Level 1, Level 2, Level 3 masks and respirators?

      A: ASTM International, formerly known as the American Society for Testing and Materials, has established performance levels for masks based on fluid resistance, bacterial filtration efficiency, particulate filtration efficiency, breathing resistance and flame spread.

      Level 1 masks have the least fluid resistance, bacterial filtration efficiency, particulate filtration efficiency and breathing resistance. These can be worn for procedures where low amounts of fluid, spray or aerosols are produced such as patient evaluations, orthodontic visits or operatory cleaning.

      Level 2 masks provide a moderate barrier for fluid resistance, bacterial and particulate filtration efficiencies and breathing resistance. These can be used for procedures producing moderate to light amounts of fluid, spray or aerosols. Some examples of procedures are sealant placement, simple restorative or composite procedures or endodontics.

      Level 3 masks provide the maximum level of fluid resistance and are designed for procedures with moderate or heavy amounts of blood, fluid spray or aerosol exposure such as crown or bridge preparations, complex oral surgery, implant placement or use of ultrasonic scalers.

      Newly released guidance from the U.S. Department of Labor, Occupational Safety and Health Administration (OSHA) states, “Workers, including those who work within 6 feet of patients known to be, or suspected of being, infected with SARS-CoV-2 and those performing aerosol-generating procedures, need to use respirators.“

      CDC has more information on the differences between N-95 respirators and surgical masks.

      If the decision is made to use respirators in your facility, OSHA does maintain requirements for medical evaluation and fit-testing in their toolkit for health care use of respirators.

Employment Issues

  • Q. If an employer directs salaried, exempt employees to take vacation (or leave bank deductions) or leave without pay during office closures due to influenza, pandemic or other public health emergency, does this impact the employee’s exempt status?

      A. Exempt, salaried employees generally must receive their full salary in any week in which they perform any work, subject to certain very limited exceptions. The FLSA does not require employer-provided vacation time.

      Where an employer offers a bona fide benefits plan or vacation time to its employees, there is no prohibition on an employer requiring that such accrued leave or vacation time be taken on a specific day(s). Further, this will not affect the employee’s salary basis of payment so long as the employee still receives in payment an amount equal to the employee’s guaranteed salary. However, an employee will not be considered paid “on a salary basis” if deductions from the predetermined compensation are made for absences occasioned by the office closure during a week in which the employee performs any work. Exempt salaried employees are not required to be paid their salary in weeks in which they perform no work.

      A private employer may direct exempt staff to take vacation or debit their leave bank account in the case of an office closure, whether for a full or partial day, provided the employees receive in payment an amount equal to their guaranteed salary. In the same scenario, an exempt employee who has no accrued benefits in the leave bank account, or has limited accrued leave and the reduction would result in a negative balance in the leave bank account, still must receive the employee’s guaranteed salary for any absence(s) occasioned by the office closure in order to remain exempt.

      For more information, see WHD Opinion Letter FLSA2005-41.

      Information provided from the U.S. Department of Labor, https://www.dol.gov/coronavirus

  • Q: How and when will I receive my rebate check?

      A. The federal government’s goal is to start issuing checks by April 6. The vast majority of people do not need to take action to receive a rebate check. The IRS will calculate and automatically send the economic impact payment to those eligible.

      For people who have already filed their 2019 tax returns, the IRS will use this information to calculate the payment amount. For those who have not yet filed their return for 2019, the IRS will use information from their 2018 tax filing to calculate the payment. The economic impact payment will be deposited directly into the same banking account reflected on the return filed.

      Source: https://www.irs.gov/newsroom/economic-impact-payments-what-you-need-to-know