About ADHA

COVID-19 Resource Center 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.

Response to World Health Organization Recommendations

8/13/2020

In response to yesterday’s World Health Organization’s (WHO) recommendation to delay “routine non-essential oral health care” in certain situations due to COVID-19, we wish to highlight a couple of key points. The WHO indicates delay of non-essential procedures until there is “sufficient reduction in COVID-19 transmission rates…according to official recommendations at national, sub-national or local level.” This is consistent with current ADHA recommendations and aligned with CDC guidance, both which direct the dental healthcare personnel (DHCP) to stay informed and regularly consult with state or local health department for region-specific information and the monitoring of trends in local case counts to determine how and when to resume non-emergency dental care.

As outlined in the latest ADHA Interim Guidance on Returning to Work, ADHA continues to support the recommendations from the CDC that “balance the need to provide necessary services while minimizing risk to patients and DHCP. Consider if elective procedures, surgeries, and non-urgent outpatient visits should be postponed in certain circumstances.

 

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

8/4/2020

The Centers for Disease Control and Prevention (CDC) released updated Guidance for Dental Settings.

Key highlights from CDC

  • 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 from potential exposure to COVID-19.
  • 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.

View full guidance here.

  • 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]


ADHA COVID-19 Policy

5/27/2020

To mitigate the spread of COVID-19, ADHA continues to support the recommendations from the Centers for Disease Control and Prevention (CDC) that balance the need to provide necessary services while minimizing risk to patients and dental healthcare personnel.


ADHA Task Force on Return to Work

8/7/2020

ADHA’s Task Force on Return to Work has reviewed the CDC’s recently updated Guidance for Dental Settings and has made changes to ADHA’s Interim Guidance on Returning to Work. ADHA encourages all dental hygienists to review the revised report in its entirety. The report is the work product of the Task Force and includes guidance for dental hygienists returning to work on PPE, patient screening, office protocol and more.

View & Download Here

A dedicated email address has been set up so that members of the dental hygiene community can have COVID-19 related questions addressed at RDHCovidInfo@adha.net.


IFDH 2020 COVID-19 Survey Results

7/17/20

The International Federation of Dental Hygienists (IFDH) recently fielded a survey to better understand the impact of the COVID-19 pandemic on the dental hygiene profession and identify opportunities to support global dental hygienists, dental therapists and oral health therapists through these difficult times. The survey collected data from May 5 – May 31 and it was supported by Procter & Gamble (Crest/Oral-B). View the survey results here.


COVID-19 + the Dental Hygienist Webinars

ADHA’s COVID-19 webinars provide updates on issues dental hygienists are facing, resources to help, and answers to questions from the dental hygiene community.

April 14 Webinar: COVID-19 Updates, Resources and Questions Answered. View Here

April 16 Webinar: Unemployment Benefits. View Here

June 3 Webinar: Interim Guidance on Returning to Work. View Here


ADHA Advocacy + Action Center

Your participation and membership is making a difference.

4/21/2020
Governor campaign on returning to work. Many states are considering how to reopen the economy, including dental practices. All dental hygienists are asked to contact their governor and urge them to continue to follow the CDC’s recommendation of postponing elective procedures, surgeries, and non-urgent dental visits.

4/9/2020
Dental Hygiene Student Campaign - Over 12,000 students, educators, licensed dental hygienists and family members from around the country contacted their governors urging them to provide relief to students graduating from dental hygiene programs.

3/26/2020
Congressional Campaign - Thank you to all the dental hygienists who participated! The legislation passed, with support from 21,470 dental hygienists and their 64,457 messages to Senators and Representatives.

3/17/2020
Campaign to urge Governors - Nearly 9,000 dental hygienists across the country urged their governor to limit dental services to emergency care during the COVID-19 pandemic.


COVID-19 Resources: Essential Updates, Info and Support

Updated - 5/4/2020


If you have dental hygiene questions related to COVID-19, please share them with us at RDHCovidInfo@adha.net.


Your Questions Answered

Updated - 5/8/2020

What ADHA is 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 automatic payment scheduled for April 1 has been postponed until May 27. If you prefer to have your payment processed before May 27, simply email us at member.services@adha.net or give us a call at 312-440-8900 (press 1).

      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 launched an advocacy campaign urging governors to continue following the CDC’s recommendation of postponing elective procedures, surgeries, and non-urgent dental visits. Taking action is easy!
      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

Donation and Volunteer Assistance Requests

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

Personal Protective Equipment (PPE)

  • Q: Does my employer have to provide Personal Protective Equipment (PPE) and who pays for it?

      A: Many OSHA standards require employers to provide personal protective equipment, when it is necessary to protect employees from job-related injuries, illnesses, and fatalities. With few exceptions, OSHA requires employers to pay for personal protective equipment when it is used to comply with OSHA standards. These typically include: hard hats, gloves, goggles, safety glasses, welding helmets and goggles, face shields, chemical protective equipment and fall protection equipment. For additional information on PPE, refer to OSHA's Personal Protective Equipment Web page.

  • Q: What if my employer will not provide proper PPE?

      A: According to OSHA’s Guidance on Preparing Workplaces for COVID-19, “employers are obligated to provide their workers with PPE needed to keep them safe while performing their jobs. The types of PPE required during a COVID-19 outbreak will be based on the risk of being infected with SARS-CoV-2 while working and job tasks that may lead to exposure. 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.”

      You have a right to a safe workplace. You can file a confidential complaint with OSHA to request an inspection of your workplace if you believe there is a serious hazard or if you believe your employer is not following OSHA standards. Learn more about filing a complaint at OSHA’s website.

  • 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.

  • Q: How can I determine if my respirator is NIOSH approved or a counterfeit?

      A: Below is information directly from the National Personal Protective Technology Laboratory (NPPTL), part of the National Institute for Occupational Safety and Health (NIOSH):

      Counterfeit respirators are products that are falsely marketed and sold as being NIOSH-approved and may not be capable of providing appropriate respiratory protection to workers.

      When NIOSH becomes aware of counterfeit respirators or those misrepresenting NIOSH approval on the market, we will post them here to alert users, purchasers, and manufacturers.

      How to identify a NIOSH-approved respirator:

      NIOSH-approved respirators have an approval label on or within the packaging of the respirator (i.e. on the box itself and/or within the users’ instructions). Additionally, an abbreviated approval is on the FFR itself. You can verify the approval number on the NIOSH Certified Equipment List (CEL) or the NIOSH Trusted-Source page to determine if the respirator has been approved by NIOSH. NIOSH-approved FFRs will always have one the following designations: N95, N99, N100, R95, R99, R100, P95, P99, P100.

      Signs that a respirator may be counterfeit:

      • No markings at all on the filtering facepiece respirator
      • No approval (TC) number on filtering facepiece respirator or headband
      • No NIOSH markings
      • NIOSH spelled incorrectly
      • Presence of decorative fabric or other decorative add-ons (e.g., sequins)
      • Claims for the of approval for children (NIOSH does not approve any type of respiratory protection for children)
      • Filtering facepiece respirator has ear loops instead of headbands

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

School Based Sealant Programs