ADHA COVID-19 Resource Center | ADHA - American Dental Hygienists Association

Resources

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.

New 7/12/2021

The Latest Edition: July 12, 2021
We have updated the ADHA Interim Guidance on Returning to Work to reflect changes to the Centers for Disease Control and Prevention (CDC) Guidance for Dental Settings, Interim Infection Prevention and Control Guidance for Dental Sections During the Coronavirus Disease 2019 (COVID-19) Pandemic.

Previously, dental healthcare personnel (DHCP) were directed to avoid aerosol-generating procedures (AGPs) for ALL patients, regardless of known or suspected SARS-CoV-2 infection status. This has been amended. It's important to note that DHCP should continue to avoid AGPs for patients with suspected or confirmed SARS-CoV-2 infection, if possible.

Also note that that the use of an N95 or equivalent remains the recommendation for AGPs in facilities in communities with moderate to substantial COVID-19 community transmission.

New 6/17/2021

Based on the "emergency temporary standard (ETS)" issued by the Occupational Safety and Health Administration (OSHA) on June 6, ADHA's Interim Guidance on Returning to Work has been updated. Find the full report here.

New 6/10/2021

OSHA Releases COVID-19 Emergency Temporary Standard (ETS) for Healthcare Services Today, the Occupational Safety and Health Administration (OSHA) issued an "emergency temporary standard" or ETS. The ETS follows an executive order signed by President Joe Biden in January directing OSHA to consider a rule that would require employers to take steps to protect workers from contracting Covid-19 while on the job. An ETS takes effect upon publication in the Federal Register and is in effect until superseded by a permanent standard. This ETS focuses exclusively on the health-care industry, including dental hygiene and dentistry.

The ETS does NOT apply to "non-hospital ambulatory care settings where all non-employees are screened prior to entry and people with suspected or confirmed COVID-19 are not permitted to enter those settings." See the resource "Is your workplace covered by the COVID-19 Healthcare ETS?" for more information.

Essentially, if dental practices are screening patients prior to entry and do not let patients with suspected or confirmed COVID-19 infection enter the practice then they would be considered exempt from the ETS.

While the ETS may not apply to many settings where dental healthcare personnel work, it does include important information that can be implemented in any health care setting, including a dental setting:

  • Develop and implement effective COVID-19 plans. Controlling COVID-19 requires employers to use multiple overlapping controls in a layered approach to better protect workers.
  • Have a designated safety coordinator with authority to ensure compliance, a workplace-specific hazard assessment, involvement of non-managerial employees in hazard assessment and plan development/implementation, and policies and procedures to minimize the risk of transmission of COVID-19 to employees.
  • Limit and monitor points of entry to settings where direct patient care is provided; screen and triage patients, clients, and other visitors and non-employees; implement patient management strategies.
  • Develop and implement policies and procedures to adhere to Standard and Transmission-Based precautions based on CDC guidelines.
  • Provide and ensure each employee wears a facemask when indoors and when occupying a vehicle with other people for work purposes; provide and ensure employees use respirators and other PPE for exposure to people with suspected or confirmed COVID-19, and for aerosol-generating procedures on a person with suspected or confirmed COVID-19.
  • Employees should change facemasks at least once per day, whenever they are soiled or damaged, and more frequently as necessary (e.g., patient care reasons)

The ETS includes within its definition of healthcare services "services that are provided to individuals by professional healthcare practitioners (e.g., doctors, nurses, emergency medical personnel, oral health professionals)". Additionally, it defines aerosol generating procedures to include "dental procedures involving: ultrasonic scalers; high-speed dental handpieces; air/water syringes; air polishing; and air abrasion". '

What is an Emergency Temporary Standard?

Under certain limited conditions, OSHA is authorized to set emergency temporary standards that take effect immediately and are in effect until superseded by a permanent standard. OSHA must determine that workers are in grave danger due to exposure to toxic substances or agents determined to be toxic or physically harmful or to new hazards and that an emergency standard is needed to protect them. Then, OSHA publishes the emergency temporary standard in the Federal Register, where it also serves as a proposed permanent standard. It is then subject to the usual procedure for adopting a permanent standard except that a final ruling should be made within six months.

Resources:

New 5/27/21

Healthcare professionals, staff, patients, and visitors should continue to wear masks and practice social distancing as recommended in all healthcare facilities.

Recently, Centers for Disease Control & Prevention (CDC) updated the Interim Public Health Recommendations for Fully Vaccinated People to advise that fully vaccinated people no longer need to wear a mask or physically distance in any setting, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including hospitals, nursing homes, schools, and any regulatory requirements of local business and workplace guidance. The Interim Public Health Recommendations for Fully Vaccinated People do not apply to healthcare settings. This means that healthcare professionals, staff, patients, and visitors should continue to wear masks and practice physical distancing as recommended in all healthcare facilities.

New 5/10/21

Spotlight on Virginia Dental Hygienists contributions to COVID-19 Vaccine Efforts

In mid-February of 2021, Virginia Governor, Ralph Northam, approved legislation allowing licensed health care providers, including dental hygienists, to administer COVID-19 Vaccines. This initiative creates a broader scope of professional opportunities for Dental Hygienists and many other healthcare professionals, who are already trained in administering anesthetics. This legislation also allows more Virginia residents to get the vaccine safely and efficiently.

Many organizations including the Virginia Medical Reserve Corp (MRC), Virginia Volunteer Vaccinator Registry (VVVR), and Virginia Commonwealth University Vaccination Corp (VCU Vaccination Corp) are spearheading volunteer efforts for vaccinations. Volunteer tasks range from greeters, filling syringes from vaccine vials, or administering the vaccines. Past President and member of both the Virginia Dental Hygienists’ Association and the Virginia Board of Dentistry, Melanie Swain, was one of the fortunate dental hygienists who secured an opportunity as a volunteer. Swain said, “I would encourage our colleagues to be advocates for dental hygienists… I shared my experiences and how we administer local anesthesia in the mouth.”

The legislation also authorized students enrolled in health profession education programs who are properly trained in vaccine administration by their program to administer vaccines. The VCU Vaccination Corp first trained dental hygiene instructors Tammy Swecker and Michelle McGregor on how to vaccinate so that they could teach their students the correct way to administer the shots. Virginia’s Dental Hygienists remain active in COVID-19 vaccination assistance. Slots are limited and fill up quickly. If you are interested in participating, please visit: vdh.virginia.gov/mrc/, vdh.virginia.gov/covid-19-community-vaccinator/ or vaccinecorps.vcu.edu.

New 5/5/21

Authorize Dental Hygienists to Administer COVID-19 Vaccines

20 states have authorized dental hygienists to administer COVID-19 vaccines. Linked here is information for the respective states. Please review and check with the state licensing authority for additional information. This resource will be updated with new information as it becomes available.

New 3/16/21

Collaborative Statement from ADHA and ADAA

As we approach the one year mark of the COVID-19 pandemic, The American Dental Hygienists’ Association (ADHA) and the American Dental Assistants Association (ADAA) reiterate the need to remain vigilant in following the Centers for Disease Control and Prevention (CDC) guidance for the health and safety of all. To support this effort, the ADHA and ADAA offer the following collaborative statement.

The health and safety of the dental team, the patients we serve, our families and communities remain our top priority. The American Dental Hygienists’ Association and the American Dental Assistants Association support the Centers for Disease Control and Prevention (CDC) Interim Infection Prevention and Control Guidance for Dental Settings during the Coronavirus Disease 2019 (COVID‐19) Pandemic. Together we encourage all members of the dental team, including dental assistants and dental hygienists, to follow the CDC recommendations including proper use of personal protective equipment (PPE) and infection control protocols.

“We were pleased to collaborate with the ADAA on this statement that encourages all members of the dental team to follow CDC recommendations,” said ADHA President Lisa Moravec, RDH, MSDH. “The health and safety of all oral health professionals and the patients they serve is of the utmost importance to ADHA and the dental hygiene community.”

ADAA President Betty Fox, AS, CDA, RDA, FADAA was in agreement, and said, “The safety of the public and the dental team is the highest priority for ADAA and we look forward to working towards these goals in unison with the ADHA. “

You can see ADAA’s recommendations on how to manage the pandemic here.

New 3/12/21

Update on Dental Hygienists as COVID-19 Vaccine Administrators

The U.S. Department of Health and Human Services (HHS) is amending an emergency declaration under the Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against COVID-19 (PREP Act).  The PREP Act is expanding the list of healthcare providers that will be authorized to administer the COVID-19 vaccine nationwide. The expanded list of providers does not include dental hygienists.

ADHA has consistently and continually advocated that dental hygienists be utilized in the pandemic response, including allowing dental hygienists to administer the COVID-19 vaccine.

Here is an overview of ADHA’s advocacy efforts surrounding the inclusion of dental hygienists as COVID-19 vaccine administrators:

  • ADHA staff participated in a listening session with U.S. Department of Health and Human services regarding ways to further support states in expanding their vaccinator workforce.
  • CEO Ann Battrell is part of a national Pandemic Response Workgroup. They advocated that the dental team, including dental hygienists and dentists be authorized COVID-19 vaccine administrators.
  • President Lisa Moravec sent a letter to the White House COVID-19 Response Team and Centers for Disease Control & Prevention (CDC) to urge inclusion of the nation’s dental hygienists in vaccine administration efforts.
  • ADHA launched an advocacy campaign urging the nation’s governors to authorize dental hygienists to administer COVID-19 vaccines.
  • ADHA participated on a call with the CDC’s COVID-19 Response team with the Vaccine Task Force.
  • Today, fourteen states have authorized dental hygienists to administer the COVID-19 vaccine including California, Connecticut, Idaho, Kentucky, Maryland, Massachusetts, Nevada, New Jersey, New York, Ohio, Rhode Island, South Carolina, Utah and Washington.

ADHA is working with federal agencies on this matter. We will continue to provide information on any further developments here. Please direct any questions to ADHA’s Director of Advocacy & Education at annl@adha.net.

The PREP Act announcement will be published in the Federal Registry (legal notice to the public) on March 16, 2021. You can read the unpublished notice here.

New 3/10/21

Dental Hygienists Needed to Participate in Critical COVID-19 Research

Your input is essential for ensuring accuracy of the data. ADHA is partnering with the ADA to collect data to monitor current employment conditions. We will be compiling trend data to track the impact of the pandemic on oral health care providers over time. We need dental hygienists to join a monthly survey panel on COVID-19 in dental hygiene practice. The next deadline is March 25. ADHA will be publishing only aggregate data that is collected, and no individual data or information identifying you will be published or shared in any way. Click here to learn more.

ADHA & ADA Reveal New Findings about Impact of COVID-19 on Dental Hygienists

ADHA & ADA just released findings about the impact of COVID-19 on Dental Hygienists. Read the papers HERE.

Learn more about ADHA and ADA’s joint research study of U.S. dental hygienists’ infection rates and infection control practices related to COVID-19. Watch the research team and find out about the pandemic’s impact on the profession including employment patterns.

Watch Now!

Speakers include:

Ann Battrell, MSDH
CEO, American Dental Hygienists’ Association

Kathleen O’Loughlin, DMD, MPH
Executive Director, American Dental Association

Cameron Estrich, MPH, PhD
Health Research Analyst, Scientific Information ADA Science and Research Institute

JoAnn Gurenlian, RDH, MS, PhD, AFAAO
ADHA Return to Work Task Force Chair 

Marko Vujicic, PhD
Chief Economist & Vice President
ADA Health Policy Institute

New 2/15/2021

C.S. Mott Children’s Hospital released survey results finding one third of parents surveyed indicate COVID-19 has made it harder to get dental care for their child. During National Children’s Dental Health Month, there’s no better time to remind parents about the importance of regular check-ups and best practices for good dental hygiene for the entire family. Reference your ADHA Interim Guidance on Returning to Work and communicate with patients about the safety protocols you have in place.

New 2/5/21

ADHA has updated the patient screening questionnaire to inquire if the patient has received a COVID-19 vaccine. This information should be noted in the patient’s health record. To view the questionnaire, visit ADHA’s Interim Guidance on Returning to Work.

New 2/4/21

Some states have authorized dental hygienists to administer COVID-19 vaccines. Linked here is information for the respective states. Please review and check with the state licensing authority for additional information. This resource will be updated with new information.

New 1/25/21

Help Get Dental Hygienists Authorized to Administer COVID-19 Vaccines

The federal government is encouraging states to increase the capacity of their health care workforce to address the COVID-19 pandemic. As vaccines become available, it will be important to have more available health care providers to administer COVID-19 vaccinations.

Dental hygienists are educated and licensed health care providers who should be empowered to assist their communities in flattening the curve by administering COVID-19 vaccines during the pandemic. With their knowledge of anatomy, physiology, immunology, pharmacology infection control and medical emergencies, dental hygienists are well suited to answer this call and administer COVID-19 vaccines.

Take action now and encourage your governor to authorize dental hygienists to administer COVID-19 vaccines.
This Action Center initiative is made possible by members of the American Dental Hygienists’ Association (ADHA) representing the professional interests of the licensed dental hygiene community.

New 1/14/21

The dental industry believes it is turning a corner and now has ample supplies of some PPE (Personal Protective Equipment) including surgical masks, respirators, and disposable gowns. This is indeed good news for the dental team! PPE optimization is no longer necessary. The announcement was shared by the Organization for Safety, Asepsis, and Prevention’s (OSAP) and can be viewed here.

New 1/12/21

The CDC has released “COVID-19 One-Stop Shop Toolkits” to pull together relevant information for health care providers. Some of the featured resources include clinical resources for each approved COVID-19 vaccine and communication resources for clinics and clinicians. For more information visit here.

New 1/6/21

Q: Where can I find information on distribution of the COVID-19 vaccines?

A: Distribution of the vaccine is largely determined at the state level and most states follow CDC recommendations for guidance. Due to the limited doses of vaccine available at this point, many states are sub-prioritizing vaccines administration. Dental hygienists should check with their local health department regarding current eligibility for receiving the vaccine and how to proceed if eligible.

The National Association of County and City Health Officials has a tool where you can search by state or zip code, or click on the interactive map, to find contact information for local health departments available here: https://www.naccho.org/membership/lhd-directory

New 12/16/20

The Centers for Disease Control and Prevention (CDC) sets the U.S. adult and childhood immunization schedules based on recommendations from the Advisory Committee on Immunization Practices (ACIP). The CDC has recommended that healthcare workers and residents of long-term care facilities be priority for the vaccine.

The CDC “Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic” defines “Healthcare Personnel” as follows:

Healthcare Personnel (HCP): HCP refers to all paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including body substances (e.g., blood, tissue, and specific body fluids); contaminated medical supplies, devices, and equipment; contaminated environmental surfaces; or contaminated air. HCP include, but are not limited to, emergency medical service personnel, nurses, nursing assistants, home healthcare personnel, physicians, technicians, therapists, phlebotomists, pharmacists, students and trainees, contractual staff not employed by the healthcare facility, and persons not directly involved in patient care, but who could be exposed to infectious agents that can be transmitted in the healthcare setting (e.g., clerical, dietary, environmental services, laundry, security, engineering and facilities management, administrative, billing, and volunteer personnel). Source: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html#anchor_1604360694408

The CDC document, “The Importance of COVID-19 Vaccination for Healthcare Personnel” provides examples of HCP, including dental hygienists. Source: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/hcp.html

The nation’s Governors will determine vaccine distribution priority in their respective states. Even with prioritization there may be challenges with supply, distribution and administering of the vaccine.

New 12/15/20

Q: What resources are available to assist health care professionals discuss COVID-19 vaccines with their patients?

A: There are a number of resources that can assist healthcare professionals in talking with their patients, including a “Quick Answers for Healthcare Professionals for Common Questions People May Ask About COVID-19 Vaccines” and a toolkit.

Q: Where can I learn more about the planning and development of the COVID-19 vaccine and considerations for getting vaccinated?

A: The CDC has developed a frequently asked questions resource to address the many questions related to planning and development of the COVID-19 vaccine and questions about getting vaccinated. To learn more, visit: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html

New 12/10/20

Where can I volunteer to help during the COVID-19 outbreak?

Scientists and doctors working on this disease need your help to develop safe and effective vaccines and medicines for preventing and treating COVID-19 that will help us all. Clinical trials need people from all age groups, races, ethnicities, and backgrounds. Through https://combatcovid.hhs.gov/ you can find information about clinical trials you can participate in as well as ways to donate blood and plasma that will lead to prevention and treatment breakthroughs to benefit everyone.

New 12/07/20

ADHA Encourages Following CDC Guidelines

ADHA continues to advocate for the health and safety of dental hygienists, the full dental team and the patients they serve. While the American Dental Hygienists’ Association (ADHA) cannot comment on the specifics of the COVID-19 outbreak at the Glendale Home in Schenectady, NY, we strongly encourage oral health professionals to follow the Centers for Disease Control and Prevention (CDC) guidelines. For more information about COVID-19, please explore the ADHA COVID-19 Resource Center for Dental Hygienists.


ADHA has been and continues to be in ongoing communication with the CDC, U. S. Health and Human Services and other federal partners regarding COVID-19 related matters. Please check out the article on page 15 in the November/December 2020 issue of Access!

During times of crisis, your membership in ADHA is working harder than ever. You make it possible for us to advocate to protect the health and safety of dental hygienists and their patients. So thank you. We are here for you, and together, we will get through this.

 

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.


Video Update from the Task Force

11/30/20

Ten months into the COVID-19 pandemic it’s as important as ever to remain vigilant in following the latest recommendations from the CDC. Have a listen to some important tips and takeaways from the Task Force on Return to Work. ADHA is here to support you as you face these incredible challenges. Keep in touch with your questions, observations and concerns: 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 - 4/19/2021

What ADHA is Doing to Address Concerns of Dental Hygienists

  • Q: Has the CDC updated the recommendation on the length of quarantine for individuals exposed to COVID-19?

      A: CDC recommends the following alternative options to a 14-day quarantine:

      • Quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring.
        • With this strategy, residual post-quarantine transmission risk is estimated to be about 1% with an upper limit of about 10%.
      • When diagnostic testing resources are sufficient and available (see bullet 3, below), then quarantine can end after Day 7 if a diagnostic specimen tests negative and if no symptoms were reported during daily monitoring. The specimen may be collected and tested within 48 hours before the time of planned quarantine discontinuation (e.g., in anticipation of testing delays), but quarantine cannot be discontinued earlier than after Day 7.
        • With this strategy, the residual post-quarantine transmission risk is estimated to be about 5% with an upper limit of about 12%.

      CDC additionally recommends the following

      1. Persons can discontinue quarantine at these time points only if the following criteria are also met:
        • No clinical evidence of COVID-19 has been elicited by daily symptom monitoring† during the entirety of quarantine up to the time at which quarantine is discontinued; and,
        • Daily symptom monitoring continues through quarantine Day 14; and,
        • Persons are counseled regarding the need to adhere strictly through quarantine Day 14 to all recommended non-pharmaceutical interventions (NPIs±, a.k.a. mitigation strategies), especially. They should be advised that if any symptoms develop, they should immediately self-isolate and contact the local public health authority or their healthcare provider to report this change in clinical status.
      2. Testing for the purpose of earlier discontinuation of quarantine should be considered only if it will have no impact on community diagnostic testing. Testing of persons seeking evaluation for infection must be prioritized.
      3. Persons can continue to be quarantined for 14 days without testing per existing recommendations. This option maximally reduces risk of post-quarantine transmission risk and is the strategy with the greatest collective experience at present.

      These recommendations for quarantine options shorter than 14 days balance reduced burden against a small but non-zero risk of post-quarantine infection that is informed by new and emerging science.
      *Monitoring can be conducted using any method acceptable to local public health authorities and could include self-monitoring using an approved checklist of signs and symptoms, direct contact daily by public health authorities or their designates, or automated communications systems (e.g., on-line or texting self-checkers).
      **NPIs that can be practiced by individuals include the following: correct and consistent mask use, social distancing, hand and cough hygiene, environmental cleaning and disinfection, avoiding crowds, ensuring adequate indoor ventilation, and self-monitoring for symptoms of COVID-19 illness. These are also summarized here.

      Source: https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-options-to-reduce-quarantine.html

  • 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

COVID-19 Vaccines

  • Q: Will dental hygienists be given top priority when a COVID-19 vaccine becomes available?

      A: The Centers for Disease Control and Prevention (CDC) sets the U.S. adult and childhood immunization schedules based on recommendations from the Advisory Committee on Immunization Practices (ACIP). The CDC recommends health care personnel, including dental hygienists be among those offered the first doses of COVID-19 vaccines. More information here.

      ADHA has been advocating for dental hygienists throughout the pandemic. Dental hygienists are especially vulnerable to COVID-19 transmission given their close proximity to patients for extended periods of time and their use of instruments that are aerosol producing. ADHA President Lisa Moravec, RDH, MS, provided a letter of comment to the Committee on Equitable Allocation of Vaccine for the Novel Coronavirus, in response to the framework developed by The National Academies of Sciences, Engineering and Medicine. The National Academies are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine. The committee was formed in July in response to a request to the National Academy of Medicine from the National Institutes of Health and Centers for Disease Control and Prevention. ADHA advocated that dental hygienists should be among those healthcare occupations that receive the highest priority for any potential COVID-19 vaccine and should be included in the “Jumpstart” Phase 1a. You can read the full letter HERE.

      ADHA has been and continues to be in ongoing communication with the CDC, U. S. Health and Human Services and other federal partners regarding COVID-19 related matters. Please check out the article on page 15 in the November/December 2020 issue of Access!

  • Q: Where can I find information on distribution of the COVID-19 vaccines?

      A: Distribution of the vaccine is largely determined at the state level and most states follow CDC recommendations for guidance. Due to the limited doses of vaccine available at this point, many states are sub-prioritizing vaccines administration. Dental hygienists should check with their local health department regarding current eligibility for receiving the vaccine and how to proceed if eligible.

      The National Association of County and City Health Officials has a tool where you can search by state or zip code, or click on the interactive map, to find contact information for local health departments available here: https://www.naccho.org/membership/lhd-directory

Donation and Volunteer Assistance Requests

Employment Issues

  • Q: Should my employer provide compensation while I await COVID-19 test results?

      A. Employees experiencing COVID-19 related symptoms may be eligible for paid sick leave under the Families First Coronavirus Response Act (FFCRA) if the employee is unable to work because the employee is quarantined (pursuant to Federal, State, or local government order or advice of a health care provider), and/or experiencing COVID-19 symptoms and seeking a medical diagnosis.

      Please note the stipulation about advice of health care provider or seeking medical diagnosis. DOL guidance specifically says: “You may not take paid sick leave under the FFCRA if you unilaterally decide to self-quarantine for an illness without medical advice, even if you have COVID-19 symptoms.” Additionally, FFCRA is set to expire December 31, 2020. More information about eligibility is available here: https://www.dol.gov/agencies/whd/pandemic/ffcra-employee-paid-leave

  • 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