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Interim Dental Infection Prevention and Control Guidance for the COVID‑19 Response – A New Paradigm

Course Number: 647

Patient Management Considerations

Implement a pre-appointment screening protocol and an upon arrival assessment protocol for all patients to reduce potential exposure to SARS‑CoV‑2.2

  • Contact all patients prior to dental treatment (e.g., telephone, text, videoconference, secure website).3

    • Screen all patients for symptoms consistent with COVID‑19 (Table 2.)

      11A useful list of screening questions is available from the ADA.3

    • Avoid non-emergent dental care if the patient reports symptoms of COVID‑19. When possible, delay dental care until the patient has recovered.

    • Assess and triage the patient’s dental condition and determine whether the patient needs to be seen in office. If feasible, consider the use of teledentistry options as alternatives to in-office care.

    • Advise patient or guardian of the need to limit the number of accompanying visitors to only those necessary (e.g., guardian, driver).

    • Advise patient or guardian that all who come to the office will undergo screening for fever and COVID‑19 symptoms and be requested to wear a face covering when entering the office.

  • Systematically assess all patients and visitors upon arrival.

    • Ensure that the patient and those accompanying them have donned their own face covering, or provide a surgical mask if supplies are adequate.

    • Ask about the presence of fever or other symptoms consistent with COVID‑19.

    • Actively take the patient’s temperature.

    • If the patient is afebrile (temperature < 100.0˚F) and otherwise without symptoms consistent with COVID‑19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations described in this document.

      • Fever may be subjective or confirmed. If the patient has a fever strongly associated with a dental diagnosis (e.g., pulpal and periapical dental pain and intraoral swelling is present), but no other symptoms consistent with COVID‑19 are present, care can be provided with appropriate protocols.

  • Ask patient to re-don their face covering at the completion of their clinical dental care when they leave the treatment area.

  • Even with appropriate screening, inadvertent treatment of a dental patient who is later confirmed to have COVID‑19 may occur. Therefore, OHCPs should request that the patient inform the dental office if they develop symptoms or are diagnosed with COVID-19 within 2 days following the dental appointment.

Table 2. Symptoms* Suggestive of COVID-19.11

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

* Symptoms may appear 2-14 days after exposure to the virus.