Update on Legislative Issues from ADA
Tuesday, March 24, 2020 

Hello, Fellow Dentists:

As the global situation on COVID-19 continues to evolve, the American Dental Association is committed to guiding the dental community through these challenging times. We are looking out for you, particularly as federal lawmakers work on legislation that could make a big difference for our profession. 

The Senate continues to work on the 3rd coronavirus legislative package, the Coronavirus Aid, Relief and Economic Security Act, also known as the CARES Act. The bill contains a number of provisions of importance to dentists and their dental practices. Despite much back and forth, the ADA is confident that Congress will complete the package shortly. We will send out details on the final provisions once they are available.

You should know that our grassroots efforts over the last 48 hours regarding the CARES Act have been outstanding -  117,462 dentists have sent 358,535 emails to Capitol Hill. There is no doubt that dentistry's message has been received!

By way of update, as you know the 2nd coronavirus legislative package, H.R. 6201, the Families First Coronavirus Response Act, was signed into law on March 18. It included some provisions that could affect your dental practice - primarily those concerning emergency paid sick leave and family medical leave.

The Department of Labor (DOL) has released summary overviews of what the law will require of employers (and employees) for emergency paid sick leave and the Family Medical Leave Act (FMLA). Please keep in mind that we anticipate further guidance from the Department of Labor to clarify these provisions. Once we receive the additional guidance, we will send an update that may assist you with your business decisions. The summary outlines can be found here: 
As you read the DOL guidance (above), please keep in mind that the ADA is still awaiting a response from the Department of Labor on our request that dental offices as small businesses (50 or fewer employees) be exempt from the emergency sick leave and FMLA, which would alter the requirements and impact of these provisions.

We will update you immediately once we receive a response from the Department of Labor to our request.

We know that these are uncertain times, and the ADA will continue to be a resource now and in the weeks and months to come. Count on us - we are working hard for you.

Stay well,

Chad P. Gehani, DDS

ADA develops guidance on dental emergency, 
non-emergency care 
Issued March 18, 2020

The ADA provided its members and their patients detailed guidance on March 18 on what to consider dental emergencies and non-emergency dental care as part of an effort to curb the spread of the coronavirus disease, COVID-19, and alleviate the burden on hospital and emergency departments.

The guide is meant to provide additional guidance following an Association recommendation that dentists nationwide postpone elective procedures to do their part to "mitigate the spread of COVID-19." It was included as part of an ADA issues alert that went to all dentists in the ADA's database.

Dental emergencies, according to the ADA, "are potentially life threatening and require immediate treatment to stop ongoing tissue bleeding [or to] alleviate severe pain or infection." Conditions include uncontrolled bleeding; cellulitis or a diffuse soft tissue bacterial infection with intraoral or extraoral swelling that potentially compromises the patient's airway; or trauma involving facial bones that potentially compromises the patient's airway.

"The guidance may change as the COVID-19 pandemic progresses," according to the Association. "Dentists should use their professional judgment in determining a patient's need for urgent or emergency care."

As part of the emergency guidance, the Association added urgent dental care which "focuses on the management of conditions that require immediate attention to relieve severe pain and/or risk of infection and to alleviate the burden on hospital emergency departments."

Examples of urgent dental care treatments, which should be treated as minimally invasively as possible, include:
*    Severe dental pain from pulpal inflammation.
*    Pericoronitis or third-molar pain.
*    Surgical postoperative osteitis or dry socket dressing changes.
*    Abscess or localized bacterial infection resulting in localized pain and swelling.
*    Tooth fracture resulting in pain or causing soft tissue trauma.
*    Dental trauma with avulsion/luxation.
*    Dental treatment cementation if the temporary restoration is lost, broken or causing gingival irritation.

Other emergency dental care includes extensive caries or defective restorations causing pain; suture removal; denture adjustments on radiation/oncology patients; denture adjustments or repairs when function is impeded; replacing temporary fillings on endo access openings in patients experiencing pain; and snipping or adjustments of an orthodontic wire or appliances piercing or ulcerating the oral mucosa.

"The American Dental Association recognizes the unprecedented and extraordinary circumstances dentists and all health care professionals face related to growing concern about COVID-19," according to the March 16 statement from ADA President Chad P. Gehani. "Concentrating on emergency dental care will allow us to care for our emergency patients and alleviate the burden that dental emergencies would place on hospital emergency departments."

Non-emergency dental procedures, according to the Association, include but are not limited to:
*    Initial or periodic oral examinations and recall visits, including routine radiographs.
*    Routine dental cleaning and other preventive therapies.
*    Orthodontic procedures other than those to address acute issues (e.g., pain, infection, trauma).
*    Extraction of asymptomatic teeth.
*    Restorative dentistry including treatment of asymptomatic carious lesions.
*    Aesthetic dental procedures.

As of March 18, there have been 7,038 cases, including 97 deaths, in the U.S., according to the Centers for Disease Control and Prevention. Globally, as of March 17, there have been 179,111 cases, according to the World Health Organization.

The American Dental Association has created an informational resource center for dentists on COVID-19 at .