While bans on dental procedures have varied from state to state during the COVID-19 pandemic, we are now seeing some of these restrictions starting to lift. Originally intended to help dedicate resources to fighting the virus, we have seen changes to the rules for dentistry in the following states. Read on for details:
Please note: This information was last updated on 6/17/2020. We are currently not updating this page.
Alabama’s Stay-at-Home Executive Order, which banned elective dental, medical, and surgical procedures, expired on April 30th. Alabama’s new, “safer at home” order allows dental procedures to resume unless the State Health Officer or his designee determines that performing such procedures would unacceptably reduce access to PPE or other resources necessary to diagnose and treat COVID-19.
Effective April 20th, health care facilities were able to resume low-risk, routine-type services that require minimal PPE by complying with specific requirements outlined in the mandate. Some examples of the procedures contemplated include routine dental cleanings.
Arizona’s stay at home order has been extended to May 15th.
However, beginning on May 1st, hospitals, dental offices, and other healthcare facilities are permitted to resume elective surgeries and procedures if they can show they’ve implemented certain safety measures (see specific measures below).
- Demonstrating greater than a 14 day supply of PPE;
- Ensuring adequate staffing and beds;
- Testing patients prior to surgery and all at-risk health care workers;
- Ensuring appropriate discharge plans for patients being transferred to nursing care facilities, including diagnostic testing for COVID-19;
- Implementing a universal symptom screening process for staff, patients, and visitors;
- Establishing an enhanced cleaning process for waiting areas; and
- Prioritizing the restart of elective surgeries based on urgency.
Certain non-essential out-patient procedures were able to resume beginning on April 27th. In accordance with the Arkansas Department of Health’s directive, elective procedures (including dental) shall be limited as follows:
- Only outpatients with no plans for overnight stay.
- An American Society of Anesthesiologists rating of I or II. If II-rating, their disease process should be well controlled.
- No contact with known COVID-19 patients during the past 14 days.
- Patients must be asymptomatic for COVID-19 per ADH guidelines.
- Start with a small initial volume of cases and increase incrementally as PPE availability and number of statewide occurrences dictate.
- Each institution must have an ample supply of PPE for resuming elective procedures while maintaining a reserve should there be a resurgence of the virus.
- For an asymptomatic patient to be a candidate for a procedure, he/she must have at least one negative COVID-19 NAAT test within 48 hours prior to the beginning of the procedure.
On April 26th, the California Department of Public Health issued an announcement regarding certain considerations and guidelines for resuming elective procedures. Some of the considerations include prevalence of COVID-19, PPE supply, others specific to the setting (e.g., outpatient, dental, skilled nursing facility, etc).
As certain Connecticut businesses begin to reopen starting on May 20th, several dental practices have begun preparations for expanding their operations beyond emergency-only care to include elective procedures and routine hygiene and health exams. Although dental practices were never subject to an Executive Order to close, Governor Lamont strongly advised voluntary dental practices to suspend all elective procedures.
Under an executive order from Gov. Jared Polis effective April 27, voluntary or elective medical and dental surgeries and procedures may resume if facilities are following required safety protocols. Facilities performing these procedures must develop a plan to reduce or stop voluntary or elective surgeries and procedures “if there is a surge” of COVID-19 infections in the county or municipality in which they are located. The state’s health department will determine the conditions that constitute a surge.
District of Columbia
District of Columbia entered Phase 1 of Reopening on 5/31. The Mayor now allows for dental procedures to resume with rigorous safeguards to reduce risk for all.
As of May 4th, dental procedures may resume in the state of Florida.
On April 23, Gov. Kemp issued a new Executive Order that temporarily suspended the requirements of his April 20th Executive Order. The new Order goes into effect on May 1, 2020 at 12 a.m. until May 13, 2020 at 11:59 p.m.
As of May 1st, elective procedures, including dental procedures, can resume in Indiana.
On May 6th, Governor Reynolds issued a Proclamation of Disaster Emergency that allows dental offices to resume elective dental care statewide, at 5:00 a.m. on May 8, 2020. The proclamation states the following: A. A dentist and his or her dental staff may resume providing any dental services if the dentist complies with the following requirements:
(1) All dental services are provided in compliance with the Guidelines for the Safe Transition Back to Practice adopted by the Iowa Dental Board on May 5, 2020.
(2) The dentist has adequate inventories of personal protective equipment (PPE) and access to a reliable supply chain without relying on state or local PPE stockpiles to comply with the Guidance for Returning to Work During COVID-19.
(3) The dentist has a plan to conserve PPE consistent with guidance from the CDC and Iowa Department of Public Health.
B. The performance of any dental procedures except in compliance with paragraph A continue to be prohibited.
C. This order shall be enforced by Iowa Dental Board investigators or their designees who, pursuant to Iowa Code § 153.33(1)(b), shall have the powers and status of peace officers when enforcing this order. Guidelines for the Safe Transition Back to Practice, adopted by the Iowa Dental Board on May 5, 2020 can be found here.
Beginning on April 27th, health care practitioners can resume non-urgent/emergent health care services, diagnostic radiology and lab services in a list of settings, including dental offices with enhanced aerosol protections.
This is considered phase 1 of Kentucky’s health care services reopening. Elective surgeries and procedures will be addressed at a subsequent phase.
Beginning on April 27th, certain dental procedures were permitted to resume under specific conditions. This includes dental procedures for treatment of emergency medical conditions, to avoid further harms from an underlying condition or disease, or for treatment of time-sensitive medical conditions.
As of May 18, dentists in Maine can now reopen for non-emergency procedures as long as they’re following guidance from the ADA and MDA, are equipped with personal protective equipment, and are prioritizing care for patients with more time-sensitive conditions.
Gov. Hogan said elective medical procedures, including dentistry, that have been on hold for weeks will be allowed beginning Thursday (May 7).
On June 6, 2020, Governor Charlie Baker announced Phase 2 reopening details for the Commonwealth. Phase 2, which is referred to as the “Cautious Phase,” allows dental providers to cautiously and incrementally resume all elective, non-urgent procedures and services, including routine hygiene appointments. Phase 2 excludes elective cosmetic services. Phase 2 incremental dental care is proposed to start on Monday, June 8.
On May 21, Gov. Whitmer issued an Executive Order which states that Michigan dental and medical offices will be free to resume regular treatment services effective May 29.
The governor also issued a separate order, stating that all reopened outpatient health-care facilities, including dental offices, must adopt strict protocols to prevent infection.
On Tuesday May 5, Gov. Walz ordered that hospitals, surgery centers and clinics — including dental and veterinary clinics — could resume elective procedures next week if they put social distancing plans in place to protect workers and patients.
Phase 4 of MSBDE Return to Work Guidelines begins May 18, 2020 when dentists may perform Essential and Non-Essential Services for all Patient Categories as defined by the MSBDE COVID-19 Protocols.
Elective surgeries at dental offices following best practices will resume on May 4.
Dental Reopening Guidelines
1. As dental services resume, there will be enhanced patient screening, elevated PPE, higher levels of infection control and limitations on certain procedures.
2. The decision to reopen or remain closed is up to each dental practice.
3. The new guidelines produced by the NDA will assist providers in making this decision.
Nevada resumed non-emergency dental care as of 5/4. Elective procedures have been deferred for a subsequent phase.
Dentists may add elective/non-emergent and orthodontic procedures for patients when practices are able to fully comply with ADA interim guidance (titled “ADA Interim Guidance for Minimizing Risk of COVID-19 Transmission”) and align with OSHA guidance on PPE while there is ongoing community transmission of COVID-19. Treatment of high-risk patients is to be performed at the doctors’ discretion in alignment with ADA guidelines.
Beginning at 5:00 a.m. on Tuesday, May 26, 2020, the suspension on elective surgeries and invasive procedures
instituted in Executive Order No. 109 (2020) is rescinded. New Jersey health officials are expected to provide additional information, including which medical facilities are eligible, what procedures must be prioritized and additional protocols for reducing the spread of COVID-19.
Governor Lujan Grisham and Secretaries Kunkel and Scrase gave final approval to reopening guidelines developed by the Dental Advisory Team: CLICK HERE. These guidelines, along with other supporting documents, will provide the framework on which dentists may gradually resume providing more services. This will occur through an amendment to the “essential services” order and will be posted on the NM COVID website sometime soon. There are some important things you need to know:
- Until the amended order is officially posted by the DOH, the restrictions of the current order will remain in place and enforceable.
- Conditions in three northwest counties, McKinley, San Juan and Cibola do not currently meet the state’s requirements to lift restrictions. There are already gating criteria in place that will allow expansion to these areas when the current conditions improve. Restrictions in other areas could be reimposed if conditions worsen.
- There are a number of requirements that offices must meet in order to reopen more broadly. This includes having two weeks of PPE on hand and signing a document attesting to the office’s understanding of the guidelines and willingness to comply. These criteria are identical to those required for the other healthcare providers that started to resume activity last week.
- Discussions with the New Mexico Department of Homeland Security to receive needed PPE that we are currently unable to get from dental suppliers are occurring. It may be necessary to make requests through the NMDA and you will probably have to pick up the supplies from a site in your area. As with all entities seeking these supplies, requests will be limited to essential needs for a two-week period.
- There will be a great deal of scrutiny during the first couple weeks to make sure that there is no spread occurring and that dental offices are complying.
Governor Andrew M. Cuomo announced that New York dentists can reopen statewide on 6/1. Dentists’ offices will be subject to state guidance on best practices for safety and social distancing.
The NC State Board of Dental Examiners and the ADA have issued recommendations regarding patient care, but there are no mandates at this time. As health care professionals, it is up to dentists to use professional judgment and make well-informed decisions about your patients and practices.
At its 4/28/2020 meeting, the ND Board of Dental Examiners issued the following guidance for all ND dental practitioners:
The North Dakota Dental Board (“Board”) has received numerous requests for guidelines for the reopening of dental offices. At this time, the Board is unable to provide such guidelines. However, in order to limit the spread of COVID-19 the Board recommends practitioners review information provided by the Centers for Disease Control and Prevention and American Dental Association for the duration of the COVID-19 pandemic. Practitioners are responsible for the safety of their patients and staff and must operate in a manner consistent with protecting their safety. Practitioners with specific questions regarding liability should consult their legal counsel and insurance providers. The Board has the authority to discipline practitioners for willful or negligent disregard for safety
As per the Governor’s announcement on April 27, 2020, dental offices are permitted to open on May 1, 2020 to provide dental services. Dental healthcare providers are advised to exercise the utmost caution and strictly adhere to infection control protocols and guidelines from the CDC to maintain a safe environment and to minimize patient-to-patient contact.
Dentists will be able to open their offices and begin seeing patients starting on 5/1. This opening is in-line with Gov. Kevin Stitt’s phased reopening, and approved by the OK board of dentistry.
Elective procedures are allowed to resume beginning on May 1st as long as certain criteria are met.
Some of the criteria for dental offices include:
- Office has adequate PPE supplies on hand.
- Dental office is following strict infection control policies as recommended by the CDC.
As of May 8, Pennsylvania dentists are allowed to resume non-urgent dental procedures after Gov. Tom Wolf and Secretary of Health Dr. Rachel Levine revised their business closure orders. Dental providers must follow CDC and OSHA protocols for all procedures, and personal protective equipment must be available for all practitioners, including hygienists.
Following a decline in patients hospitalized with COVID-19 infections, on Monday May 11, the Lifespan hospital group announced plans to lift restrictions on scheduling elective surgical procedures that were halted because of the coronavirus outbreak in Rhode Island.
This follows a 4/27 announcement from Governor Gina Raimano, stating it was time for Rhode Island hospitals “to get back into the business” of performing some non-critical surgeries.
Beginning on May 1, the only COVID-specific limitations on practicing dentistry would be: (1) any COVID-related rules dictated by the applicable licensing agency and (2) reserving 15% capacity for COVID patients in certain hospitals.
Here are links to both Executive Orders for reference:
Gov. Gary Herbert announced that dental offices can immediately reopen and elective surgeries can resume throughout the state. The change in restrictions came as officials also previewed a new smartphone app, developed to help users know if they come in contact with anyone who has the coronavirus.
On May 22nd, the Governor authorized additional medical procedures and health services to resume, under the guidance of the Health Department. This includes inpatient surgeries and procedures; outpatient services, including clinic visits, diagnostic imaging and limited outpatient surgeries and procedures; and elective dental services. Each service area must follow stringent mitigation strategies and a phased implementation timeline, developed in consultation with industry associations and experts.
Virginia Governor Ralph Northam announced Wednesday that providers would start to be allowed to perform non-emergency medical and dental procedures on Friday.
The order that blocked non-emergency treatment is set to expire at midnight on Thursday, and Northam said after procuring and learning to clean PPE, the state was ready to move forward.
This means everything from knee replacements to some cancer treatments can start back up again.
A proclamation signed by Governor Inslee doesn’t allow elective surgeries. This order expires on May 18, meaning dental offices can open the next day. However, it’s up to each dentist to decide if they will. The opening of offices will only happen if the governor doesn’t sign another proclamation or extend the current one.
Gov. Jim Justice had included dental offices on his list of medical businesses and services deemed ready to resume operations on April 30, the first day of Week One of his phased reopening plan, but the West Virginia Board of Dentistry urged state dental practitioners to delay reopening until May 11.
On June 4th, Dental offices across the state started to reopen for non-emergency procedures amid the COVID-19
On June 4th, Dental offices across the state have started to reopen for non-emergency procedures amid the COVID-19 pandemic.