We will send a link in the coming weeks with instructions to access the meeting. If you have any questions or concerns prior to the meeting, please feel free to email me.
Looking forward to seeing as many of you as possible next month.
Refugio Gonzalez III, DDS President, Texas Academy of Pediatric Dentistry
Guidance for TAPD Members on Latest Practice Restrictions
Posted on March 23, 2020
Gov. Greg Abbott has issued an executive order requiring all medical providers—including dentists—to delay until midnight on April 21 “all surgeries and procedures that are not immediately medically necessary to preserve a patient’s life or avoid adverse medical consequences.” In accordance with this executive order and to alleviate the burden on hospital systems, the Texas State Board of Dental Examiners issued a directive saying “…It is imperative that dental clinicians care for emergency patients in a timely manner rather than referring them to emergency facilities.” Violating the governor’s order is punishable by a fine or jail time.
It is up to each dentist’s professional judgment to determine what constitutes a medically necessary situation (ie, dental emergency), and you are encouraged to consultThe American Dental Association (ADA) Emergency Procedures Guideas a reference. If you have any questions regarding this order, the standard of care or a specific case, please contact the Texas State Board of Dental Examiners at firstname.lastname@example.org.
Everyone in the medical/dental community is working hard—and working together—to respond to this unprecedented crisis. TAPD Secretary Ben Morgan is collecting information regarding donations of medical supplies and personal protection equipment (PPE) in conjunction with the Texas Hospital Association. If you have any medical supplies or personal protection equipment you would like to donate to hospital workers, please email email@example.com with your name, location and what supplies you have.
We know this is a difficult time for everyone and we hope this guidance helps answer the questions many of you have had. We are all in this together—please know that we are here to support you however we can. We will get through this together.
Dental Board Statement Regarding Gov. Abbott Executive Order
Posted on March 22, 2020
The following was issued by the Texas State Board of Dental Examiners:
In his press conference today, Governor Abbott issued an executive order restricting healthcare professionals and facilities. According to the Executive Order No. GA-09, “beginning now and continuing until 11:59 p.m. on April 21, 2020, all licensed health care professionals and all licensed health care facilities shall postpone all surgeries and procedures that are not immediately medically necessary to correct a serious medical condition of, or to preserve the life of, a patient who without immediate performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient’s physician;”
“PROVIDED, however, that this prohibition shall not apply to any procedure that, if performed in accordance with the commonly accepted standard of clinical practice, would not deplete the hospital capacity or the personal protective equipment needed to cope with the COVID- 19 disaster.”
Since the Governor is addressing a shortage of hospital capacity, it is imperative that dental clinicians care for emergency patients in a timely manner rather than referring them to emergency facilities. The governor also pointed out in his comments that violation of executive orders could lead to potential fines and even jail time for those who do not comply.
Posted on March 17, 2020
We are in unprecedented times and as much as we want concrete answers, COVID-19 is a fluid situation. TAPD continues to follow guidance from AAPD, ADA, TDA, the Texas State Board of Dental Examiners, the Governor’s Office and state and local public health authorities related to the latest information on COVID-19.
Below is the latest guidance from AAPD:
The ADA has recommended that dentists postpone elective procedures for the next three weeks. A number of states have strongly recommended that dentists postpone non-emergency care as well. These ADA and state recommendations are consistent with AAPD’s statement of March 16. Children in need of urgent/emergency care should be treated, while elective care can be postponed. Urgent/emergency care means treatment of pain, swelling, trauma, and infection. Hygiene and prophylaxis visits, cosmetic, and elective operative procedures should be considered non-urgent/non-emergency.
Governor Greg Abbott announced yesterday that he believes by the end of this week, everyone who needs a coronavirus test should be able to obtain one with a doctor’s order. TAPD encourages all of our members to visit the Texas Department of State Health Services and the Texas State Board of Dental Examiners websites to obtain the most up-to-date information for the state of Texas. They have a dedicated call center to answer COVID-19 related questions and concerns Monday-Friday 7:00am-6:00pm which can be reached at 1-877-570-9779.
We understand this is an anxious time for everyone. Your health and safety, and that of your patients, staff and families, is our highest priority. Our ongoing commitment to you is to ensure that you have the latest resources available to make an informed decision about your practices, and to continue to support you however we can. We are in this together.
I hope you, your families and staff are all well. The TAPD board understands and respects your concerns regarding Coronavirus (COVID-19) and want you to know we are speaking with and getting information from ADA, AAPD, TDA, CDC, the Governor’s Office and health authorities and will disseminate that information as quickly as possible to you. Know that we will not only support their recommendations, but we will assist them in any way possible.
Please be aware that the Texas Attorney General has issued a statement regarding price gouging of supplies. If any of you have any issues with increased prices of masks, hand sanitizer, gloves or other necessary items, please contact the Texas Attorney General’s toll-free complaint line at (800) 621-0508 or file a complaint online at www.texasattorneygeneral.gov/consumer-protection.
TAPD is committing to ensuring every Texas child has a change at optimal oral health. That is why we recently signed on to the following letter to the Center for Medicare and Medicaid Services (CMS) to highlight concerns for its recent guidance allowing states to apply for a waiver to set caps in their Medicaid programs.
Dear Administrator Verma:
As leading national, state, and local organizations, representing health care consumers and patients, providers, and other stakeholders, we are writing in strong opposition to recent guidance from CMS, Healthy Adult Opportunity, which allows states to fundamentally change the nature of their Medicaid programs. We urge the Administration to rescind this guidance, which could hurt millions of families that rely on Medicaid.
Medicaid is an essential source of coverage for over 70 million people. Medicaid’s current state-federal partnership helps states provide quality health insurance to their residents –it ensures that children are able to get a healthy start in life, provides long-term care to seniors and people with disabilities, and vital health care for many adults including pregnant women. The current state-federal funding structure provides states and taxpayers a level of financial security, ensuring that as Medicaid spending fluctuates from year to year, the state and its taxpayers are not made solely responsible for covering any increased costs. Efforts to restructure or cut Medicaid would shift health care costs to the states, hurt local economies, and threaten care and coverage for millions.
The Administration’s long-anticipated State Medicaid Director Letter, which was published on January 30, encourages states to adopt caps on their federal Medicaid funds voluntarily under a Medicaid section 1115 demonstration waiver. This arrangement involves major fiscal risk for states; the “flexibility” states will have is to cut services or take away coverage if and when they hit their new federal funding cap. Capping and restructuring Medicaid would create an awful choice for states in the event of increasing health care costs. Once that happens, the state will start rolling back coverage for kids, people with disabilities, and seniors and cost-effective optional benefits like dental care, without oversight.
Further, the Administration does not have jurisdiction to waive Medicaid’s financing structure through the 1115 waiver process. Such a fundamental change to Medicaid’s structure requires a change in statute and therefore an act of Congress. In 2017, when Congress considered federal funding caps, millions of people from around the country raised their voices in opposition, and lawmakers rejected the proposal on a bipartisan basis.
We urge the Administration to rescind this guidance that promises flexibility, but will surely lead to catastrophic implications for state budgets, and state Medicaid programs and the communities they serve. We implore you to reconsider this proposal, and protect the children, seniors, people with disabilities, women, parents, people of color, and working families that rely on Medicaid for health care.
Urge Congress to Support the Ensuring Lasting Smiles Act
Posted on February 26, 2020
The Texas Academy of Pediatric Dentistry, along with the American Academy of Pediatric Dentistry and a number of other organizations, supports the Ensuring Lasting Smiles Act (ELSA), which would ensure all group and individual health plans cover medically necessary services, including needed dental procedures such as orthodontic or prosthodontic support, as a result of a congenital anomaly. But we need your help to urge Congress to ensure it passes.
According to the Centers for Disease Control and Prevention, one in 33 newborns in the U.S. suffers from a congenital abnormality, and severe dental anomalies are a common symptom of many craniofacial conditions. Most private health plans cover surgical treatment for these conditions, and their coverage is a requirement in many states. However, claims for oral or dental-related procedures, including orthodontia and dental implants, are often deemed cosmetic and denied. Patients often face significant out of pocket expenses as a result.
ELSA would alleviate this financial burden, ensuring access to necessary diagnosis and treatment for those with congenital craniofacial abnormalities.
With more than 260 bipartian cosponsors, ELSA is a much-needed solution for American patients. Please urge your representatives in Congress and the U.S. Senate to support the bill and sign on as coauthors if they haven’t already.
AAPD will advocate for ELSA during its Congressional visits on March 3-4 as part of our Pediatric Oral Health Advocacy Conference. Help amplify their efforts to get ELSA passed by contacting Congress today.
The below information is guidance we received from the Texas State Board of Dental Examiners (TSBDE) regarding coronal polishing and pit and fissure sealant requirements. Please reach out to us at firstname.lastname@example.org with any questions.
The TSBDE no longer issues certificates for applying pit and fissure sealants and performing coronal polishing. 22 Tex. Admin. Code §114.3(d) and §114.5(b) do still require that a dental assistant have the required education/qualifications to perform either service.
Because TSBDE no longer requires dental assistants to submit their certification, it is up to the dental assistant and the supervising dentist to ensure that the dental assistant meets the requirements under the rule before dental procedures may be delegated. If not, the dentist and the dental assistant may be subject to disciplinary action.
Pit and Fissure Sealants Pursuant to 22 Tex. Admin. Code §114.3(d), a Texas-licensed dentist may delegate the application of pit and fissure sealants to a dental assistant if the dental assist has:
1) at least two years of experience as a dental assistant;
2) successfully completed a current course in basic life support; and
3) completed a minimum of 8 hours of education that includes clinical and didactic education in pit and fissure sealants taken through a CODA-accredited dental, dental hygiene, or dental assistant program approved by the Board whose course of instruction includes: a. infection control; b. cardiopulmonary resuscitation; c. treatment of medical emergencies; d. microbiology; e. chemistry; f. dental anatomy; g. ethics related to pit and fissure sealants; h. jurisprudence related to pit and fissure sealants; and i. the correct application of sealants, including the actual clinical application of sealants.
Pursuant to 22 Tex. Admin. Code §114.3(f)(f), the dental assistant must comply with the Dental Practice Act and Board Rules in the application of pit and fissure sealants. Pursuant to §258.003 of the Dental Practice Act, the delegating dentist is responsible for all dental acts delegated to a dental assistant, including application of pit and fissure sealant.
Coronal Polishing Pursuant 22 Tex. Admin. Code §114.5(b), a Texas-licensed dentist may delegate coronal polishing to a dental assistant if the dental assistant:
1) works under the direct supervision of the licensed dentist; and has
2) at least two years experience as a dental assistant; and either
a. completed a minimum of eight (8) hours of clinical and didactic education in coronal polishing taken through a dental school, dental hygiene school, or dental assisting program accredited by the Commission on Dental Accreditation of the American Dental Association and approved by the Board. The education must include courses on: i. oral anatomy and tooth morphology relating to retention of plaque and stain; ii. indications, contraindications, and complications of coronal polishing; iii. principles of coronal polishing, including armamentarium, operator and patient positioning, technique, and polishing agents; iv. infection control procedures; v. polishing coronal surfaces of teeth; and vi. jurisprudence relating to coronal polishing; or
b. has either: i. graduated from a dental assisting program accredited by the Commission on Dental Accreditation of the American Dental Association and approved by the board that includes specific didactic course work and clinical training in coronal polishing; or ii. received certification of completion of requirements specified by the Dental Assisting National Board and approved by the Board.
Pursuant to 22 Tex. Admin. Code §114.5(e)(e), the dental assistant must comply with the Dental Practice Act and Board Rules in the act of coronal polishing. Pursuant to §258.003 of the Dental Practice Act, the delegating dentist is responsible for all dental acts delegated to a dental assistant, including coronal polishing.
Dr. James at AAPD Media Training
Posted on April 4, 2019
Dr. Laji James (Houston) was selected to attend the American Academy of Pediatric Dentistry Media Training Course in Chicago, Illinois.