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TSBDE Emergency Meeting
Today, the Texas State Board of Dental Examiners met to review 22 Tex. Admin. Code§ 108.7 – Minimum Standard of Care, General, the emergency rule adopted which allows dental health care professionals to practice under COVID-19 safety protocols. With the approval of the Governor, the rule will be extended for 120 days with the removed language notated in red and the modified language notated in yellow. Please note that a dentist can set safety protocols for his/her office, so if a dentist would like to continue limiting the number of companions allowed in an office, he/she is allowed to do so.
The Texas State Board of Dental Examiners will notify you by email when this rule change will go into effect.
(16)conduct his/her practice according to the minimum standards for safe practice during the COVID-19 disaster pursuant to the Centers for Disease Control Guidelines and the following guidelines:
(A)Before dental treatment begins:
(i)each dental office shall create COVID-19 procedures and provide dental health care personnel (DHCP) training regarding the COVID-19 office procedures. These procedures must include the pre-schedule screening protocol, in office screening protocol for patients and DHCP, office’s transmission-based infection control precautions, as well as protocol to be implemented if DHCP suspects an exposure to COVID-19;
(ii)DHCP experiencing influenza-like-illness (ILI) (fever with either cough or sore throat, muscle aches) should not report to work;
(iii)DHCP who are of older age, have a pre-existing, medically compromised condition, pregnant, etc., are perceived to be at a higher risk of contracting COVID-19 from contact with known or suspected COVID-19 patients. Providers who do not fall into these categories (older age; presence of chronic medical conditions, including immunocompromising conditions; pregnancy) may be prioritized to provide care;
(iv)all DHCP should self-monitor by remaining alert to any respiratory symptoms (e.g., cough, shortness of breath, sore throat) and check their temperature twice a day, regardless of the presence of other symptoms consistent with a COVID-19 infection;
(v)contact your local health department immediately if you suspect a patient has COVID-19, to prevent transmission to DHCP or other patients;
(vi)remove magazines, reading materials, toys and other objects that may be touched by others and which are not easily disinfected;
(vii)place signage in the dental office for instructing staff and patients on standard recommendations for respiratory hygiene/cough etiquette and social distancing;
(viii)develop and utilize an office protocol to screen all patients by phone before scheduling and during patient confirmation prior to appointment;
(ix)schedule appointments apart enough to minimize possible contact with other patients in the waiting room;
(x)notify patients that they may not bring a companion to their appointment, unless the patient requires assistance (e.g., pediatric patients, special needs patients, elderly patients, etc.). Patient companions should also be screened for signs and symptoms of COVID- 19 during patient check-in.
(B)During dental care:
(i)perform in office screening protocol which must include a temperature check, upon patient arrival;
(ii)DHCP shall adhere to standard precautions, which include but are not limited to: hand hygiene, use of personal protective equipment (PPE), respiratory hygiene/etiquette, sharps safety, safe injection practices, sterile instruments and devices, clean and disinfected environmental surfaces;
(iii)DHCP shall implement Transmission-Based Precautions, including N-95 respirator masks, KN-95 masks, or their substantial equivalent for all DHCP who will be within six (6) feet of any and all procedures likely to involve aerosols;
(iv)DHCP shall adhere to the standard sequence of donning and doffing of PPE;
(C)Clinical technique:
(i)Patients should perform a pre-procedure rinse, if medically safe;
(ii)Reduce aerosol production as much as possible, as the transmission of COVID-19 seems to occur via droplets or aerosols, DHCP may prioritize the use of hand instrumentation;
(iii)DHCP should use dental isolation if an aerosol-producing procedure is being performed to help minimize aerosol or spatter.
(D)After dental care is provided:
(i)instruct patients to contact the office if they experience COVID-19 symptoms within 14 7 days after the dental appointment;
(ii)DHCPs should remove PPE before returning home.