28 March 2020

COVID-19 update - Level 3 restrictions in place for dental practices

On 26 March 2020 the Australian Health Protection Principal Committee (AHPPC), comprising of all state and territory Chief Health Officers, provided the following advice to the National Cabinet for their endorsement:

"AHPPC recommends adopting the 'Managing COVID-19 Guidelines' published by the Australian Dental Association (ADA) and implementing a triage system for dental practice. AHPPC recommends that all dental practices implement Level 3 restrictions as outlined in ADA's guidance. That is, dentists should only perform dental treatments that do not generate aerosols, or where treatment generating aerosols is limited. All routine examinations and treatments should be deferred."

This recommendation is based on the continuing spread of COVID-19 including more cases of community transmission, and the risk associated with aerosols created during dental procedures.

What does this mean for dental pratices?

AHPPC noted that if access to urgent dental care was to cease entirely, this would place a burden on medical primary care and emergency services. Therefore it is important that patients still have access to dental care for urgent and emergency dental care. AHPPC also noted that these restrictions can be implemented gradually to defer dental treatments based on urgency and need, which would allow for additional infection prevention control measures to be implemented to mitigate the risk of infection to dentists (including reducing aerosol-generating procedures and the need for P2 masks). Dentists will have to use their clinical judgement in making decisions about what treatment and when to defer.

The ADAVB is recommending that dentists should now follow the advice of AHPCC and transition to Level 3 restrictions. This means that you should only provide dental treatment that does not generate aerosols, or where treatment generating aerosols is limited to urgent and emergency care such as acute dental pain or significant dental trauma. Routine dental treatment should be deferred. More detail is provided in the ADA Managing COVID-19 Guidelines.

In all cases, urgent dental treatment for people who have been identified as either at moderate to high risk of COVID-19 or confirmed as a COVID-19 case should be provided under transmission based precautions using appropriate PPE as per the ADA Managing COVID-19 Guidelines.

There is an expectation that dentists will be required to move to Level 4 restrictions in the near future if measures to reduce the spread of COVID-19 are not effective. We encourage you to review the framework and begin to make preparations for this eventuality.

Further information and helpful links

ADA Dental Service Restrictions in COVID-19 (recently updated)
adavb.org/covid19 - FAQs and resources
ada.org.au/covid19 - Access full suite of ADA resources
Victorian Government’s management of COVID-19
Australian Government economic response package
Australian Dental Association advice for practitioners and practice owners
ADA HR Advisory Service: 1300 232 462 and hrhotline@ada.org.au
LifeWorks member assistance program 24/7 phone counselling: 1300 361 008