The COVID-19 pandemic impacts are far-reaching, and are being felt in dental practices. The following information and resources are designed to assist your practice in managing COVID-19.
Level 3 restrictions
On 26 March 2020 the Australian Health Protection Principal Committee (AHPPC), comprising all of the state and territory Chief Health Officers, provided the following advice to the National Cabinet: 'AHPPC recommends adopting the Managing COVID-19 Guidelines published by the 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.'
AHPPC noted that:
- Should access to urgent dental care cease entirely, this would place a burden on medical primary care and emergency services.
- 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).
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.
The ADA recently updated the Dental Service Restrictions in COVID-19 framework, and it is essential that dentists familiarise themselves with these new guidelines. Review the ADA webinar that explains the new restrictions and HR implications here.
Frequently asked questions – Level 3 restrictions
What does it mean for me?
National Cabinet endorsed the AHPPC recommendation, and the Dental Board of Australia also advised that this recommendation now applies to all practitioners. Therefore, all dental practitioners should now commence operating under Level 3 restrictions. This includes deferring all routine dental treatment for patients who do not meet the risk categories identified under the new framework.
Do we have to stop all procedures that produce aerosols?
Aerosol-generating procedures increase the risk of transmission for COVID-19, so the advice to dentists under Level 3 is to only perform dental treatment that does not generate aerosols. The only exceptions are for urgent dental treatment as outlined in the Dental Service Restrictions in COVID-19 framework. Clinicians should ensure they take all reasonable steps to reduce aerosols, including the use of rubber dam and high-speed evacuation, and also consider what alternative treatment modalities might be used to reduce aerosols in these cases.
What if I have patients already booked in for treatment?
You need to consider whether the treatment required meets the criteria for Level 3 restrictions, otherwise you should defer treatment to a later date.
What about [particular] treatment?
ADAVB staff cannot advise you on specific dental conditions or treatment procedures. Dentists MUST exercise their clinical judgement using the framework and guidelines, taking into account the particular circumstances of the patient and the risk involved.
What about a patient with confirmed COVID-19?
Confirmed COVID-19 cases with a dental emergency should be triaged by phone. If they cannot be managed pharmacologically, they should be referred to an acute hospital setting for treatment where there are appropriate treatment facilities including a negative pressure room. Victorian acute hospitals with the facilities and registrars are:
- Royal Melbourne Hospital
- Austin Hospital
- Dandenong Hospital
- Monash Hospital
- St Vincent’s Hospital
- Geelong Hospital - Barwon
- Western Hospital – Footscray
- Royal Children’s Hospital
It is expected that only a very small number of people would require referral to an acute hospital for treatment.
What happens next?
Given the continued rapid transmission of COVID-19, it is possible that we might see an escalation to Level 4 restrictions. Dentists must be prepared for that eventuality.
Given the further spread of the disease and the likelihood of community transmission, it is increasingly likely that dentists and their staff will come in contact with coronavirus cases. The safety of our members, your staff and patients is of utmost concern. These resources are based on the current advice available, and will be reviewed and updated as required on a regular basis. Make sure you continue to visit this site to ensure that you have the most up-to-date information and resources.
- Managing COVID-19 Guidelines: A guide to managing COVID-19 in your practice.
- Dental Service Restrictions in COVID-19: A framework outlining the ADA's recommendations in relation to the continuation of dental services.
- Dental practice treatment guidelines: Advice for managing patient appointments, dental practice environment and treatment guidelines
- Exposure response plan: Provides guidance for dental practices in dealing with a possible exposire to COVID-19.
- Practice policy COVID-19: Provides guidance on COVID-19 risk management in the practice.
- Dental practice COVID-19 information for patients template: Can be used at the reception desk and also when confirming patient appointments to reduce the risk of contact with suspected cases of COVID-19.
Further guidance on environmental cleaning post-exposure is currently being developed.
Advice and support
Victorian Department of Health and Human Services
- List of COVID-19 testing clinics/assessment centres
- COVID-19 public enquiry hotlines:
- National: 1800 020 080
- Victorian: 1800 675 398
- COVID-19 clinical advice hotline (Victorian Department of Health and Human Services):
- Ph: 1300 651 160, 24 hours a day. Choose the ‘Specialist Medical Advice’ option. Pending demand, you may be asked to leave a message for return phone call.
LifeWorks ADAVB member assistance program
Members can access free counselling on personal or work issues with our member assistance program provided by LifeWorks. To make an appointment, or for phone counselling 24/7, call 1300 361 008.
- Financial support measures for businesses
- Financial support measures for individuals and households
- Australian Government fact sheets on the economic response package. Note: Dental practices are no longer eligible for the Victorian Business Support Fund Grant. Eligibility criteria were updated to narrow the categories of businesses that could apply for this funding. The ADAVB will continue to monitor the environment for more financial support opportunities for members.
- Australian Dental Assocation: www.ada.org.au/Campaign/COVID-19/Financial-Support-(1)
Please check your email inbox for both ADAVB and ADA updates, and refer to the ADA COVID-19 page at adavb.org.au/covid19 regularly for more updates and new resources.