17 August 2020

FAQs

Find below helpful answers to a compilation of frequently asked questions by our members.

Metropolitan Melbourne Stage 4 Government Restrictions (Urgent Care)

Can I do [this] treatment?

If you are in metropolitan Melbourne, the Government has mandated that you can only provide urgent dental care. The Level 3 restriction guidelines provides guidance for what treatment can be provided. It is up to you to exercise your clinical judgement to determine if the treatment is urgent, or whether it can be deferred for at least six weeks.

Are these restrictions for metropolitan Melbourne mandatory?

Yes. For the purposes of the Restricted Activity Directions (Restricted Area) (No 6), effective as at 5 August 2020 from 11:59pm, all public and private health services including dentists for urgent care are permitted workplaces. Therefore, all dental practices in metropolitan Melbourne are able to operate as a permitted workplace but must only provide urgent care. These directives are issued in accordance with emergency powers arising from declared state of emergency pursuant to the Public Health and Wellbeing Act 2008 (Vic).

What is urgent treatment?

Level 3 dental restrictions provide guidance on urgent dental care that can be provided. Find out more here: ada.org.au/Covid-19-Portal/Dental-Professionals.

Consider whether the treatment is necessary to prevent a significant change/deterioration in oral health that might require an escalation of care (e.g. preventing a poorer oral health outcome, a requirement for specialist intervention, or avoiding a hospital admission or emergency department presentation).

The ADA cannot provide specific advice about whether specific treatment is permitted because we have not seen the patient. You must critically assess whether the service is essential for the patient in the next six-week plus period. 

How can I assess the need for urgent treatment?

An examination may be necessary to assess the urgency of treatment. If the examination can be performed using telehealth it is recommended. If not, an examination is permitted within your facility in accordance with Level 3 guidance. Worker permits and a COVID Safe Plan must be in place.

Can I cement a crown that has already been prepared and currently has a temporary crown?

Yes, being mindful of minimising aerosols. This would fit into the category of 'preventing higher risk of negative outcomes for the patient'.

I practice in regional Victoria, so does this apply to me?

The restrictions on urgent treatment only apply to metropolitan Melbourne.

Dentists in regional Victoria (including the Shire of Mitchell) should operate at Level 2 dental restrictions.

If there are no active cases in your region and you believe it is safe to do so, you can operate at Level 1 dental restrictions.

If you are in an area of increased COVID activity (e.g. Colac) then you should apply your clinical judgement and undertake a risk assessment. The ADAVB would recommend that dentists in the Colac region practice at Level 3 dental restrictions.

Further information and cases in your area: adavb.org/resources/for-dental-professionals/covid-19/recent-updates.

What about orthodontic treatment?

The Australian Orthodontic Society has provided specific guidance on orthodontic treatment. It can be found on the ADA website.

Can I cement a crown that has already been prepped?

Yes, being mindful of minimising aerosols. This would fit into the category of 'preventing higher risk of negative outcomes for the patient'.

Can a DA/receptionist can be on-site to receive phone calls for urgent treatment?

Yes, all dental staff are permitted to attend the workplace under Stage 4 restrictions. They must have a permit from the workplace to attend the premises. Therefore, if staff can not access patient histories or communicate with patients remotely it may be necessary for a staff member to be onsite. Staff will be required to travel and attend the workplace when urgent care is being provided. 

Is there a personal protective equipment (PPE) shortage, and why is the cost of PPE so high?

The challenges around PPE in Australia are multifaceted, with increase in demand due to COVID-19 around the globe, trade barriers, manufacturing restrictions and international competition we are seeing both an increase in price and ongoing acquisition challenges for local suppliers.

The ADA is working with suppliers to maintain a list of in stock PPE at ada.org.au/Covid-19. Any members that are experiencing genuine PPE shortages (after exploring all opportunities through existing suppliers) can contact the ADA directly (contact@ada.org.au) to purchase a small amount of emergency (at cost) P2/N9 masks, to get you through to your next order.

The ADA continues to encourage suppliers to prioritise dental customers, charge reasonable costs and wherever possible maintain supplies at reasonable levels, however suppliers are incurring additional costs (particularly air freight) to source and distribute PPE and this is reflected in the increasing purchase price.

Please be patient with suppliers, we are all in this together and everyone is doing their very best to give you what you need when you need it.

Can I treat a patient who has recovered from COVID-19?

Yes. Sometimes patients will have written confirmation of clearance, but this might not always be the case, and they usually won’t have a negative test to ‘prove’ they no longer have COVID-19.

Patients will be released from isolation according to the following criteria:

  • Confirmed cases who were asymptomatic will be released 10 days after the first positive PCR swab was taken and no symptoms have developed in this period
  • Confirmed cases who had mild symptoms and were not hospitalised will be released if 10 days have passed since the onset of symptoms and they have remained symptomfree for the past 72 hours
  • Confirmed cases with more sever symptoms who have been hospitalised will be released if 10 days have passed since hospital discharge and they have remained symptomfree for the past 72 hours.

Patients should be able to provide evidence of the date of their positive test (usually an SMS). It is important as part of the screening to ask:

  • When did the patient test positive?
  • Did they have symptoms?
  • Where they hospitalised?

Use this information and the criteria above to determine whether the patient should be out of isolation and therefore safe to treat.

View our recent member webinar, COVID-19 Level 3: Your questions answered (member login required).